MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
RANDOLPH AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002196707

Phone
(660) 263-3600

Physical Address
1000 SHEPHARD BROTHERS BLVD
MOBERLY
MO 65270-3800

Owner
RANDOLPH AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
PO BOX 176
MOBERLY
MO 65270-0176

Provider/Director
APPLEGARTH, BETHANY ERIN

E-mail Address
tarbatowicz@randolphareaymca.com

Incorporated
Incorporated

Child Care Specialist
SUSAN MARIE DOUGLAS

Age Range
5 YEARS - 12 YEARS

Capacity
49

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
11/02/2022

Arrival Time
4:15 PM

Departure Time
5:21 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2434562415

Document	Document-Date
APPLICATION	08/23/2019
STAFF SHEET	11/22/2019
SANITATION INSPECTION	12/16/2021
DIRECTOR'S QUALIFICATIONS	01/21/2022
CERTIFICATE OF GOOD STANDING	02/04/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/11/2022
FIRE/SAFETY INSPECTION	10/27/2021
EQUIPMENT LIST	03/16/2022
ANNUAL DECLARATION	03/11/2022
ARTICLES OF INCORPORATION	02/02/2010
LOCAL ZONING APPROVAL	02/02/2010
DAILY SCHEDULE	02/03/2010
CHILD CARE PRACTICES	05/02/2019
LINES OF ADMINISTRATIVE AUTHORITY	02/03/2010
DISCIPLINE POLICIES	05/02/2019
POLICIES	05/02/2019
DIAGRAM/INDOOR	05/06/2010
DIAGRAM/OUTDOOR	05/06/2010
SAMPLE WEEKLY MENU	02/03/2010

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 3

Total Children 27

Staff	Child	Class Age	Note
3	27	MIXED	J.F staff , C C staff and B.J. acting director. 27 children ages 3 to 10 6