DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

001632719

(417) 455-9999

4701 CHOUTEAU DR
NEOSHO
MO  64850-9123

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

4701 CHOUTEAU DR
NEOSHO
MO  64850-9123

BLANCHARD, SANDRA JO

tina@tristatefamilyymca.org

Incorporated

ANGEL DONSON

24 MONTHS - 6 YEARS

42

GROUP HOME AND CENTER

 
Inspection Information

02/28/2022

3:07 PM

4:15 PM

UNANNOUNCED

COMPLIANCE MONITORING

2418820138


DocumentDocument-Date
DIRECTOR'S QUALIFICATIONS 03/26/2012
EQUIPMENT LIST 05/17/2021
FIRE/SAFETY INSPECTION 09/28/2021
SANITATION INSPECTION 06/23/2021
APPLICATION 05/16/2018
STAFF SHEET 07/13/2018
CERTIFICATE OF GOOD STANDING 07/31/2018
ANNUAL DECLARATION 09/14/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 09/14/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 26
StaffChildClass AgeNote
1 9 PRESCHOOL Caregiver Alyssa Greninger with nine children age 4-5 year old.
1 10 PRESCHOOL Caregiver Amber Mullin with 10 children ages 3-4 years old.
1 7 PRESCHOOL Caregiver Talissa Ortega with seven children. Three children are age 2 years old and four children are 3 years old.

 
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
Violation
 Provider Comments
Violation
The requirements for protective outlet covers or twist-lock outlets were not met as evidenced by electrical outlets were not covered in that three electrical outlets did not have a cover.
Licensing Rule Reference
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers (1) (G) states: Protective outlet covers or twist-lock outlets shall be used in areas accessible to the children.
Correction Required
The facility shall use outlet covers or twist-lock outlets as required.

Correction Verification
Corrected on Site

Compliance Date
2/28/2022
5 CSR 25-500.087 Fire Safety
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 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.152 Hourly Care Facilities
Compliance
5 CSR 25-500.162 Overlap Care of Children
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
Violation
 Provider Comments
Violation
One 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

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
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