DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

002064402

(573) 324-8461

700 W ADAMS ST
BOWLING GREEN
MO  63334-2046

TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

614 KELLY LN
LOUISIANA
MO  63353-2409

SNELL, DEBRA JUNE

cassie.spangler@twinpikefamilyymca.org

Incorporated

SUSAN MARIE DOUGLAS

5 YEARS - 13 YEARS

120

SCHOOL AGE

 
Inspection Information

11/04/2022

3:00 PM

4:00 PM

UNANNOUNCED

COMPLIANCE MONITORING

2434773980


DocumentDocument-Date
SAMPLE FORMS 09/04/2007
LINES OF ADMINISTRATIVE AUTHORITY 08/27/2007
LOCAL FIRE DEPARTMENT NOTIFICATION 09/04/2007
DIRECTOR'S JOB RESPONSIBILITIES 09/04/2007
DIRECTOR'S QUALIFICATIONS 04/09/2009
DAILY SCHEDULE 09/04/2007
CHILD CARE PRACTICES 10/02/2007
CERTIFICATE OF INCORPORATION 09/04/2007
ARTICLES OF INCORPORATION 09/04/2007
APPLICATION 02/14/2019
STAFF SHEET 04/08/2019
CERTIFICATE OF GOOD STANDING 05/20/2022
ANNUAL DECLARATION 05/20/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 05/20/2022
EQUIPMENT LIST 05/17/2022




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 52
StaffChildClass AgeNote
5 52 SCHOOL AGE K.S. staff, P.W. staff, S.T. staff, M.H. staff was present with 52 children ages 5 to 11

 
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
Violation
 Provider Comments
Violation
The department did not receive notification of a director change.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 6. states: The center owner(s), or the board president or chairperson, shall notify the department immediately when there is a change of directors and shall have a qualifying criminal background check on file as required by 5 CSR 25-600.020 General Requirements.
Correction Required
The facility shall notify the department immediately when there is a change of directors and submit required background check request.

Correction Verification
Corrected on Site

Compliance Date
11/4/2022
Violation
The facility does not have an approved director on staff.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 3. states: The licensee is required to maintain an approved certificated group child care home provider or center director on staff.
Correction Required
The facility shall have an approved director/group home provider.

Correction Verification
Submit Documentation

Compliance Date

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
Not Observed
5 CSR 25-600.020 General Requirements
Not Observed
5 CSR 25-600.040 Background Screening Findings
Not Observed
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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed