MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-JEFFERSON COUNTY BRANCH-HILLSBORO PRIMARY

Facility DVN
000557268

Phone
(636) 789-9926

Physical Address
101 LEON HALL PKY
HILLSBORO
MO 63050

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
1303 YMCA DR
FESTUS
MO 63028

Provider/Director
LINK, DANA

E-mail Address
dana.link@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
BRITTANY HECHT

Age Range
5 YEARS - 12 YEARS

Capacity
48

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
12/14/2022

Arrival Time
7:50 AM

Departure Time
8:29 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2437558478

Document	Document-Date
SAMPLE FORMS	05/11/1995
ARTICLES OF INCORPORATION	09/13/2011
LINES OF ADMINISTRATIVE AUTHORITY	08/19/1993
JOB RESPONSIBILITIES	08/19/1993
SAMPLE WEEKLY MENU	07/26/1993
DAILY SCHEDULE	07/26/1993
CHILD CARE PRACTICES	05/11/1995
POLICIES	05/11/1995
REGISTERING FICTITIOUS NAMES	08/28/2015
CERTIFICATE OF GOOD STANDING	02/22/2017
LOCAL FIRE DEPARTMENT NOTIFICATION	08/07/2000
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/20/2012
CERTIFICATE OF INCORPORATION	10/26/2006
DISCIPLINE POLICIES	07/26/1993
APPLICATION	04/12/2019
DIRECTOR'S QUALIFICATIONS	04/15/2019
STAFF SHEET	04/15/2019
DIRECTOR'S JOB RESPONSIBILITIES	04/15/2019
EQUIPMENT LIST	06/24/2021
ANNUAL DECLARATION	06/24/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/24/2021

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 3

Total Children 22

Staff	Child	Class Age	Note
3	22	SCHOOL AGE	DP, Site Manager MP & SL, Caregivers 22 - 5-10 Year Olds


5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Violation
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 Violation
5 CSR 25-500.092 Furniture, Equipment and Materials Compliance
5 CSR 25-500.102 Personnel Violation
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Violation
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 Violation
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
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