MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

Back

Facility Information

Facility Name
YMCA-FOUR RIVERS BRANCH-NEW HAVEN ELEMENTARY

Facility DVN
002767439

Phone
(636) 239-5704

Physical Address
201 ELTON AVE
NEW HAVEN
MO 63068-1194

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
400 GRAND AVE
WASHINGTON
MO 63090-1204

Provider/Director
PENNOCK, DALLAS JORDAN

E-mail Address
melissa.mueller@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
ALLA GERASIMOVA

Age Range
5 YEARS - 12 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
04/13/2023

Arrival Time
8:30 AM

Departure Time
9:14 AM

Notice
ANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2445239939

Document	Document-Date
DAILY SCHEDULE	04/23/2019
DIAGRAM/INDOOR	04/16/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/23/2019
CHILD CARE PRACTICES	05/06/2019
DISCIPLINE POLICIES	05/06/2019
JOB RESPONSIBILITIES	04/24/2019
POLICIES	05/06/2019
LINES OF ADMINISTRATIVE AUTHORITY	04/23/2019
SAMPLE WEEKLY MENU	04/23/2019
SAMPLE FORMS	04/23/2019
STAFF SHEET	04/23/2019
DIAGRAM/OUTDOOR	04/24/2019
APPLICATION	04/23/2019
DIRECTOR'S QUALIFICATIONS	12/01/2020
EQUIPMENT LIST	04/09/2021
CERTIFICATE OF GOOD STANDING	02/15/2021
REGISTERING FICTITIOUS NAMES	02/22/2021
ANNUAL DECLARATION	04/07/2023
DIRECTOR'S JOB RESPONSIBILITIES	04/24/2019
EQUIPMENT LIST	04/07/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/07/2023

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

NOTE

The licensee is responsible for compliance with all licensing rules, including but not limited to the rules listed on this compliance report form.

Staff	Child	Class Age	Note
0	0	NO CHILDREN IN ATTENDANCE	Melissa Mueller - a child care director with no children in attendance. The site is currently in-active.