DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

BOYS & GIRLS CLUB OF JEFFERSON CITY

001834939

(573) 634-2582

1105 LAFAYETTE ST
JEFFERSON CITY
MO  65101-3572

BOYS & GIRLS CLUB OF JEFFERSON CITY

PO BOX 105558
JEFFERSON CITY
MO  65110-5558

MARSHALL, KELLY NATASHA

kmarshall@bgcjc.com

Incorporated

KATHLEEN WILSON

5 YEARS - 16 YEARS

250

GROUP HOME AND CENTER

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

05/16/2023

12:45 PM

4:39 PM

UNANNOUNCED

COMPLIANCE MONITORING

2447482498


DocumentDocument-Date
CERTIFICATE OF GOOD STANDING 07/11/2017
ARTICLES OF INCORPORATION 07/11/2017
JOB RESPONSIBILITIES 07/11/2017
LINES OF ADMINISTRATIVE AUTHORITY 07/11/2017
SAMPLE WEEKLY MENU 07/11/2017
DIAGRAM/INDOOR 07/12/2017
DIAGRAM/OUTDOOR 07/12/2017
REGISTERING FICTITIOUS NAMES 07/11/2017
DAILY SCHEDULE 07/12/2017
CHILD CARE PRACTICES 07/11/2017
DISCIPLINE POLICIES 07/11/2017
POLICIES 07/11/2017
LLC OPERATING AGREEMENT 05/17/2017
LLC ARTICLES OF ORGANIZATION 05/17/2017
LOCAL FIRE DEPARTMENT NOTIFICATION 08/09/2017
DIRECTOR'S QUALIFICATIONS 08/25/2017
LOCAL ZONING APPROVAL 06/02/2017
LOCAL BUILDING APPROVAL 06/02/2017
APPLICATION 07/03/2019
STAFF SHEET 07/03/2019
EQUIPMENT LIST 04/25/2022
SANITATION INSPECTION 01/11/2022
ANNUAL DECLARATION 04/25/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/25/2022
FIRE/SAFETY INSPECTION 12/15/2022




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 15
Total Children 118
StaffChildClass AgeNote
6 0 NO CHILDREN IN ATTENDANCE Kelly Marshall (director), Wade Middaugh (CEO), Shelby Wankum (executive assist), John Schaefferkoetter (HR/fund raising), Jennifer Ennes (director of admin/finances) and Donna Watson (cook) all present at center but without children in attendance.
1 14 SCHOOL AGE Hannah Buschman with fourteen children age 8 years old.
2 25 SCHOOL AGE Tiera Jones and Nyla Bennett with twenty five children ages 8-9 years old.
2 23 SCHOOL AGE Mekiah Shofner and Miles Cooper with twenty three children ages 10-11 years old.
1 12 SCHOOL AGE Jaida Walker with twelve children ages 11-12 years old.
1 15 SCHOOL AGE Kourtney Davis with fifteen children age 6 years old.
1 14 SCHOOL AGE Tai-Rece Basey with fourteen children ages 6-7 years old.
1 15 SCHOOL AGE Donna Horton-Taylor with fifteen children ages 6-7 years old.

 
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 A.Brown, A.Sappington, D.Taylor, J.Ennes, D.Watson, D.Chaney, K.Marshall, T.Basey, W.Middaugh, and N.Smith 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

Violation
The Family Care Safety Registry check was not conducted for E.Dixon, C.Golden, L.Gardner, D.Stallings, M.Cooper, P.Winn, J.Schaefferkoetter, J.Walker, H.Buschman, S.Wankum, N.Bennett, and K.Davis 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
Corrected on Site

Compliance Date
5/16/2023
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 requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2022, the staff listed need the following information: P.Winn needs 3.0 hours, K.Marshall needs 6.5 hours, N.Smith needs 4.0 hours, N.Bennett needs 9.0 hours, and K.Davis needs 9.5 hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report(s) was/were not on file for J.Walker, N.Smith, and M.Shofner as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (A) states: All persons working in a child care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
A medical examination report did not include either a Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) for the following staff: M.Cooper, M.Shofner, J.Walker, and N.Smith.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberculin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date

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