DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-MID COUNTY BRANCH-MARK TWAIN ELEMENTARY

001606828

(314) 962-0613

8636 LITZSINGER RD
ST LOUIS
MO  63144-2423

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

1900 URBAN DR
BRENTWOOD
MO  63144-1824

KOZAK, JONATHAN JOSEPH

Jacob.Nelson@gwrymca.org

Incorporated

JANET M WALKER

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

10/07/2019

3:30 PM

6:28 PM

UNANNOUNCED

COMPLIANCE MONITORING

2366420216


DocumentDocument-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: 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 3
Total Children 26
StaffChildClass AgeNote
3 26 SCHOOL AGE Ashley Byrd - Person in Charge Connie James - Staff Vincent Russo - Staff 5 year - 12 year old

 
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 criminal background check. The provider did not request the results of a criminal background check prior to employment or presence in the facility for the following staff: Ashley Byrd and Connie James.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (L) 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 criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The center director was not responsible for the daily planning, monitoring and managing of the facilities program as evidence by there is no approve director.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 1. states: The group day care home provider or the individual designated as the center director shall be responsible for planning, monitoring, and managing the facility's daily program.
Correction Required
Group Day Care Home provider or center director shall be responsible for the daily planning, monitoring and managing of the facilities daily operations.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. The staff listed need the following information: Lydia Ostrom, John Hoffman, Evan Dierker, and Jennifer Bergman - all caregivers listed need 12 clock hours for 2018.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group day care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each employee.

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 Ashley Byrd, Connie James, Lydia Ostrom, John Hoffman, Evan Dierker, Jennifer Bergman and Vincent Russo 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 Ashley Byrd, Connie James, Lydia Ostrom, John Hoffman, Evan Dierker, Jennifer Bergman and Vincent Russo.
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
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
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
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance