DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

YMCA-O'FALLON BRANCH-MOUNT HOPE ELEMENTARY

000369917

(314) 471-4486

1099 MOUNT HOPE LN
O FALLON
MO  63366-1000

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3451 PHEASANT MEADOW DR
O FALLON
MO  63368-7324

CRAWFORD, KIMBERLY MICHELLE

kimberly.crawford@gwrymca.org

Incorporated

KIMBERLY KINNAIRD

5 YEARS - 12 YEARS

48

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

02/04/2025

4:22 PM

4:22 PM

UNANNOUNCED

SUPPLEMENTAL

2486975769


DocumentDocument-Date
DAILY SCHEDULE 06/21/1979
DISCIPLINE POLICIES 06/21/1979
DIRECTOR'S QUALIFICATIONS 01/14/2013
SAMPLE WEEKLY MENU 08/22/1984
SAMPLE FORMS 08/22/1984
POLICIES 08/22/1984
LINES OF ADMINISTRATIVE AUTHORITY 08/22/1984
JOB RESPONSIBILITIES 08/22/1984
DIAGRAM/OUTDOOR 12/22/1989
DIAGRAM/INDOOR 12/22/1989
CHILD CARE PRACTICES 06/21/1979
DIRECTOR'S JOB RESPONSIBILITIES 10/13/2015
LOCAL FIRE DEPARTMENT NOTIFICATION 06/20/2012
CERTIFICATE OF INCORPORATION 06/20/2012
ARTICLES OF INCORPORATION 06/20/2012
APPLICATION 10/07/2019
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/03/2016
STAFF SHEET 11/02/2020
REGISTERING FICTITIOUS NAMES 11/06/2023
CERTIFICATE OF GOOD STANDING 11/06/2023
EQUIPMENT LIST 10/25/2023
ANNUAL DECLARATION 10/25/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/25/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 9
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
Not Observed
5 CSR 25-500.042 Licensing Process
Not Observed
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
Evidence of local building and zoning approval was not received.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (B) states: Evidence of compliance with local building and zoning requirements, if applicable.
Correction Required
The facility shall submit evidence of local building/zoning approval as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The equipment list was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The staff sheet was not submitted.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date

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

Violation
The Family Care Safety Registry check was not conducted for Breanna Shilts 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

5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Not Observed
5 CSR 25-500.090 Disaster and Emergency Preparedness
Not Observed
5 CSR 25-500.092 Furniture, Equipment and Materials
Not Observed
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
The requirements for first aid/CPR were not met as evidenced by at least one caregiver certified in age-appropriate first aid was not on site.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (T) states: The licensee shall have documentation on file at the facility of current certification in age-appropriate first aid and cardiopulmonary resuscitation (CPR) training for a sufficient number of child care staff to ensure that there is one (1) caregiver at the facility for every twenty (20) children in the licensed capacity. At least one (1) caregiver with current certification in age appropriate first aid and CPR must be on site at all times when children are present. The training shall be certified by a nationally-recognized organization, such as the American Red Cross, American Heart Association, or an equivalent certification, include an in-person skills assessment, and be [and] approved by the department.
Correction Required
Required age-appropriate certification in first aid/CPR shall be on file, with at least one caregiver with certification on site.

Correction Verification
Submit Documentation

Compliance Date

Violation
A facility orientation was not conducted for a caregiver(s) before being left alone with children. The following staff need a facility orientation: Breanna Shilts
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (K) . states: The child care provider shall ensure that within seven (7) days of employment or volunteering, and before being left alone with children, that caregivers employed on or after August 30, 2019, receive a facility orientation. The facility orientation shall include--
Correction Required
The facility shall ensure that a facility orientation occurs within 7 days of employment or volunteering and before caregivers are left alone with children.

Correction Verification
Submit Documentation

Compliance Date

5 CSR 25-500.112 Staff/Child Ratios
Not Observed
5 CSR 25-500.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Breanna Shilts 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

5 CSR 25-500.132 Admission Policies and Procedures
Not Observed
5 CSR 25-500.142 Nighttime Care
Not Observed
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
Not Observed
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
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Breanna Shilts.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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. —
Not Observed
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Not Observed