DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

GROUP HOME AND CENTER INSPECTION REPORT
Facility Information

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

002942669

(417) 427-3249

4709 CHOUTEAU DR
NEOSHO
MO  64850-9123

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

4701 CHOUTEAU DR
NEOSHO
MO  64850-9123

FERGUSON, TINA RAE

tina@tristatefamilyymca.org

Incorporated

ANGEL DONSON

5 YEARS - 13 YEARS

64

GROUP HOME AND CENTER

 
Inspection Information

03/17/2025

12:00 PM

1:13 PM

UNANNOUNCED

COMPLIANCE MONITORING

2489215778


DocumentDocument-Date
APPLICATION 01/27/2022
CERTIFICATE OF GOOD STANDING 03/25/2022
CHILD CARE PRACTICES 03/25/2022
DAILY SCHEDULE 03/25/2022
DIAGRAM/INDOOR 03/25/2022
DIAGRAM/OUTDOOR 06/09/2022
DIRECTOR'S QUALIFICATIONS 06/09/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/25/2022
DISCIPLINE POLICIES 03/25/2022
JOB RESPONSIBILITIES 03/25/2022
POLICIES 03/25/2022
SAMPLE WEEKLY MENU 03/25/2022
LINES OF ADMINISTRATIVE AUTHORITY 06/09/2022
LOCAL BUILDING APPROVAL 06/14/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 06/14/2022
LOCAL ZONING APPROVAL 06/14/2022
SANITATION INSPECTION 01/13/2025
FIRE/SAFETY INSPECTION 12/10/2024
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/04/2025
ANNUAL DECLARATION 02/04/2025
EQUIPMENT LIST 03/17/2025




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.
Attendance at Time of Inspection
Total Staff 2
Total Children 23
StaffChildClass AgeNote
2 23 SCHOOL AGE Misty Renfro and Alexander Woodward with 23 children ages 5-12 years old.

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 equipment list did not contain a list of equipment as required in 5 CSR 25-500.092.
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
Corrected on Site

Compliance Date
3/17/2025
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.087 Fire Safety
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
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
Violation
 Provider Comments
Violation
Three child(ren) records did not include date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
3/17/2025
Violation
One child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
3/17/2025
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