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

06/27/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2426101455


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.
Compliance 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.

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
Violation
 Provider Comments
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
6/22/2022
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
6/22/2022
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