MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002603945

Phone
(573) 657-9600

Physical Address
300 E BROADWAY
ASHLAND
MO 65010-9305

Owner
JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
PO BOX 56
ASHLAND
MO 65010-0056

Provider/Director
SHANKS, NABRINA MARIE

E-mail Address
nabrinas@jcymca.org

Incorporated
Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
5 YEARS - 12 YEARS

Capacity
46

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
10/05/2022

Arrival Time
4:00 PM

Departure Time
5:05 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2432411976

Document	Document-Date
DAILY SCHEDULE	06/15/2018
SAMPLE WEEKLY MENU	06/15/2018
CHILD CARE PRACTICES	06/09/2018
DISCIPLINE POLICIES	06/09/2018
ARTICLES OF INCORPORATION	10/22/2018
LINES OF ADMINISTRATIVE AUTHORITY	06/15/2018
POLICIES	06/15/2018
REGISTERING FICTITIOUS NAMES	10/22/2018
LOCAL BUILDING APPROVAL	02/22/2019
DIAGRAM/OUTDOOR	10/23/2018
JOB RESPONSIBILITIES	06/15/2018
LOCAL FIRE DEPARTMENT NOTIFICATION	02/01/2019
LOCAL ZONING APPROVAL	02/22/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/27/2019
APPLICATION	03/26/2019
STAFF SHEET	03/01/2019
CERTIFICATE OF GOOD STANDING	01/12/2021
DIRECTOR'S QUALIFICATIONS	09/28/2020
LICENSING ORIENTATION	06/09/2018
SAMPLE FORMS	10/02/2018
DIAGRAM/INDOOR	05/12/2021
SANITATION INSPECTION	01/04/2022
FIRE/SAFETY INSPECTION	02/07/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/02/2022
EQUIPMENT LIST	03/02/2022
ANNUAL DECLARATION	03/02/2022

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

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 5

Total Children 31

Staff	Child	Class Age	Note
2	0	NO CHILDREN IN ATTENDANCE	N. K., facility director and J. W. (staff in training)
3	31	SCHOOL AGE	children ages five to ten; R. S., M. G., and E. S.

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 25-500.087 Fire Safety

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 25-500.142 Nighttime Care

Compliance

5 CSR 25-500.162 Overlap Care of Children

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

Violation

	Provider Comments
Violation Criminal background check results were not on file for J. W. Licensing Rule Reference 5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department. Correction Required Required results of criminal background checks shall be on file. Correction Verification Submit Documentation Compliance Date

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