MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-MID COUNTY BRANCH-MARK TWAIN ELEMENTARY

Facility DVN
001606828

Phone
(314) 962-0613

Physical Address
8636 LITZSINGER RD
ST LOUIS
MO 63144-2423

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
1900 URBAN DR
BRENTWOOD
MO 63144-1824

Provider/Director
KOZAK, JONATHAN JOSEPH

E-mail Address
Jacob.Nelson@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
ALYSSA MARIE RILEY

Age Range
5 YEARS - 12 YEARS

Capacity
48

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
09/23/2019

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2364747585

Document	Document-Date
SAMPLE WEEKLY MENU	08/28/2011
SAMPLE FORMS	08/28/2011
REGISTERING FICTITIOUS NAMES	06/02/2010
POLICIES	08/28/2011
LINES OF ADMINISTRATIVE AUTHORITY	08/28/2011
DISCIPLINE POLICIES	08/28/2011
DIRECTOR'S QUALIFICATIONS	02/25/2013
DIRECTOR'S JOB RESPONSIBILITIES	08/28/2011
DAILY SCHEDULE	08/28/2011
CHILD CARE PRACTICES	08/28/2011
CERTIFICATE OF INCORPORATION	08/28/2011
CERTIFICATE OF GOOD STANDING	03/09/2011
ARTICLES OF INCORPORATION	08/28/2011
JOB RESPONSIBILITIES	07/02/2001
DISASTER AND EMERGENCY PREPAREDNESS PLAN	09/26/2018
APPLICATION	04/03/2019
EQUIPMENT LIST	04/19/2019
STAFF SHEET	04/19/2019

Inspection determined facility to be in compliance with licensing rules.

Open Violations: NA

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.


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 Violation
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 Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials Compliance
19 CSR 30-62.102 Personnel Compliance
19 CSR 30-62.112 Staff/Child Ratios Compliance
19 CSR 30-62.122 Medical Examination Reports Compliance
19 CSR 30-62.132 Admission Policies and Procedures Compliance
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 Violation
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
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Compliance