MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-SOUTH COUNTY BRANCH-FORDER ELEMENTARY

Facility DVN
000186310

Phone
(314) 467-5688

Physical Address
623 W RIPA AVE
ST LOUIS
MO 63125

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
12736 SOUTHFORK RD
ST LOUIS
MO 63128

Provider/Director
BOWMAN, MELISSA DAWN

E-mail Address
melissabowman@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
THERESA ZEHNLE

Age Range
5 YEARS - 12 YEARS

Capacity
40

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
10/05/2022

Arrival Time
7:15 AM

Departure Time
7:46 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2432297155

Document	Document-Date
SAMPLE WEEKLY MENU	09/04/1985
SAMPLE FORMS	09/04/1985
POLICIES	09/04/1985
LINES OF ADMINISTRATIVE AUTHORITY	09/04/1985
JOB RESPONSIBILITIES	09/04/1985
DISCIPLINE POLICIES	09/04/1985
DIRECTOR'S JOB RESPONSIBILITIES	09/04/1985
DAILY SCHEDULE	09/04/1985
CERTIFICATE OF INCORPORATION	02/25/1998
ARTICLES OF INCORPORATION	02/25/1998
CHILD CARE PRACTICES	09/04/1985
DIRECTOR'S QUALIFICATIONS	01/09/2007
CERTIFICATE OF GOOD STANDING	04/15/2014
APPLICATION	04/04/2018
EQUIPMENT LIST	02/23/2022
STAFF SHEET	04/04/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	05/20/2019
ANNUAL DECLARATION	02/23/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	02/23/2022

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 2

Total Children 12

Staff	Child	Class Age	Note
2	12	SCHOOL AGE	AF, group leader, and TH, group leader, were present with twelve children ages 5-years-old to 9-years-old