MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
SALT FORK YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002487081

Phone
(660) 886-9622

Physical Address
411 N BENTON AVE
MARSHALL
MO 65340-1301

Owner
SALT FORK YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
740 E YERBY ST
MARSHALL
MO 65340-2352

Provider/Director
HOPPING, DALLAS RAY

E-mail Address
alexander@saltforkymca.org

Incorporated
Incorporated

Child Care Specialist
JONATHAN BRADLEY

Age Range
5 YEARS - 12 YEARS

Capacity
40

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
05/02/2023

Arrival Time
3:20 PM

Departure Time
3:43 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2446434995

Document	Document-Date
CERTIFICATE OF GOOD STANDING	12/16/2021
CHILD CARE PRACTICES	12/21/2021
DAILY SCHEDULE	12/21/2021
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
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/24/2022
EQUIPMENT LIST	11/28/2022
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.

Attendance at Time of Inspection

Total Staff 1

Total Children 10

Staff	Child	Class Age	Note
1	10	SCHOOL AGE	Teacher Heather Thompson with children ages 6 years through 10 years old.


5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Not Observed
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials Not Observed
5 CSR 25-500.102 Personnel Not Observed
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Not Observed
5 CSR 25-500.132 Admission Policies and Procedures Not Observed
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 Not Observed
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 Not Observed
5 CSR 25-600.020 General Requirements Not Observed
5 CSR 25-600.040 Background Screening Findings Not Observed
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. — Not Observed
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Not Observed