DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

RANDOLPH AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

002196707

(660) 263-3600

1000 KWIX RD
MOBERLY
MO  65270

RANDOLPH AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

PO BOX 176
MOBERLY
MO  65270-0176

ARBATLWICZ, TABI

tarbatowicz@randolphareaymca.com

Incorporated

ELLEN DONOHO

5 YEARS - 12 YEARS

49

GROUP HOME AND CENTER

 
Inspection Information

11/25/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2370173857


DocumentDocument-Date
APPLICATION 08/23/2019
EQUIPMENT LIST 11/12/2015
STAFF SHEET 11/12/2017
SANITATION INSPECTION 10/16/2018
FIRE/SAFETY INSPECTION 11/01/2017




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
 Provider Comments
Violation
The staff sheet was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (J) states: Current staff sheet;
Correction Required
The facility shall submit a current staff sheet as required for renewal.

Correction Verification
Submit Documentation

Compliance Date
11/22/2019
Violation
The facility's equipment list was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (I) states: A current list of available equipment;
Correction Required
The facility shall submit an equipment list as required for renewal.

Correction Verification
Submit Documentation

Compliance Date
11/22/2019
Violation
The sanitation inspection was not conducted.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (B) states: Evidence of compliance with local or state, or both, sanitation requirements;
Correction Required
The facility shall submit evidence of compliance with sanitation requirements for renewal.

Correction Verification
Submit Documentation

Compliance Date
11/12/2019
Violation
The fire inspection was not approved.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (1) (A) states: Evidence of compliance with a fire and safety inspection as conducted by the State Fire Marshal or his/her designee;
Correction Required
The facility shall submit evidence of compliance with fire and safety requirements for renewal.

Correction Verification
Submit Documentation

Compliance Date
11/21/2019
Violation
The facility did not meet requirements for a criminal background check. Results were not on file for the following staff member(s): Casey Aholt.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (4) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
11/22/2019
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.087 Fire Safety
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 30-62.142 Nighttime Care
Compliance
19 CSR 30-62.152 Hourly Care Facilities
Compliance
19 CSR 30-62.162 Overlap Care of Children
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