MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
BOONSLICK HEARTLAND YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

Facility DVN
002205536

Phone
(660) 882-8500

Physical Address
757 THIRD ST
BOONVILLE
MO 65233

Owner
BOONSLICK HEARTLAND YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

Mailing Address
757 3RD ST
BOONVILLE
MO 65233-1670

Provider/Director
WOLFE, KATHLEEN RENEE

E-mail Address
cyndir@bhymca.org

Incorporated
Incorporated

Child Care Specialist
SUSAN MARIE DOUGLAS

Age Range
5 YEARS - 15 YEARS

Capacity
74

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
05/02/2022

Arrival Time
3:10 PM

Departure Time
4:13 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2422864578

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/12/2022
ANNUAL DECLARATION	03/29/2022
APPLICATION	03/02/2020
EQUIPMENT LIST	04/12/2022
STAFF SHEET	08/31/2020
DISASTER AND EMERGENCY PREPAREDNESS PLAN	03/14/2018
CHILD CARE PRACTICES	04/12/2022
DISCIPLINE POLICIES	04/12/2022
DIRECTOR'S QUALIFICATIONS	02/14/2018
LOCAL ZONING APPROVAL	02/23/2010
SAMPLE WEEKLY MENU	02/25/2010
ARTICLES OF INCORPORATION	02/23/2010
CERTIFICATE OF GOOD STANDING	04/29/2021
LINES OF ADMINISTRATIVE AUTHORITY	04/12/2022
JOB RESPONSIBILITIES	02/25/2010
POLICIES	04/12/2022
DAILY SCHEDULE	04/24/2018
DIAGRAM/INDOOR	04/27/2018
DIAGRAM/OUTDOOR	04/27/2018
LOCAL FIRE DEPARTMENT NOTIFICATION	10/18/2018
FIRE/SAFETY INSPECTION	12/20/2021
SANITATION INSPECTION	02/28/2022

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 6

Total Children 41

Staff	Child	Class Age	Note
2	0	NO CHILDREN IN ATTENDANCE	Cyndi Roth, director of children's programs and Corey Price , cook were present at the inspection
2	19	SCHOOL AGE	Ashley Tilman and Endiya DeVoe were present with 19 children ages 6 to 8
2	22	SCHOOL AGE	Alyssa Gross and Isabella Fuller were present with 22 children ages 5 to 7


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 25-500.087 Fire Safety 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 25-500.142 Nighttime Care Compliance
5 CSR 25-500.152 Hourly Care Facilities Compliance
5 CSR 25-500.162 Overlap Care of Children 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