DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-FOUR RIVERS BRANCH-CENTRAL ELEMENTARY

000237836

(314) 598-1938

207 JEFFERSON AVE
UNION
MO  63084

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

400 GRAND AVE
WASHINGTON
MO  63090

MUELLER, MELISSA

melissa.mueller@gwrymca.org

Incorporated

LEATRICE L DIXON

5 YEARS - 12 YEARS

49

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

09/05/2019

3:15 PM

4:21 PM

UNANNOUNCED

COMPLIANCE MONITORING

2363781108


DocumentDocument-Date
CERTIFICATE OF GOOD STANDING 02/14/2019
STAFF SHEET 02/14/2019
LINES OF ADMINISTRATIVE AUTHORITY 08/27/2001
JOB RESPONSIBILITIES 08/27/2001
CERTIFICATE OF INCORPORATION 02/06/2003
ARTICLES OF INCORPORATION 02/06/2003
CHILD CARE PRACTICES 08/27/2001
SAMPLE WEEKLY MENU 02/06/2007
DAILY SCHEDULE 02/06/2007
POLICIES 08/27/2001
DIRECTOR'S QUALIFICATIONS 10/25/2016
APPLICATION 01/29/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 02/26/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 6
NOTE
The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.
Attendance at Time of Inspection
Total Staff 5
Total Children 35
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Melissa Mueller, director
4 35 SCHOOL AGE Samantha Gardner, Adrianna Collins, Patricia Pursley and Nakya Criebaum with children ages 5 to 12 years

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Compliance
19 CSR 30-62.052 License Renewal
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The provider did not meet requirements for a crinimial background check. The provider did not request the results of a criminal background check for Adrianna Gardner, Patricia Pursley and Nakya Criebaum prior to their employment or presence in a group child care home/child care center.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) states: The provider shall request the results of a criminal background check for child care staff members as required by 19 CSR 30-63.020 General Requirements.
Correction Required
Required requests of crinimal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for first aid and CPR training were not met as evidenced by at least one caregiver for every 20 children in capacity was not certified in first aid/CPR in that the facility needs 3 staff with CPR and First Aid. There are only 2 staff with documented CPR/First Aid training.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (R) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age-appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification and approved by the department. First aid/CPR training may count toward the annual clock hour training requirement.
Correction Required
Required certification in first aid/CPR shall be on file. At least one caregiver with the certification shall be on site as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Adrianna Collins as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Adrianna Collins.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Compliance
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance