MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Facility DVN
002603945

Phone
(573) 657-9622

Physical Address
809 S HENRY CLAY BLVD
ASHLAND
MO 65010-9436

Owner
JEFFERSON CITY AREA YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
405 S MAIN ST
ASHLAND
MO 65010-9550

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
99

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
10/16/2024

Arrival Time
3:20 PM

Departure Time
4:05 PM

Notice
UNANNOUNCED

Inspection Type
POST LICENSING

Inspection ID
2480191676

Document	Document-Date
LOCAL FIRE DEPARTMENT NOTIFICATION	02/01/2019
DIRECTOR'S QUALIFICATIONS	09/28/2020
SAMPLE FORMS	10/02/2018
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	03/04/2024
DISASTER AND EMERGENCY PREPAREDNESS PLAN	06/05/2024
EQUIPMENT LIST	06/05/2024
DIRECTOR'S JOB RESPONSIBILITIES	06/15/2018
LICENSING ORIENTATION	06/09/2018
JOB RESPONSIBILITIES	06/15/2018
POLICIES	06/15/2018
LINES OF ADMINISTRATIVE AUTHORITY	06/15/2018
DAILY SCHEDULE	06/15/2018
SAMPLE WEEKLY MENU	06/15/2018
DISCIPLINE POLICIES	06/09/2018
CHILD CARE PRACTICES	06/09/2018
CERTIFICATE OF GOOD STANDING	06/05/2024
ARTICLES OF INCORPORATION	10/22/2018
APPLICATION	05/20/2024

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 6

Total Children 69

Staff	Child	Class Age	Note
2	27	SCHOOL AGE	children ages six and seven; Sage Crump and Evan Thomassen
2	20	SCHOOL AGE	children ages five and six; Angela Egloff and Jules Patton
2	22	SCHOOL AGE	children ages eight to eleven; Brian Short and Rhonda Stowe

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 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 Not Observed
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 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