MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-FOUR RIVERS BRANCH-BEAUFORT ELEMENTARY

Facility DVN
002369360

Phone
(314) 443-4357

Physical Address
3200 HIGHWAY 50
BEAUFORT
MO 63013-1509

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
400 GRAND AVE
WASHINGTON
MO 63090-1204

Provider/Director
SOUDERS, NANCY

E-mail Address
melissa.mueller@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
CYNTHIA D MADDOX

Age Range
5 YEARS - 12 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations
AFTER SCHOOL CARE ONLY

Inspection Information

Date
03/28/2022

Arrival Time
11:30 AM

Departure Time
12:10 PM

Notice
ANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2420496393

Document	Document-Date
DISASTER AND EMERGENCY PREPAREDNESS PLAN	05/10/2018
APPLICATION	04/11/2018
EQUIPMENT LIST	02/10/2022
CERTIFICATE OF GOOD STANDING	02/18/2021
STAFF SHEET	04/11/2018
DIRECTOR'S QUALIFICATIONS	08/25/2015
DIRECTOR'S JOB RESPONSIBILITIES	10/27/2014
REGISTERING FICTITIOUS NAMES	02/18/2021
CHILD CARE PRACTICES	08/19/2014
DAILY SCHEDULE	08/19/2014
ARTICLES OF INCORPORATION	08/19/2014
LINES OF ADMINISTRATIVE AUTHORITY	08/19/2014
DISCIPLINE POLICIES	08/19/2014
JOB RESPONSIBILITIES	08/19/2014
LOCAL FIRE DEPARTMENT NOTIFICATION	08/13/2014
POLICIES	08/19/2014
SAMPLE WEEKLY MENU	08/19/2014
SAMPLE FORMS	08/19/2014
CERTIFICATE OF INCORPORATION	08/20/2014
ANNUAL DECLARATION	02/10/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	02/10/2022

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 1

Staff	Child	Class Age	Note
1	0	NO CHILDREN IN ATTENDANCE	Melissa Mueller was the staff present at the facility. No children present since facility is currently on inactive status.


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