MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

Facility DVN
002064359

Phone
(573) 754-4497

Physical Address
500 SCHOOL ST
FRANKFORD
MO 63441-1019

Owner
TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

Mailing Address
614 KELLY LN
LOUISIANA
MO 63353-2409

Provider/Director
WARD, DIANE MARIE

E-mail Address
cassie.spangler@twinpikefamilyymca.org

Incorporated
Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
5 YEARS - 13 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
11/17/2021

Arrival Time
3:25 PM

Departure Time
3:59 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2413144853

Document	Document-Date
SAMPLE FORMS	09/05/2007
POLICIES	10/01/2007
LOCAL FIRE DEPARTMENT NOTIFICATION	09/05/2007
LINES OF ADMINISTRATIVE AUTHORITY	09/05/2007
JOB RESPONSIBILITIES	09/05/2007
SAMPLE WEEKLY MENU	09/05/2007
DISCIPLINE POLICIES	10/01/2007
DIRECTOR'S QUALIFICATIONS	12/03/2012
DIRECTOR'S JOB RESPONSIBILITIES	09/05/2007
DAILY SCHEDULE	09/05/2007
CHILD CARE PRACTICES	10/01/2007
CERTIFICATE OF GOOD STANDING	03/07/2013
CERTIFICATE OF INCORPORATION	09/05/2007
ARTICLES OF INCORPORATION	09/05/2007
APPLICATION	02/14/2019
STAFF SHEET	03/14/2019
ANNUAL DECLARATION	05/14/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/14/2021
EQUIPMENT LIST	05/14/2021

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

Total Children 13

Staff	Child	Class Age	Note
3	13	SCHOOL AGE	children ages five to ten; Diane Ward, Mariena Tipton,and Kathy Miller


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 Compliance
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