MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
001632719

Phone
(417) 455-9999

Physical Address
4701 CHOUTEAU DR
NEOSHO
MO 64850-9123

Owner
TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
4701 CHOUTEAU DR
NEOSHO
MO 64850-9123

Provider/Director
SMITH, ELIZABETH L

E-mail Address
tina@tristatefamilyymca.org

Incorporated
Incorporated

Child Care Specialist
ANGEL DONSON

Age Range
24 MONTHS - 6 YEARS

Capacity
42

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
09/19/2023

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2454990158

Document	Document-Date
DIRECTOR'S QUALIFICATIONS	03/26/2012
APPLICATION	05/16/2018
STAFF SHEET	07/13/2018
CERTIFICATE OF GOOD STANDING	07/31/2018
ANNUAL DECLARATION	07/03/2023
EQUIPMENT LIST	07/03/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/03/2023
FIRE/SAFETY INSPECTION	07/13/2023
SANITATION INSPECTION	05/31/2023

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.