MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

Facility DVN
001671034

Phone
(660) 826-8331

Physical Address
1100 W 16TH ST
SEDALIA
MO 65301-7010

Owner
BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

Mailing Address
3100 AARON AVE
SEDALIA
MO 65301-7907

Provider/Director
JONES, DYTISHA

E-mail Address
lschirlls@bgckids.com

Incorporated
Incorporated

Child Care Specialist
ELLEN DONOHO

Age Range
5 YEARS - 11 YEARS

Capacity
60

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
03/28/2022

Arrival Time
2:30 PM

Departure Time
3:20 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2420489045

Document	Document-Date
JOB RESPONSIBILITIES	05/19/2009
CERTIFICATE OF INCORPORATION	05/19/2009
ARTICLES OF INCORPORATION	05/19/2009
LINES OF ADMINISTRATIVE AUTHORITY	05/19/2009
DIRECTOR'S JOB RESPONSIBILITIES	05/19/2009
DIRECTOR'S QUALIFICATIONS	07/08/2009
SAMPLE FORMS	05/19/2009
CHILD CARE PRACTICES	05/19/2009
SAMPLE WEEKLY MENU	05/19/2009
DAILY SCHEDULE	05/19/2009
POLICIES	05/19/2009
DISCIPLINE POLICIES	05/19/2009
LOCAL FIRE DEPARTMENT NOTIFICATION	11/02/2018
APPLICATION	05/08/2019
STAFF SHEET	05/08/2019
CERTIFICATE OF GOOD STANDING	05/10/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	05/17/2019
ANNUAL DECLARATION	10/25/2021
EQUIPMENT LIST	03/28/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/28/2022

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 35

Staff	Child	Class Age	Note
3	35	SCHOOL AGE	Kindergarten-4th grade Sarah Cristen, Tiffany Zullig and DyTisha Jones, Staff


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