DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-EMERSON BRANCH-JAMESTOWN ELEMENTARY

001873398

(314) 953-4337

13750 OLD JAMESTOWN RD
BLACK JACK
MO  63033-4514

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3390 PERSHALL RD
FERGUSON
MO  63135-1407

WILLIAMS, TIFFANY MICHELLE

tiffany.williams@gwrymca.org

Incorporated

SHALINDA WALLACE

5 YEARS - 13 YEARS

20

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

05/27/2021

12:00 PM

12:01 PM

ANNOUNCED

SUPPLEMENTAL

2401018172


DocumentDocument-Date
DISCIPLINE POLICIES 03/26/2012
SAMPLE WEEKLY MENU 03/26/2012
LINES OF ADMINISTRATIVE AUTHORITY 03/26/2012
CHILD CARE PRACTICES 03/26/2012
ARTICLES OF INCORPORATION 03/26/2012
JOB RESPONSIBILITIES 03/26/2012
DAILY SCHEDULE 03/26/2012
POLICIES 03/26/2012
CERTIFICATE OF GOOD STANDING 09/08/2012
DIRECTOR'S QUALIFICATIONS 12/23/2015
SAMPLE FORMS 03/26/2016
CERTIFICATE OF INCORPORATION 03/26/2012
LOCAL FIRE DEPARTMENT NOTIFICATION 03/26/2012
REGISTERING FICTITIOUS NAMES 03/26/2012
DIRECTOR'S JOB RESPONSIBILITIES 03/26/2012
DISASTER AND EMERGENCY PREPAREDNESS PLAN 09/26/2016
STAFF SHEET 10/23/2018
EQUIPMENT LIST 10/23/2018
APPLICATION 09/27/2018




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 1
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
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Mark Pacatte- Program not in operation.

 
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
Not Observed
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
A caregiver did not submit the Clock Hour Training Reassignment form to apply current year's clock hours for the prior year. The following staff need clock hours reassigned to the previous year: 2020- Terry Norman- 12.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (K) states: Clock hours earned to complete the previous year’s requirements shall not be applied to the current year’s clock hour requirements. Caregivers shall submit the Clock Hour Training Credit Reassignment form to the OPEN Initiative to assign clock hours to the appropriate year. See Clock Hours Training Credit Reassignment form promulgated as of 2018 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. This rule does not incorporate any subsequent amendments or additions.
Correction Required
Caregivers shall submit the Clock Hour Training Credit Reassignment form to reassign current year's clock hours to the prior year.

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
Not Observed
19 CSR 30-63.020 General Requirements
Not Observed
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