MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
GRAND RIVER AREA FAMILY YMCA, INC.

Facility DVN
002547391

Phone
(660) 542-0011

Physical Address
207 E 9TH ST
CARROLLTON
MO 64633-2342

Owner
GRAND RIVER AREA FAMILY YMCA, INC.

Mailing Address
PO BOX 184
CARROLLTON
MO 64633-0184

Provider/Director
CABANISS, CANDACE NICOLE

E-mail Address
CCABANISS@CARROLLCOUNTYAREAYMCA.ORG

Incorporated
Incorporated

Child Care Specialist
ELLEN DONOHO

Age Range
5 YEARS - 12 YEARS

Capacity
60

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
04/01/2022

Arrival Time
2:15 PM

Departure Time
3:11 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2420794422

Document	Document-Date
POLICIES	06/29/2016
LINES OF ADMINISTRATIVE AUTHORITY	08/04/2016
JOB RESPONSIBILITIES	09/09/2015
SAMPLE WEEKLY MENU	08/04/2016
ARTICLES OF INCORPORATION	09/09/2015
DISCIPLINE POLICIES	06/29/2015
CHILD CARE PRACTICES	06/29/2015
DAILY SCHEDULE	09/15/2014
DIRECTOR'S JOB RESPONSIBILITIES	09/09/2014
DIRECTOR'S QUALIFICATIONS	09/09/2014
LOCAL FIRE DEPARTMENT NOTIFICATION	08/04/2016
APPLICATION	01/24/2018
CERTIFICATE OF GOOD STANDING	02/04/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/19/2020
STAFF SHEET	04/07/2021
EQUIPMENT LIST	01/03/2022
ANNUAL DECLARATION	01/02/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/03/2022

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 24

Staff	Child	Class Age	Note
3	24	SCHOOL AGE	5 years - 11 years Candace Cabannas, Jordan Harris and Riley Looney, 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