DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

MEXICO AREA FAMILY YMCA INC.

001379995

(573) 581-1540

1127 ADAMS ST
MEXICO
MO  65265-2288

MEXICO AREA FAMILY YMCA INC.



 

JORGENSEN, JUSTINE

samantha.wilson@mexicoymca.org

Incorporated

SUSAN MARIE DOUGLAS

5 YEARS - 12 YEARS

45

GROUP HOME AND CENTER

 
Inspection Information

03/01/2023

2:50 PM

4:11 PM

UNANNOUNCED

COMPLIANCE MONITORING

2442181869


DocumentDocument-Date
POLICIES 08/07/2017
CHILD CARE PRACTICES 08/07/2017
DIAGRAM/INDOOR 07/25/2017
DIAGRAM/OUTDOOR 08/07/2017
DISCIPLINE POLICIES 08/07/2017
ARTICLES OF INCORPORATION 07/25/2017
SAMPLE FORMS 08/07/2017
APPLICATION 03/11/2019
STAFF SHEET 05/07/2019
DIRECTOR'S QUALIFICATIONS 10/15/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN 07/25/2017
ANNUAL DECLARATION 03/01/2023
SANITATION INSPECTION 12/19/2022
CERTIFICATE OF GOOD STANDING 10/28/2022
FIRE/SAFETY INSPECTION 12/07/2022
EQUIPMENT LIST 03/01/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 03/01/2023
SAMPLE WEEKLY MENU 07/27/1999
LOCAL ZONING APPROVAL 03/18/2022
LINES OF ADMINISTRATIVE AUTHORITY 03/11/2022
JOB RESPONSIBILITIES 03/11/2022
DAILY SCHEDULE 03/11/2022




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 4
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 2
Total Children 22
StaffChildClass AgeNote
2 22 SCHOOL AGE Justine Jorgensen , director and Jordain Barnett, staff were present at inspection with 22 children ages 6 years to 11 years.

 
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 Lynn Thompson, Board President 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

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
Violation
 Provider Comments
Violation
The outdoor play equipment, 3 slide unit has 2 slides , from which a child might fall was more than six feet in height. The height was 7 feet 9 inches.
Licensing Rule Reference
5 CSR 25-500.092 Furniture, Equipment and Materials (3) (E) states: For facilities initially licensed after the effective date of these rules or for facilities installing new equipment, any part of the equipment from which children might fall shall not be more than six feet (6') in height.
Correction Required
The maximum height of any part of equipment, from which children might fall, shall not be more than six feet in height.

Correction Verification
Submit Documentation

Compliance Date

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 25-500.142 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
Violation
 Provider Comments
Violation
1 child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Lynn Thompson.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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