DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-FOUR RIVERS BRANCH-SOUTH POINT ELEMENTARY

000198316

(314) 598-5004

2300 SOUTHBEND DR
WASHINGTON
MO  63090

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

400 GRAND AVE
WASHINGTON
MO  63090

PENNOCK, DALLAS JORDAN

melissa.mueller@gwrymca.org

Incorporated

LEATRICE L DIXON

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

10/31/2019

4:00 PM

5:27 PM

UNANNOUNCED

COMPLIANCE MONITORING

2368283439


DocumentDocument-Date
SAMPLE WEEKLY MENU 08/30/2001
POLICIES 03/28/2009
LINES OF ADMINISTRATIVE AUTHORITY 06/21/1979
DISCIPLINE POLICIES 03/28/2009
DIRECTOR'S JOB RESPONSIBILITIES 08/30/2001
DAILY SCHEDULE 08/17/2009
CHILD CARE PRACTICES 03/28/2009
CERTIFICATE OF INCORPORATION 08/30/2001
ARTICLES OF INCORPORATION 08/30/2001
DIRECTOR'S QUALIFICATIONS 01/24/2017
STAFF SHEET 04/04/2018
EQUIPMENT LIST 04/04/2018
CERTIFICATE OF GOOD STANDING 04/04/2018
APPLICATION 04/04/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/08/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 11
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 2
Total Children 2
StaffChildClass AgeNote
2 2 SCHOOL AGE Gia Mesz and Anna Marie Tihen with children ages 7-8 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 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: There is no documentation that comprehensive background screenings have been conducted for any staff. There are no letters of eligibility for any staff on site.
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 facility did not meet requirements for a criminal background check. Results were not on file for the following staff member(s): Melissa Mueller, Zane Moore, Sara Newbanks, Aaron (AJ) Nance, Gia Mesz, Anna Marie Tihen, Keegan Scheel, and Sandi Seaman.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (M) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements.
Correction Required
Required results of criminal 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 requires 3 staff members with CPR and 1st Aid certification. Only Aaron Nance has documentation of CPR and 1st Aid certification. 2 additional staff members are needed with CPR and 1st Aid certification.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (S) 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, include an in-person skills assessment, and be and approved by the department.
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

Violation
Prospective child care staff member(s), Melissa Mueller, Zane Moore, Sara Newbanks, Aaron (AJ) Nance, Gia Mesz, Anna Marie Tihen, Keegan Scheel, and Sandi Seaman, was/were not supervised at all times by another child care staff member who received a qualifying result on the criminal background check within the past five years.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (O) states: A prospective child care staff member may begin work for a child care provider after the criminal background check has been requested from the department; however, pending completion of the criminal background check, the prospective child care staff member shall be supervised at all times by another child care staff member who received a qualifying result on the criminal background check within the past five (5) years.
Correction Required
All prospective child care staff member(s) who have requested a criminal background check shall be supervised at all times by another child care staff member who has received a qualifying result on the criminal background check within the past five years.

Correction Verification
Submit Documentation

Compliance Date

Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: all new staff hired as of 09.01.19. There are no records for some staff and it cannot be verified what their start dates are. There is no documentation of any staff orientations having been conducted. .
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

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 Dallas Pennock is the approved director. He no longer works for the program.
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 director is not routinely on duty as required, as evidenced by Dallas Pennock is the approved director. He no longer works for the program.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 2. states: Center directors and group day care home providers routinely shall be on duty during the hours of highest attendance a minimum of forty (40) hours per week. If the facility operates less than forty (40) hours per week, the center director or group day care home provider shall be on duty at least fifty percent (50%) of the operating hours.
Correction Required
The director/group day care home provider shall be routinely on duty as required.

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 certified in first aid/CPR was not on site.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (S) 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, include an in-person skills assessment, and be and approved by the department.
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 Melissa Mueller, Zane Moore, Aaron (AJ) Nance, Gia Mesz, Anna Marie Tihen, Keegan Schell, and Sandi Seaman 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 Melissa Mueller, Zane Moore, Aaron (AJ) Nance, Gia Mesz, Anna Marie Tihen, Keegan Schell, and Sandi Seaman.
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
Violation
 Provider Comments
Violation
1 (child 4) child(ren) records did not include date care begins and ends.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
10/31/2019
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