DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

RANDOLPH AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

002196707

(660) 263-3600

1000 SHEPHARD BROTHERS BLVD
MOBERLY
MO  65270-3800

RANDOLPH AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

PO BOX 176
MOBERLY
MO  65270-0176

APPLEGARTH, BETHANY ERIN

bjamerson@randolphareaymca.com

Incorporated

SUSAN MARIE DOUGLAS

5 YEARS - 12 YEARS

49

GROUP HOME AND CENTER

 
Inspection Information

11/16/2022

3:40 PM

4:13 PM

UNANNOUNCED

REINSPECTION

2435623060


DocumentDocument-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: 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 4
Total Children 12
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Ben Jamerson, acting CEO
3 12 SCHOOL AGE C.K., staff, D.S. staff, were present with 12 children ages 8 to 11 years

 
5 CSR 25-500.032 Organization and Administration
Not Observed
5 CSR 25-500.042 Licensing Process
Violation
 Provider Comments
Violation
The ages of children was/were exceeded as evidenced by 3 year old was present .
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (18) states: The number and ages of children a group child care home or child care center is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.
Correction Required
The facility shall maintain compliance with the specifications on the license.

Correction Verification
Return Inspection

Compliance Date
11/16/2022
5 CSR 25-500.052 Annual Requirements
Not Observed
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
5 CSR 25-500.087 Fire Safety
Not Observed
5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials
Not Observed
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
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
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Not Observed
5 CSR 25-500.132 Admission Policies and Procedures
Not Observed
5 CSR 25-500.142 Nighttime Care
Not Observed
5 CSR 25-500.162 Overlap Care of Children
Not Observed
5 CSR 25-500.172 Emergency School Closings
Not Observed
5 CSR 25-500.182 Child Care Program
Not Observed
5 CSR 25-500.192 Health Care
Not Observed
5 CSR 25-500.202 Nutrition and Food Service
Not Observed
5 CSR 25-500.212 Transportation and Field Trips
Not Observed
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