DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

NORTHSIDE YOUTH AND SENIOR SERVICE CENTER, INC.

000335720

(314) 723-3069

1224 S 14TH ST
ST LOUIS
MO  63104

NORTHSIDE YOUTH AND SENIOR SERVICE CENTER, INC.

4120 MAFFITT AVE
ST LOUIS
MO  63113

AVANT, DOMINIQUE ALVIN

davant@nsyssc.com

Incorporated

TARA D BURNETT

5 YEARS - 12 YEARS

50

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

02/14/2025

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2487636815


DocumentDocument-Date
DIRECTOR'S JOB RESPONSIBILITIES 04/10/2007
DAILY SCHEDULE 04/10/2007
SAMPLE WEEKLY MENU 04/10/2007
SAMPLE FORMS 04/10/2007
POLICIES 04/10/2007
DISCIPLINE POLICIES 04/10/2007
LINES OF ADMINISTRATIVE AUTHORITY 04/10/2007
JOB RESPONSIBILITIES 04/10/2007
DIRECTOR'S QUALIFICATIONS 03/31/2015
ARTICLES OF INCORPORATION 03/16/2007
CHILD CARE PRACTICES 04/02/2007
STAFF SHEET 01/30/2017
APPLICATION 02/11/2019
EQUIPMENT LIST 04/01/2024
ANNUAL DECLARATION 04/01/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/01/2024




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
Violation
 Provider Comments
Violation
The name, address and telephone number of the board chairperson was not prominently posted near the license.
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (13) (C) states: Board president or chairperson;
Correction Required
The name, address, and board president or chairperson shall be posted near the license.

Correction Verification
Submit Documentation

Compliance Date
2/14/2025
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
Violation
 Provider Comments
Violation
The facility's list of emergency numbers are not posted in each room used for child care, specifically cafeteria and gymnasium.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 1. B. states: A list of emergency numbers, including 911, if available, the fire department, police department, ambulance service, poison control center, and local radio station;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date
2/14/2025
Violation
The facility's evacuation route diagram was not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 2. states: A diagram of evacuation routes from the room;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date
2/14/2025
Violation
The facility’s special instructions for infants and non-ambulatory children were not posted in each room.
Licensing Rule Reference
5 CSR 25-500.090 Disaster and Emergency Preparedness (2) (B) 3. states: Any special instructions for infants and non-ambulatory children;
Correction Required
Facility must post information as required.

Correction Verification
Submit Documentation

Compliance Date
2/14/2025
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
Compliance
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
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