DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

002073036

(660) 826-8331

500 S KEENEY ST
COLE CAMP
MO  65325-1059

BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

3100 AARON AVE
SEDALIA
MO  65301-7907

CROSSWHITE, SHAYLEN ELIZABETH

lschirlls@bgckids.com

Incorporated

SHARLENE WHEATLEY

5 YEARS - 16 YEARS

60

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

09/19/2023

2:30 PM

4:53 PM

UNANNOUNCED

COMPLIANCE MONITORING

2455508285


DocumentDocument-Date
SAMPLE FORMS 08/20/2009
LOCAL FIRE DEPARTMENT NOTIFICATION 08/20/2009
JOB RESPONSIBILITIES 08/20/2009
CHILD CARE PRACTICES 08/20/2009
SAMPLE WEEKLY MENU 08/20/2009
POLICIES 08/20/2009
LINES OF ADMINISTRATIVE AUTHORITY 08/20/2009
DIRECTOR'S QUALIFICATIONS 03/01/2010
DAILY SCHEDULE 08/20/2009
ARTICLES OF INCORPORATION 08/20/2009
CERTIFICATE OF GOOD STANDING 11/14/2013
APPLICATION 09/30/2019
STAFF SHEET 09/23/2021
EQUIPMENT LIST 09/19/2023
ANNUAL DECLARATION 09/12/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 09/19/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 18
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 3
Total Children 66
StaffChildClass AgeNote
3 66 SCHOOL AGE Karlie Tucker, Daynelle Wolford and Logan Smart with sixty six children ages 5-16 years old.

Compliance List
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Violation
 Provider Comments
Violation
The number of children was/were exceeded as evidenced by 66 children ages 5 to 16 years old were present when attendance was taken. .
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (18) states: The number and ages of children a group child care home or child care center is authorized to have in care at any one time shall be specified on the license and shall not be exceeded except as permitted within these rules.
Correction Required
The facility shall maintain compliance with the specifications on the license.

Correction Verification
Return Inspection

Compliance Date

5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Brittany Tubbs, Gary Beckman, Tyler Hudson, Laurie Schrills, Patricia Henson 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 Jessica Hazel, Karlie Tucker, Brittany Tubbs, Logan Smart or Daynelle Wolford on 9/19/23 annual inspection 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 Annual Declaration was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (A) states: An Annual Declaration for Licensed Facility form, revised 2021 and incorporated by reference in this rule. As published by the Missouri Department of Elementary and Secondary Education, PO Box 480, Jefferson City, MO 65102-0480 and available by the department at https://dese.mo.gov/childhood/forms, indicating the licensee’s intent to continue operating a licensed group child care home or child care center and agreement to comply with all statutes and department licensing rules.
Correction Required
The facility shall submit the Annual Declaration as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The staff sheet was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Corrected on Site

Compliance Date
9/19/2023
Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Corrected on Site

Compliance Date
9/19/2023
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
Violation
 Provider Comments
Violation
The department did not receive notification of a director change.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 6. states: The center owner(s), or the board president or chairperson, shall notify the department immediately when there is a change of directors and shall have a qualifying criminal background check on file as required by 5 CSR 25-600.020 General Requirements.
Correction Required
The facility shall notify the department immediately when there is a change of directors and submit required background check request.

Correction Verification
Submit Documentation

Compliance Date

Violation
In the absence of the director, there was no responsible individual designated to be in charge of the facility.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 5. states: In the absence of the center director or group child care home provider, another responsible individual shall be designated to be in charge of the facility.
Correction Required
The facility shall designate someone in charge in the absence of the director/group home provider.

Correction Verification
Submit Documentation

Compliance Date

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: Brittany Tubbs needs 6.5 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
Violation
 Provider Comments
Violation
Staff/child ratio requirements were not met as evidenced by 66 children, ages 5-16 years old, were cared for by three (Karlie Tucker, Logan Smart, Daynelle Wolford) caregiver(s).
Licensing Rule Reference
5 CSR 25-500.112 Staff/Child Ratios (1) (D) states: Ages Five (5) and Up. Groups composed solely of five (5)-year olds and older shall have no less than one (1) adult to every sixteen (16) children;
Correction Required
Correct staff/child ratios shall be maintained.

Correction Verification
Return Inspection

Compliance Date

5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: B.Tubbs, L.Smart and D.Wolford.
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 tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
Medical examination report was not on file for Jessica Hazel as evidenced by the medical examination was not signed by the required medical source.
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

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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by 3 children's immunization record(s) was/were not on file .
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

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
On 9/19/23 One child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
On 9/19/23 One child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
1 child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
1 child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
On 9/19/23 One child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
On 9/19/23 One child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Madison Clifton, Gary Beckman, Laurie Schrills, Patricia Henson.
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

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