MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
YMCA-FOUR RIVERS BRANCH-NEW HAVEN ELEMENTARY

Facility DVN
002767439

Phone
(636) 239-5704

Physical Address
201 ELTON AVE
NEW HAVEN
MO 63068-1194

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
400 GRAND AVE
WASHINGTON
MO 63090-1204

Provider/Director
MUELLER, MELISSA

E-mail Address
melissa.mueller@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
LAUREN R RAYWARNKE

Age Range
5 YEARS - 12 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
04/11/2024

Arrival Time
2:45 PM

Departure Time
3:40 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2468223919

Document	Document-Date
DAILY SCHEDULE	04/23/2019
DIAGRAM/INDOOR	04/16/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/23/2019
CHILD CARE PRACTICES	05/06/2019
DISCIPLINE POLICIES	05/06/2019
JOB RESPONSIBILITIES	04/24/2019
POLICIES	05/06/2019
LINES OF ADMINISTRATIVE AUTHORITY	04/23/2019
SAMPLE WEEKLY MENU	04/23/2019
SAMPLE FORMS	04/23/2019
STAFF SHEET	04/23/2019
DIAGRAM/OUTDOOR	04/24/2019
APPLICATION	04/23/2019
DIRECTOR'S QUALIFICATIONS	12/01/2020
EQUIPMENT LIST	03/21/2024
CERTIFICATE OF GOOD STANDING	02/15/2021
REGISTERING FICTITIOUS NAMES	02/22/2021
ANNUAL DECLARATION	03/21/2024
DIRECTOR'S JOB RESPONSIBILITIES	04/24/2019
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/21/2024

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 1

Total Children 3

Staff	Child	Class Age	Note
1	3	SCHOOL AGE	Caregiver Franni Goetti with 3 children ages 7 through 8 year's old.