MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-MID COUNTY BRANCH-BUDER ELEMENTARY

Facility DVN
000214959

Phone
(314) 493-6300

Physical Address
10350 BALTIMORE AVE
ST ANN
MO 63074-3837

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
1900 URBAN DR
ST LOUIS
MO 63144

Provider/Director
BERGMAN, JENNIFER

E-mail Address
CELIA.MEEKS@GWRYMCA.ORG

Incorporated
Incorporated

Child Care Specialist
SHALINDA WALLACE

Age Range
5 YEARS - 13 YEARS

Capacity
32

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
05/12/2022

Arrival Time
2:05 PM

Departure Time
2:27 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2423577901

Document	Document-Date
LINES OF ADMINISTRATIVE AUTHORITY	03/11/2005
SAMPLE WEEKLY MENU	03/10/1986
DAILY SCHEDULE	03/10/1986
SAMPLE FORMS	03/10/1986
POLICIES	03/10/1986
CHILD CARE PRACTICES	03/10/1986
DISCIPLINE POLICIES	03/10/1986
APPLICATION	04/06/2018
DIRECTOR'S QUALIFICATIONS	11/06/2017
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/19/2018
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	05/11/2022
EQUIPMENT LIST	05/11/2022
ANNUAL DECLARATION	05/11/2012

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	Mr. Mark Pacatte- Director

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 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