MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
BOYS & GIRLS CLUBS OF GREATER ST. LOUIS - HAZELWOOD ELEMENTARY SCHOOL CLUB

Facility DVN
002787275

Phone
(314) 335-8350

Physical Address
1025 TRAMPE AVE
ST LOUIS
MO 63138-3013

Owner
BOYS & GIRLS CLUBS OF GREATER ST. LOUIS, INC.

Mailing Address
2901 N GRAND BLVD
ST LOUIS
MO 63107-2608

Provider/Director
WILSON, AUDREY RENE

E-mail Address
keisha@bgcstl.org

Incorporated
Incorporated

Child Care Specialist
VIKTORIA ZABARA

Age Range
6 YEARS - 13 YEARS

Capacity
125

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
08/30/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2453572256

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/28/2023
CERTIFICATE OF GOOD STANDING	08/28/2023
APPLICATION	07/22/2019
DIAGRAM/INDOOR	08/08/2019
DIAGRAM/OUTDOOR	08/08/2019
REGISTERING FICTITIOUS NAMES	08/08/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/08/2019
DAILY SCHEDULE	08/08/2019
SAMPLE WEEKLY MENU	08/08/2019
CHILD CARE PRACTICES	08/08/2019
DISCIPLINE POLICIES	08/08/2019
POLICIES	08/08/2019
SAMPLE FORMS	08/08/2019
DIRECTOR'S QUALIFICATIONS	08/08/2019
JOB RESPONSIBILITIES	08/08/2019
LINES OF ADMINISTRATIVE AUTHORITY	08/08/2019
STAFF SHEET	07/01/2022
EQUIPMENT LIST	08/28/2023
ANNUAL DECLARATION	07/01/2023

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 25-500.090 Disaster and Emergency Preparedness

Compliance

5 CSR 25-500.092 Furniture, Equipment and Materials

Compliance

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 25-500.172 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

Violation

	Provider Comments
Violation Criminal background check results were not on file for Levi Galloway. 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 8/29/2023

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