DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-O'FALLON BRANCH-MOUNT HOPE ELEMENTARY

000369917

(314) 471-4486

1099 MOUNT HOPE LN
O FALLON
MO  63366-1000

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3451 PHEASANT MEADOW DR
O FALLON
MO  63368-7324

BEGEMANN, KARA LYNN

Kara.begemann@gwrymca.org

Incorporated

KATHERINE D SIMS

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

11/12/2021

7:00 AM

7:36 AM

UNANNOUNCED

COMPLIANCE MONITORING

2412383536


DocumentDocument-Date
ANNUAL DECLARATION 11/01/2020
DAILY SCHEDULE 06/21/1979
DISCIPLINE POLICIES 06/21/1979
REGISTERING FICTITIOUS NAMES 06/20/2012
DIRECTOR'S QUALIFICATIONS 01/14/2013
SAMPLE WEEKLY MENU 08/22/1984
SAMPLE FORMS 08/22/1984
POLICIES 08/22/1984
LINES OF ADMINISTRATIVE AUTHORITY 08/22/1984
JOB RESPONSIBILITIES 08/22/1984
DIAGRAM/OUTDOOR 12/22/1989
DIAGRAM/INDOOR 12/22/1989
CHILD CARE PRACTICES 06/21/1979
CERTIFICATE OF GOOD STANDING 09/04/2013
DIRECTOR'S JOB RESPONSIBILITIES 10/13/2015
LOCAL FIRE DEPARTMENT NOTIFICATION 06/20/2012
CERTIFICATE OF INCORPORATION 06/20/2012
ARTICLES OF INCORPORATION 06/20/2012
APPLICATION 10/07/2019
STAFF SHEET 11/02/2020
EQUIPMENT LIST 11/02/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/03/2016




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 8
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 2
Total Children 7
StaffChildClass AgeNote
2 7 SCHOOL AGE Jeanette Staskewicz and Sierra Burton present with 7 children, all school age

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Violation
 Provider Comments
Violation
The name, address and telephone number of the board president was not prominently posted near the license.
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;
Correction Required
The name, address, and board president or chairperson shall be posted near the license.

Correction Verification
Return Inspection

Compliance Date
11/12/2021
Violation
Posting requirements were not met as evidenced by the license was not posted near the entrance.
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.
Correction Required
The official license shall be posted.

Correction Verification
Return Inspection

Compliance Date
11/12/2021
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Jeanette Staskewicz within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 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

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
Violation
 Provider Comments
Violation
The facility’s special instructions for infants and non-ambulatory children were not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date
11/12/2021
Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Return Inspection

Compliance Date
11/12/2021
5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
A facility orientation was not documented and available for review for all caregivers. The following staff need documentation of a facility orientation: Bethany McClintock and Abby Herod.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering and before being left alone with children that caregivers receive a facility orientation. The child care provider shall ensure that documentation verifying completion of the facility orientation is maintained and on file for review by the department for each caregiver. The facility orientation shall include:
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days and documentation verifying completion is maintained and on file for review by the department for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

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 Jeanette Staskewicz and Abby Herod 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

Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Jeanette Staskewicz and Abby Herod.
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

5 CSR 25-500.132 Admission Policies and Procedures
Compliance
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by Child's A immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Return Inspection

Compliance Date
11/12/2021
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
2 child(ren) records did not include date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
3 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
Submit Documentation

Compliance Date

Violation
One child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-500.222 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
Return Inspection

Compliance Date
11/12/2021
Violation
2 child(ren) records did not include child's address.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
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
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Jeanette Staskewicz.
Licensing Rule Reference
5 CSR 25-600.020 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

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