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) 287-1164

500 S KEENEY ST
COLE CAMP
MO  65325-1059

BOYS' AND GIRLS' CLUBS OF WEST CENTRAL MISSOURI

3100 AARON AVE
SEDALIA
MO  65301-7907

HAZEL, JESSICA RENE

lschirlls@bgckids.com

Incorporated

KATHLEEN WILSON

5 YEARS - 16 YEARS

60

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

10/11/2024

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2479929319


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 09/17/2024
ANNUAL DECLARATION 09/26/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 09/17/2024




Inspection determined facility to be in compliance with licensing rules.
Compliance 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.

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
Violation
 Provider Comments
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
9/19/2024
Violation
The Family Care Safety Registry check was not conducted for Emily Hatfield, Jennifer Peace, Logan Smart, Karlie Tucker, Jessica Hazel 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
10/11/2024
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
Violation
 Provider Comments
Violation
Medical examination report was not on file for Emily Hatfield and Jennifer Peace as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
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
10/11/2024
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: Emily Hatfield and Jennifer Peace.
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
10/11/2024
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
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
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Compliance
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were older than five (5) years for Jessica Hazel.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (5) states: Criminal background checks shall be completed for each child care staff member every five (5) years.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
9/19/2024
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