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

12/19/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2437859324


DocumentDocument-Date
APPLICATION 08/23/2019
STAFF SHEET 11/22/2019
SANITATION INSPECTION 12/16/2021
DIRECTOR'S QUALIFICATIONS 12/19/2022
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: 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
Compliance
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.087 Fire Safety
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 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
12/19/2022
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 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.162 Overlap Care of Children
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
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