DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

BOYS AND GIRLS CLUB OF JEFFERSON CITY

001834939

(573) 634-2582

1105 LAFAYETTE ST
JEFFERSON CITY
MO  65101

BOYS & GIRLS CLUB OF JEFFERSON CITY

PO BOX 105558
JEFFERSON CITY
MO  65110-5558

MARSHALL, KELLY NATASHA

sjohnson@bgcjc.com


SHELBY N KOETTING

5 YEARS - 16 YEARS

250

GROUP HOME AND CENTER

 
Inspection Information

07/15/2020

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2382719837


DocumentDocument-Date
CERTIFICATE OF GOOD STANDING 07/11/2017
ARTICLES OF INCORPORATION 07/11/2017
JOB RESPONSIBILITIES 07/11/2017
LINES OF ADMINISTRATIVE AUTHORITY 07/11/2017
SAMPLE WEEKLY MENU 07/11/2017
DIAGRAM/INDOOR 07/12/2017
DIAGRAM/OUTDOOR 07/12/2017
REGISTERING FICTITIOUS NAMES 07/11/2017
DAILY SCHEDULE 07/12/2017
CHILD CARE PRACTICES 07/11/2017
DISCIPLINE POLICIES 07/11/2017
POLICIES 07/11/2017
LLC OPERATING AGREEMENT 05/17/2017
LLC ARTICLES OF ORGANIZATION 05/17/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 08/09/2017
DIRECTOR'S QUALIFICATIONS 08/25/2017
LOCAL ZONING APPROVAL 06/02/2017
LOCAL BUILDING APPROVAL 06/02/2017
APPLICATION 07/03/2019
EQUIPMENT LIST 07/03/2019
STAFF SHEET 07/03/2019
SANITATION INSPECTION 10/04/2019
FIRE/SAFETY INSPECTION 09/16/2019




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
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
Children were not restricted to approved space as evidenced by children are using an old office room converted to a tutoring space without measurements.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (C) states: Children shall have no access to areas not approved for child care.
Correction Required
Caregivers shall restrict children to approved space.

Correction Verification
Submit Documentation

Compliance Date
3/19/2020
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
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. The staff listed need the following information: Rushonia Blanche (needs 12), Cory Bradley (needs 1.5), Sabria Hendricks (needs 10), David Hendrickson (needs 5), Cory Lee (needs 10), Rayvon Mallett (needs 12), Barbara Martin (needs 8.5), Connie McGowan (needs 7.5), Briana Oliver (needs 7.5), Cheyenne Ross (needs 3), Tyreesha Young (needs 5), Justin Adams (needs 3), Cameron Blair (needs 2), Jalesa Campbell (needs 3), Cardasia Futrell (needs 2), Castrele Hoy (needs 4), Paris Lewis (needs 7.5), Rachelle Montgomery (needs 3), Shianne Sheely (needs 2), Shakya Walters (needs 5), and Timberly Woods (needs 1) clock hour trainings for 2019 calendar year.
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
5/20/2020
Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Cameron Blair, Ashley Davis, Cardasia Futrell, Castrele Hoy, Kendall Coffelt, Kelly Marshall, Christopher Sawyer, Shianne Sheely, and Timberly Woods.
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
7/11/2020
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for Shakya Walters, Paul Winn, Timberly Woods, Jalesa Campbell, Cardasia Futrell, Castrele Hoy, Paris Lewis, and Christopher Sawyer 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
3/18/2020
Violation
A medical examination report did not include a completed Risk Assessment for Tuberculosis form for Paul Winn, Castrele Hoy, Paris Lewis, Rachelle Montgomery and Christopher Sawyer.
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
3/18/2020
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
The facility did not meet requirements for child enrollment and health information as evidenced by specialized care forms were not on file for 2 children within 30 days of enrollment.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (8) (E) 2. states: Information regarding a child's personal development, behavior patterns, habits and individual needs;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/11/2020
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
Violation
 Provider Comments
Violation
4 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/11/2020
Violation
3 child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/11/2020
Violation
1 child(ren) records did not include telephone number of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/11/2020
Violation
1 child(ren) records did not include name of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/11/2020
Violation
2 child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/11/2020
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.115. Reports of abuse, neglect, and under age eighteen deaths — persons required to report — supervisors and administrators not to impede reporting — deaths required to be reported to the division or child fatality review panel, when — report made to another state, when. —
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance