DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

Y-CARE PIONEER TRAIL ELEMENTARY SCHOOL

002786543

(573) 632-3400

301 PIONEER TRAIL DR
JEFFERSON CITY
MO  65109-1508

JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

PO BOX 104176
JEFFERSON CITY
MO  65110-4176

LEHMEN, LEIGH ANNE

jkever@jcymca.org

Incorporated

KELLY L SCHEUERMAN

5 YEARS - 12 YEARS

99

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

10/28/2021

3:00 PM

4:39 PM

UNANNOUNCED

COMPLIANCE MONITORING

2410655313


DocumentDocument-Date
APPLICATION 07/18/2019
DIRECTOR'S QUALIFICATIONS 08/07/2019
CERTIFICATE OF GOOD STANDING 08/07/2019
ARTICLES OF INCORPORATION 08/07/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/07/2019
SAMPLE FORMS 08/07/2019
CERTIFICATE OF INCORPORATION 08/07/2019
LINES OF ADMINISTRATIVE AUTHORITY 08/07/2019
DISCIPLINE POLICIES 08/07/2019
POLICIES 08/07/2019
DAILY SCHEDULE 08/07/2019
SAMPLE WEEKLY MENU 08/07/2019
JOB RESPONSIBILITIES 08/07/2019
DIRECTOR'S JOB RESPONSIBILITIES 08/07/2019
REGISTERING FICTITIOUS NAMES 08/07/2019
CHILD CARE PRACTICES 08/07/2019
STAFF SHEET 08/14/2019
LOCAL FIRE DEPARTMENT NOTIFICATION 08/27/2019
EQUIPMENT LIST 03/31/2021
ANNUAL DECLARATION 03/30/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/22/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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 4
Total Children 44
StaffChildClass AgeNote
4 44 SCHOOL AGE Leigh Anne Lehmen-Director, Ivory Shikles, Joxita Iris Desha, and Connor Henderson with 44 school aged children.

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Compliance
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Deborah Harding as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 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
10/18/2021
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Deborah Harding.
Licensing Rule Reference
5 CSR 25-500.122 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
10/18/2021
5 CSR 25-500.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.172 Emergency School Closings
Compliance
5 CSR 25-500.182 Child Care Program
Compliance
5 CSR 25-500.192 Health Care
Compliance
5 CSR 25-500.202 Nutrition and Food Service
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Violation
 Provider Comments
Violation
One child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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
Corrected on Site

Compliance Date
10/28/2021
Violation
Records were not available for inspection by the department upon request as evidenced by no file available for review for Ivory Shikles as she was working on cite during the inspection.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (11) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date

Violation
Four child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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

5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 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