MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
NORTHSIDE YOUTH AND SENIOR SERVICE CENTER, INC.

Facility DVN
000335720

Phone
(314) 723-3069

Physical Address
1224 S 14TH ST
ST LOUIS
MO 63104

Owner
NORTHSIDE YOUTH AND SENIOR SERVICE CENTER, INC.

Mailing Address
4120 MAFFITT AVE
ST LOUIS
MO 63113

Provider/Director
AVANT, DOMINIQUE ALVIN

E-mail Address
davant@nsyssc.com

Incorporated
Incorporated

Child Care Specialist
TANISHA BELL

Age Range
5 YEARS - 12 YEARS

Capacity
50

Facility Type
SCHOOL AGE

Limitations
AFTER SCHOOL CARE ONLY

Inspection Information

Date
12/05/2022

Arrival Time
4:10 PM

Departure Time
5:02 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2436742892

Document	Document-Date
DIRECTOR'S JOB RESPONSIBILITIES	04/10/2007
DAILY SCHEDULE	04/10/2007
SAMPLE WEEKLY MENU	04/10/2007
SAMPLE FORMS	04/10/2007
POLICIES	04/10/2007
DISCIPLINE POLICIES	04/10/2007
LINES OF ADMINISTRATIVE AUTHORITY	04/10/2007
JOB RESPONSIBILITIES	04/10/2007
DIRECTOR'S QUALIFICATIONS	03/31/2015
ARTICLES OF INCORPORATION	03/16/2007
CHILD CARE PRACTICES	04/02/2007
STAFF SHEET	01/30/2017
APPLICATION	02/11/2019
EQUIPMENT LIST	03/25/2022
ANNUAL DECLARATION	03/25/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/25/2022

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 6

Total Children 32

Staff	Child	Class Age	Note
6	32	SCHOOL AGE	K.H., H.P. U.R. I.B., J.G. (Teachers), and D.A (Director) were present with thirty-two children, 5-years-old-10-years-old.