DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

002164009

(660) 826-8331

401 W PETTIS ST
GREEN RIDGE
MO  65332-0070

BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

3100 AARON AVE
SEDALIA
MO  65301-7907

HAZEL, JESSICA RENE

jhazel@bgckids.com

Incorporated

SUSAN MARIE DOUGLAS

5 YEARS - 16 YEARS

60

SCHOOL AGE

 
Inspection Information

04/15/2021

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2397553116


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/04/2021
ANNUAL DECLARATION 02/11/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 12/13/2019
LINES OF ADMINISTRATIVE AUTHORITY 05/19/2009
JOB RESPONSIBILITIES 05/19/2009
SAMPLE FORMS 05/19/2009
SAMPLE WEEKLY MENU 05/19/2009
CHILD CARE PRACTICES 05/19/2009
POLICIES 05/19/2009
DIAGRAM/OUTDOOR 05/19/2009
DIAGRAM/INDOOR 05/19/2009
ARTICLES OF INCORPORATION 05/19/2009
DIRECTOR'S JOB RESPONSIBILITIES 05/19/2009
DISCIPLINE POLICIES 05/19/2009
DIRECTOR'S QUALIFICATIONS 10/26/2015
APPLICATION 04/02/2018
DAILY SCHEDULE 04/06/2018
STAFF SHEET 04/06/2018
EQUIPMENT LIST 03/04/2021
CERTIFICATE OF GOOD STANDING 04/25/2018
LOCAL FIRE DEPARTMENT NOTIFICATION 10/01/2018




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 Licensing Process
Compliance
19 CSR 30-62.052 Annual Requirements
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
3/31/2021
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
 Provider Comments
Violation
1 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
4/9/2021
Violation
1 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
4/9/2021
Violation
1 child(ren) records did not include work schedule 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
4/13/2021
Violation
1 child(ren) records did not include employers' name 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
4/9/2021
19 CSR 30-63.020 General Requirements
Compliance
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