DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

SALT FORK YOUNG MEN'S CHRISTIAN ASSOCIATION

002487081

(660) 886-9622

411 N BENTON AVE
MARSHALL
MO  65340-1301

SALT FORK YOUNG MEN'S CHRISTIAN ASSOCIATION

740 E YERBY ST
MARSHALL
MO  65340-2352

HOPPING, DALLAS RAY

alexander@saltforkymca.org

Incorporated

JONATHAN BRADLEY

5 YEARS - 12 YEARS

40

SCHOOL AGE

 
Inspection Information

12/21/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2437855657


DocumentDocument-Date
CERTIFICATE OF GOOD STANDING 12/16/2021
CHILD CARE PRACTICES 12/21/2021
DAILY SCHEDULE 12/21/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/24/2022
EQUIPMENT LIST 11/28/2022
DIRECTOR'S QUALIFICATIONS 12/21/2021
SAMPLE WEEKLY MENU 12/21/2021
LINES OF ADMINISTRATIVE AUTHORITY 12/09/2021
ARTICLES OF INCORPORATION 08/12/2021
CERTIFICATE OF INCORPORATION 08/12/2021
JOB RESPONSIBILITIES 12/09/2021
DIRECTOR'S JOB RESPONSIBILITIES 07/28/2021
APPLICATION 12/29/2021
DISCIPLINE POLICIES 12/29/2021
POLICIES 12/29/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN 12/29/2021
LICENSING ORIENTATION 12/28/2021
ANNUAL DECLARATION 11/28/2022




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.

 
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
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for DH, PC, HT, MM, and SA within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date
12/9/2022
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
Compliance
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by Child A's immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
12/20/2022
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
Compliance
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