MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-ST. CHARLES BRANCH-JEFFERSON INTERMEDIATE

Facility DVN
002053816

Phone
(636) 443-4421

Physical Address
2660 ZUMBEHL RD
ST CHARLES
MO 63301-1134

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
3900 SHADY SPRINGS LN
ST PETERS
MO 63376-6467

Provider/Director
THORNHILL, ASHLEY ELIZABETH

E-mail Address
LAURIE.MCTEARNEN@GWRYMCA.ORG

Incorporated
Incorporated

Child Care Specialist
CHARMEL WILLIAMS

Age Range
9 YEARS - 12 YEARS

Capacity
32

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
04/27/2022

Arrival Time
3:00 PM

Departure Time
3:32 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2422585879

Document	Document-Date
LINES OF ADMINISTRATIVE AUTHORITY	08/09/2007
DISCIPLINE POLICIES	08/09/2007
DIRECTOR'S JOB RESPONSIBILITIES	08/09/2007
DAILY SCHEDULE	08/09/2007
CHILD CARE PRACTICES	08/09/2007
DIRECTOR'S QUALIFICATIONS	08/27/2012
ARTICLES OF INCORPORATION	08/09/2007
JOB RESPONSIBILITIES	03/24/2015
POLICIES	03/24/2015
SAMPLE WEEKLY MENU	08/09/2007
SAMPLE FORMS	03/24/2015
CERTIFICATE OF INCORPORATION	01/20/2016
CERTIFICATE OF GOOD STANDING	01/20/2016
REGISTERING FICTITIOUS NAMES	01/20/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/09/2017
STAFF SHEET	10/15/2021
APPLICATION	03/06/2019
ANNUAL DECLARATION	03/22/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/22/2021
EQUIPMENT LIST	04/29/2021

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 5

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 6

Staff	Child	Class Age	Note
2	6	SCHOOL AGE	Kaitlyn Campbell and Matthew Mueller were present with six children; ages 10 to 12 years old