MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
THE ADAIR COUNTY FAMILY YMCA, INC.

Facility DVN
002892768

Phone
(660) 665-1922

Physical Address
1815 E HAMILTON ST
KIRKSVILLE
MO 63501-3903

Owner
THE ADAIR COUNTY FAMILY YMCA, INC.

Mailing Address
1708 S JAMISON ST
KIRKSVILLE
MO 63501

Provider/Director
SPARKS, JAMIE

E-mail Address
krouner@adairymca.org

Incorporated
Incorporated

Child Care Specialist
BETHANY CARREL DUCKWORTH

Age Range
5 YEARS - 9 YEARS

Capacity
100

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
04/22/2024

Arrival Time
3:20 PM

Departure Time
3:54 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2468702624

Document	Document-Date
APPLICATION	05/20/2021
ARTICLES OF INCORPORATION	08/04/2021
CERTIFICATE OF GOOD STANDING	08/04/2021
CERTIFICATE OF INCORPORATION	08/04/2021
CHILD CARE PRACTICES	08/04/2021
DAILY SCHEDULE	08/04/2021
DIRECTOR'S JOB RESPONSIBILITIES	08/04/2021
DIRECTOR'S QUALIFICATIONS	05/14/2021
DISCIPLINE POLICIES	08/04/2021
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/04/2021
EQUIPMENT LIST	07/28/2023
JOB RESPONSIBILITIES	08/04/2021
LINES OF ADMINISTRATIVE AUTHORITY	08/04/2021
POLICIES	08/04/2021
SAMPLE FORMS	08/04/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	07/28/2023
SAMPLE WEEKLY MENU	08/04/2021
LICENSING ORIENTATION	05/17/2021
ANNUAL DECLARATION	07/28/2023

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 5

Total Children 36

Staff	Child	Class Age	Note
1	0	NO CHILDREN IN ATTENDANCE	Staff: Jamie Sparks. Not counted in staff/child ratio at time of inspection.
1	12	SCHOOL AGE	Staff: Lisa McClain. Age range 6 years through 7 years.
2	13	SCHOOL AGE	Staff: Terri Deeds and Mary Grace Schneller. Age range 5 years through 6 years.
1	11	SCHOOL AGE	Staff: Missy Dempsey. Age range 7 years through 8 years.

Compliance List
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 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 25-500.172 Emergency School Closings Not Observed
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Not Observed
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. — Compliance
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Compliance