MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
MEXICO AREA FAMILY YMCA INC.

Facility DVN
001379995

Phone
(573) 581-1540

Physical Address
1127 ADAMS ST
MEXICO
MO 65265-2288

Owner
MEXICO AREA FAMILY YMCA INC.

Mailing Address

Provider/Director
JORGENSEN, JUSTINE

E-mail Address
samantha.wilson@mexicoymca.org

Incorporated
Incorporated

Child Care Specialist
SUSAN MARIE DOUGLAS

Age Range
5 YEARS - 12 YEARS

Capacity
45

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
09/08/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2454146043

Document	Document-Date
POLICIES	08/07/2017
CHILD CARE PRACTICES	08/07/2017
DIAGRAM/INDOOR	07/25/2017
DIAGRAM/OUTDOOR	03/01/2023
DISCIPLINE POLICIES	08/07/2017
ARTICLES OF INCORPORATION	07/25/2017
SAMPLE FORMS	08/07/2017
APPLICATION	03/11/2019
STAFF SHEET	05/07/2019
DIRECTOR'S QUALIFICATIONS	10/15/2018
DISASTER AND EMERGENCY PREPAREDNESS PLAN	07/25/2017
ANNUAL DECLARATION	03/01/2023
SANITATION INSPECTION	12/19/2022
CERTIFICATE OF GOOD STANDING	10/28/2022
FIRE/SAFETY INSPECTION	12/07/2022
EQUIPMENT LIST	03/01/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/01/2023
SAMPLE WEEKLY MENU	07/27/1999
LOCAL ZONING APPROVAL	03/18/2022
LINES OF ADMINISTRATIVE AUTHORITY	03/11/2022
JOB RESPONSIBILITIES	03/11/2022
DAILY SCHEDULE	03/11/2022

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.

Compliance List

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

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 25-500.142 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

Violation

	Provider Comments
Violation Criminal background check results were not on file for Colony Bledsoe. 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 9/8/2023

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