MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA SOUTH COUNTY BRANCH HAGEMANN ELEMENTARY

Facility DVN
000625863

Phone
(314) 467-5788

Physical Address
6401 HAGEMAN RD
ST LOUIS
MO 63128

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
12736 SOUTHFORK DR
ST LOUIS COUNTY
MO 63128

Provider/Director
MAIXNER, RACHEL D

E-mail Address
RACHEL.MAIXNER@GWRYMCA.ORG

Incorporated
Incorporated

Child Care Specialist
MICHELLE (SHELLEY) TRUESDALE

Age Range
5 YEARS - 12 YEARS

Capacity
48

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
04/26/2022

Arrival Time
3:35 PM

Departure Time
4:25 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2422515488

Document	Document-Date
CERTIFICATE OF GOOD STANDING	02/13/2020
DAILY SCHEDULE	09/02/1994
SAMPLE WEEKLY MENU	09/02/1994
LLC ARTICLES OF ORGANIZATION	09/02/1994
JOB RESPONSIBILITIES	09/02/1994
SAMPLE FORMS	09/02/1994
DIRECTOR'S JOB RESPONSIBILITIES	09/02/1994
REGISTERING FICTITIOUS NAMES	06/02/2012
CHILD CARE PRACTICES	09/02/1994
DISCIPLINE POLICIES	09/02/1994
DIRECTOR'S QUALIFICATIONS	04/23/2020
POLICIES	09/02/1994
APPLICATION	02/12/2020
EQUIPMENT LIST	11/03/2021
STAFF SHEET	02/12/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/15/2018
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	11/03/2021
ANNUAL DECLARATION	11/03/2021

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 4

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 2

Total Children 21

Staff	Child	Class Age	Note
2	21	SCHOOL AGE	Caregivers Susan Marty, Kim Heumann, & 2 teen-age staff present with children ages 5 - 10-years-old

Compliance List
5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Violation
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 Violation
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Violation
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 Violation
5 CSR 25-600.020 General Requirements Violation
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