DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

002942669

(417) 427-3249

4709 CHOUTEAU DR
NEOSHO
MO  64850-9123

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

4701 CHOUTEAU DR
NEOSHO
MO  64850-9123

FERGUSON, TINA RAE

tina@tristatefamilyymca.org

Incorporated

ANGEL DONSON

5 YEARS - 13 YEARS

64

GROUP HOME AND CENTER

 
Inspection Information

05/12/2023

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2447361065


DocumentDocument-Date
LOCAL ZONING APPROVAL 06/14/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 06/14/2022
LOCAL BUILDING APPROVAL 06/14/2022
LINES OF ADMINISTRATIVE AUTHORITY 06/09/2022
SAMPLE WEEKLY MENU 03/25/2022
POLICIES 03/25/2022
JOB RESPONSIBILITIES 03/25/2022
DISCIPLINE POLICIES 03/25/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/25/2022
DIRECTOR'S QUALIFICATIONS 06/09/2022
DIAGRAM/OUTDOOR 06/09/2022
DIAGRAM/INDOOR 03/25/2022
DAILY SCHEDULE 03/25/2022
CHILD CARE PRACTICES 03/25/2022
CERTIFICATE OF GOOD STANDING 03/25/2022
APPLICATION 01/27/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/15/2023
EQUIPMENT LIST 02/15/2023
ANNUAL DECLARATION 02/15/2023
FIRE/SAFETY INSPECTION 12/20/2022
SANITATION INSPECTION 11/15/2022




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
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
A caregiver did not obtain a Missouri Professional Development Identification (MOPD ID) number. The staff listed need a MOPD ID: Morgan Reece.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (F) 1. states: Caregivers shall obtain a Missouri Professional Development Identification (MOPD ID) number at www.OPENInitiative.org.
Correction Required
All caregivers shall obtain a MOPD ID.

Correction Verification
Submit Documentation

Compliance Date
5/12/2023
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by required immunizations verifying the type of vaccine and the month, day and year of administration was not on file for three child(ren).
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
4/19/2023
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
Six child(ren) records did not include date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
3/23/2023
Violation
Records were not available for inspection by the department upon request as evidenced by two staff records were not available at the facility for review.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (10) states: All records shall be available in the facility for inspection by the department upon request.
Correction Required
Records shall be available at the facility for inspection.

Correction Verification
Submit Documentation

Compliance Date
5/3/2023
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