MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT

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Facility Information

Facility Name
JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002603945

Phone
(573) 657-9600

Physical Address
300 E BROADWAY
ASHLAND
MO 65010-9305

Owner
JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
PO BOX 56
ASHLAND
MO 65010-0056

Provider/Director
KELTNER, NABRINA MARIE

E-mail Address
nabrinas@jcymca.org

Incorporated
Incorporated

Child Care Specialist
JOY LYNN NICHOLS

Age Range
5 YEARS - 12 YEARS

Capacity
46

Facility Type
GROUP HOME AND CENTER

Limitations

Inspection Information

Date
10/03/2023

Arrival Time
4:15 PM

Departure Time
4:42 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2456060589

Document	Document-Date
DAILY SCHEDULE	06/15/2018
SAMPLE WEEKLY MENU	06/15/2018
CHILD CARE PRACTICES	06/09/2018
DISCIPLINE POLICIES	06/09/2018
ARTICLES OF INCORPORATION	10/22/2018
LINES OF ADMINISTRATIVE AUTHORITY	06/15/2018
POLICIES	06/15/2018
REGISTERING FICTITIOUS NAMES	10/22/2018
LOCAL BUILDING APPROVAL	02/22/2019
DIAGRAM/OUTDOOR	10/23/2018
JOB RESPONSIBILITIES	06/15/2018
LOCAL FIRE DEPARTMENT NOTIFICATION	02/01/2019
LOCAL ZONING APPROVAL	02/22/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/27/2019
APPLICATION	03/26/2019
STAFF SHEET	03/01/2019
CERTIFICATE OF GOOD STANDING	01/12/2021
DIRECTOR'S QUALIFICATIONS	09/28/2020
LICENSING ORIENTATION	06/09/2018
SAMPLE FORMS	10/02/2018
DIAGRAM/INDOOR	05/12/2021
SANITATION INSPECTION	01/18/2023
FIRE/SAFETY INSPECTION	03/17/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/02/2023
EQUIPMENT LIST	03/02/2023
ANNUAL DECLARATION	03/02/2023

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.

Attendance at Time of Inspection

Total Staff 4

Total Children 33

Staff	Child	Class Age	Note
4	33	SCHOOL AGE	children ages five to eleven; Nabrina Keltner, Dana Begemann, Brian Short, and Sage Crump


5 CSR 25-500.032 Organization and Administration Not Observed
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
5 CSR 25-500.132 Admission Policies and Procedures Not Observed
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 Not Observed
5 CSR 25-500.212 Transportation and Field Trips Not Observed
5 CSR 25-500.222 Records and Reports Not Observed
5 CSR 25-600.020 General Requirements Not Observed
5 CSR 25-600.040 Background Screening Findings Not Observed
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. — Not Observed
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Not Observed