MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-O'FALLON BRANCH-DARDENNE ELEMENTARY

Facility DVN
000271978

Phone
(636) 293-6484

Physical Address
2621 HIGHWAY K
O FALLON
MO 63366

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
3451 PHEASANT MEADOW DR
O FALLON
MO 63368-7324

Provider/Director
MILLER, CHRISTINA

E-mail Address
Laurie.mctearnen@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
CHARMEL WILLIAMS

Age Range
5 YEARS - 12 YEARS

Capacity
32

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
02/07/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2412392154

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	11/02/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	11/02/2021
ANNUAL DECLARATION	09/20/2021
SAMPLE WEEKLY MENU	05/15/1992
SAMPLE FORMS	05/15/1992
REGISTERING FICTITIOUS NAMES	05/15/1992
POLICIES	05/15/1992
LOCAL FIRE DEPARTMENT NOTIFICATION	05/15/1992
LINES OF ADMINISTRATIVE AUTHORITY	05/15/1992
JOB RESPONSIBILITIES	05/15/1992
DISCIPLINE POLICIES	05/15/1992
DIRECTOR'S JOB RESPONSIBILITIES	05/08/1992
DAILY SCHEDULE	05/15/1992
CHILD CARE PRACTICES	05/15/1992
DIRECTOR'S QUALIFICATIONS	10/26/2010
CERTIFICATE OF INCORPORATION	02/25/1898
ARTICLES OF INCORPORATION	05/15/1992
CERTIFICATE OF GOOD STANDING	10/16/2018
APPLICATION	09/27/2018
EQUIPMENT LIST	08/23/2021
STAFF SHEET	10/04/2018

Inspection determined facility to be in compliance with licensing rules.

Open Violations: NA

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

Staff	Child	Class Age	Note
2	0	NO CHILDREN IN ATTENDANCE	Byron Henderson Director, and Jamie Ovlia Managing Member, were present without children
1	0	NO CHILDREN IN ATTENDANCE	Nicole Agrusa Education Coach, was present without children

Compliance List
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
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 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 Compliance
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