DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

000189335

(573) 761-3196

285 S SUMMIT DR
HOLTS SUMMIT
MO  65043-1445

JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

PO BOX 104176
JEFFERSON CITY
MO  65110-4176

GREEN, JORDAN ROBERT

JKEVER@JCYMCA.ORG

Incorporated

JIM PARSLEY

5 YEARS - 12 YEARS

99

SCHOOL AGE

 
Inspection Information

10/12/2021

3:00 PM

4:02 PM

UNANNOUNCED

COMPLIANCE MONITORING

2410273642


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 12/13/2012
DISCIPLINE POLICIES 08/05/1985
DIRECTOR'S JOB RESPONSIBILITIES 08/26/1993
JOB RESPONSIBILITIES 08/05/1985
LINES OF ADMINISTRATIVE AUTHORITY 08/05/1985
CHILD CARE PRACTICES 08/05/1985
DAILY SCHEDULE 08/05/1985
POLICIES 08/05/1985
SAMPLE FORMS 08/10/1984
SAMPLE WEEKLY MENU 08/05/1985
CERTIFICATE OF INCORPORATION 07/19/1984
CERTIFICATE OF GOOD STANDING 04/12/2021
STAFF SHEET 04/12/2021
EQUIPMENT LIST 04/12/2021
APPLICATION 04/03/2019
ANNUAL DECLARATION 04/12/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 12/03/2013
LICENSING ORIENTATION 08/05/1985
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/12/2021
ARTICLES OF INCORPORATION 08/05/1985
LOCAL FIRE DEPARTMENT NOTIFICATION 08/05/1985
OWNER/PROVIDER REFERENCES 04/12/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 3
Total Children 40
StaffChildClass AgeNote
3 40 SCHOOL AGE There were 40 school age children 5-12 years of age being supervised by: (1) Brittany Watkins (2) Sydney Crockett (3) Amajes Boyd

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Licensing Process
Compliance
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Justice Alonzo, Michael Cheek, Tiana Harley, Matthew Witt, Brayden Lagendoefer 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
10/12/2021
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
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. For the calendar year of 2020, the staff listed need the following information: Justice Alonzo (10 hrs), Michael Cheek (8.5 hrs), Tiana Harley (6 hrs), Matthey Witt (10 hrs), Brayden Lagendoefer (1 hr).
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
10/12/2021
Violation
The director was not responsible for the daily planning, monitoring and managing of the facilities program as evidence by the previous director left and a new director had not yet been approved.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (2) (A) 1. . states: An approved certificated group child care home provider or center director shall be responsible for planning, monitoring, and managing the facility’s daily program.
Correction Required
The director or group home provider shall be responsible for the daily program.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Sydney Crockett and Iris DeSha 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

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Sydney Crockett and Iris Desha.
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

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
Not Observed
19 CSR 30-62.222 Records and Reports
Compliance
19 CSR 30-63.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Brittany Watkins, Sydney Crockett, Amajes Boyd, Iris Desha.
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
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