DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-JEFFERSON COUNTY BRANCH-PEVELY ELEMENTARY

001012684

(636) 479-5200

30 MAIN ST
PEVELY
MO  63070

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

1303 YMCA DR
FESTUS
MO  63028

LINK, DANA

dana.link@gwrymca.org

Incorporated

BRITTANY HECHT

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

06/16/2022

7:30 AM

8:19 AM

UNANNOUNCED

COMPLIANCE MONITORING

2425689266


DocumentDocument-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/08/2022
ANNUAL DECLARATION 04/19/2022
ARTICLES OF INCORPORATION 10/05/2006
LINES OF ADMINISTRATIVE AUTHORITY 08/19/1997
SAMPLE WEEKLY MENU 08/19/1997
SAMPLE FORMS 08/19/1997
JOB RESPONSIBILITIES 08/19/1997
CHILD CARE PRACTICES 08/19/1997
DAILY SCHEDULE 08/19/1997
POLICIES 08/19/1997
LOCAL FIRE DEPARTMENT NOTIFICATION 09/11/2013
REGISTERING FICTITIOUS NAMES 09/04/2013
CERTIFICATE OF GOOD STANDING 10/19/2015
DISASTER AND EMERGENCY PREPAREDNESS PLAN 04/11/2012
DIRECTOR'S JOB RESPONSIBILITIES 08/01/1997
DISCIPLINE POLICIES 08/19/1997
APPLICATION 10/11/2019
STAFF SHEET 10/24/2019
EQUIPMENT LIST 12/16/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 4
Total Children 17
StaffChildClass AgeNote
4 17 SCHOOL AGE Tammy Thomas, Caregiver/Designated Person in Charge Sheryl Herbert, Jennifer Cox & Vicki Dennington, Caregivers

 
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 3 immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Corrected on Site

Compliance Date
6/16/2022
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
 Provider Comments
Violation
1 child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
1 child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

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