DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-SOUTH CITY BRANCH-ST. AMBROSE CATHOLIC SCHOOL

003019512

(314) 772-1437

5110 WILSON AVE
ST LOUIS
MO  63110-3110

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3150 SUBLETTE AVE
ST LOUIS
MO  63139-1467

DECLUE, CHRISTINA

christina.declue@gwrymca.org

Incorporated

BRITTNEY RALPH

5 YEARS - 13 YEARS

40

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

02/27/2024

3:15 AM

3:36 PM

UNANNOUNCED

COMPLIANCE MONITORING

2465129913


DocumentDocument-Date
APPLICATION 07/05/2023
CERTIFICATE OF GOOD STANDING 07/05/2023
ARTICLES OF INCORPORATION 07/05/2023
CERTIFICATE OF INCORPORATION 07/05/2023
CHILD CARE PRACTICES 08/01/2023
DAILY SCHEDULE 08/01/2023
DIRECTOR'S JOB RESPONSIBILITIES 08/01/2023
DIRECTOR'S QUALIFICATIONS 08/01/2023
DISCIPLINE POLICIES 08/01/2023
EQUIPMENT LIST 08/02/2023
JOB RESPONSIBILITIES 08/01/2023
LICENSING ORIENTATION 02/13/2022
LINES OF ADMINISTRATIVE AUTHORITY 08/01/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/01/2023
POLICIES 08/01/2023
SAMPLE FORMS 08/01/2023
SAMPLE WEEKLY MENU 08/01/2023
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/01/2023




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 2
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 2
Total Children 24
StaffChildClass AgeNote
2 24 SCHOOL AGE Care givers, Brenda Walker and Casey Lord were present with twenty-four children ages ranging from 5-years-old to 13-years-old.

 
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
Violation
 Provider Comments
Violation
Requirements of the facility's participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
1 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
Compliance
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