MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
MEXICO AREA FAMILY YMCA INC.

Facility DVN
001379995

Phone
(573) 581-1540

Physical Address
1127 ADAMS ST
MEXICO
MO 65265-2288

Owner
MEXICO AREA FAMILY YMCA INC.

Mailing Address

Provider/Director
JORGENSEN, JUSTINE

E-mail Address
samantha.wilson@mexicoymca.org

Incorporated
Incorporated

Child Care Specialist
SUSAN MARIE DOUGLAS

Age Range
5 YEARS - 12 YEARS

Capacity
45

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
05/25/2022

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2424320777

Document	Document-Date
SAMPLE WEEKLY MENU	07/27/1999
JOB RESPONSIBILITIES	03/11/2022
LINES OF ADMINISTRATIVE AUTHORITY	03/11/2022
LOCAL ZONING APPROVAL	03/18/2022
DAILY SCHEDULE	03/11/2022
POLICIES	08/07/2017
CERTIFICATE OF GOOD STANDING	02/03/2022
CHILD CARE PRACTICES	08/07/2017
DIAGRAM/INDOOR	07/25/2017
DIAGRAM/OUTDOOR	08/07/2017
DISCIPLINE POLICIES	08/07/2017
ARTICLES OF INCORPORATION	07/25/2017
SAMPLE FORMS	08/07/2017
APPLICATION	03/11/2019
STAFF SHEET	05/07/2019
DIRECTOR'S QUALIFICATIONS	10/15/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/25/2017
FIRE/SAFETY INSPECTION	12/06/2021
SANITATION INSPECTION	12/07/2021
EQUIPMENT LIST	03/07/2022
ANNUAL DECLARATION	02/10/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/07/2022

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.