DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-ST. CHARLES BRANCH-BLACKHURST ELEMENTARY

002304063

(314) 606-1870

2000 ELM ST
ST CHARLES
MO  63301

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3900 SHADY SPRINGS LN
ST PETERS
MO  63376-6467

THORNHILL, ASHLEY ELIZABETH

laurie.mctearnen@gwrymca.org

Incorporated

LAURA WILMESHER

5 YEARS - 13 YEARS

32

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

04/22/2021

3:50 PM

4:02 PM

UNANNOUNCED

REINSPECTION

2398221581


DocumentDocument-Date
LOCAL FIRE DEPARTMENT NOTIFICATION 08/03/2016
LINES OF ADMINISTRATIVE AUTHORITY 08/03/2016
DIRECTOR'S QUALIFICATIONS 08/03/2016
JOB RESPONSIBILITIES 08/03/2016
DIRECTOR'S JOB RESPONSIBILITIES 08/03/2016
SAMPLE WEEKLY MENU 08/03/2016
CHILD CARE PRACTICES 08/03/2016
DISCIPLINE POLICIES 08/03/2016
DAILY SCHEDULE 08/03/2016
POLICIES 08/03/2016
REGISTERING FICTITIOUS NAMES 04/01/2021
CERTIFICATE OF GOOD STANDING 04/01/2021
ARTICLES OF INCORPORATION 08/03/2016
CERTIFICATE OF INCORPORATION 08/03/2016
SAMPLE FORMS 08/03/2016
APPLICATION 01/23/2018
EQUIPMENT LIST 04/25/2018
STAFF SHEET 04/25/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 5
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 1
Total Children 12
StaffChildClass AgeNote
1 12 SCHOOL AGE Kaitlyn Campbell with children age 5 years to 9 years.

 
19 CSR 30-62.032 Organization and Administration
Not Observed
19 CSR 30-62.042 Licensing Process
Not Observed
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Rebecca Kinder within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date
4/22/2021
Violation
The staff sheet was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The equipment list was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Annual Declaration was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, promulgated as of 2020 and incorporated by reference in this rule. As published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102-0570 and available by the department at https://health.mo.gov/safety/childcare/forms.php indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
19 CSR 30-62.090 Disaster and Emergency Preparedness
Not Observed
19 CSR 30-62.092 Furniture, Equipment and Materials
Not Observed
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (T) 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 age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Return Inspection

Compliance Date
4/22/2021
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2020, the staff listed need the following information: Kaitlyn Campbell needs 7.5 additional hours.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group child 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 caregiver.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Not Observed
19 CSR 30-62.122 Medical Examination Reports
Not Observed
19 CSR 30-62.132 Admission Policies and Procedures
Not Observed
19 CSR 30-62.172 Emergency School Closings
Not Observed
19 CSR 30-62.182 Child Care Program
Not Observed
19 CSR 30-62.192 Health Care
Not Observed
19 CSR 30-62.202 Nutrition and Food Service
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Not Observed
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
One 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
4/22/2021
Violation
One 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
4/22/2021
Violation
One child(ren) records did not include field trip and transportation authorization.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (F) states: Field trip and transportation authorization.
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
4/22/2021
19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Rebecca Kinder.
Licensing Rule Reference
19 CSR 30-63.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a family child care home, group child care home, child care center, or license-exempt facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-63.040 Background Screening Findings
Not Observed
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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed