DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT
Facility Information

YMCA-SOUTH CITY BRANCH-ST. AMBROSE CATHOLIC SCHOOL

003019512

(314) 772-1437

5110 WILSON AVE
ST LOUIS
MO  63110-3110

GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

3150 SUBLETTE AVE
ST LOUIS
MO  63139-1467

DECLUE, CHRISTINA

christina.declue@gwrymca.org

Incorporated

TARA D BURNETT

5 YEARS - 13 YEARS

40

SCHOOL AGE GHC

AFTER SCHOOL CARE ONLY
 
Inspection Information

03/24/2025

3:07 PM

4:46 PM

UNANNOUNCED

COMPLIANCE MONITORING

2489709438


DocumentDocument-Date
APPLICATION 07/05/2023
CERTIFICATE OF GOOD STANDING 07/05/2023
ARTICLES OF INCORPORATION 07/05/2023
CERTIFICATE OF INCORPORATION 07/05/2023
CHILD CARE PRACTICES 08/01/2023
DAILY SCHEDULE 08/01/2023
DIRECTOR'S JOB RESPONSIBILITIES 08/01/2023
DIRECTOR'S QUALIFICATIONS 08/01/2023
DISCIPLINE POLICIES 08/01/2023
EQUIPMENT LIST 08/02/2023
JOB RESPONSIBILITIES 08/01/2023
LICENSING ORIENTATION 02/13/2022
LINES OF ADMINISTRATIVE AUTHORITY 08/01/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/01/2023
POLICIES 08/01/2023
SAMPLE FORMS 08/01/2023
SAMPLE WEEKLY MENU 08/01/2023
DISASTER AND EMERGENCY PREPAREDNESS PLAN 08/01/2023




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 7
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 16
StaffChildClass AgeNote
2 16 SCHOOL AGE Teacher, Brenda Walker and Teacher, Dustin Jacobs present with sixteen children ages 6-years-old to 13-years-old

Compliance List
5 CSR 25-500.032 Organization and Administration
Not Observed
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

5 CSR 25-500.052 Annual Requirements
Not Observed
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 , the facility has an approved variance to transport the emergency preparedness plan. The plan does not include the phone numbers for ambulance, local fire department, police department, poison control center or the local news station.
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

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

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

5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Violation
 Provider Comments
Violation
The requirements for obtaining 12 clock hours each calendar year were not met. For the calendar year of 2023, the staff listed need the following information: Brenda Walker 12 clock hours and Casey Lord 2 clock hours.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (3) (A) states: The center director, group child care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each caregiver.

Correction Verification
Submit Documentation

Compliance Date

Violation
The director was not responsible for planning, monitoring, and managing the facility's daily program as evidenced by the facility has an approved variance to have a log documenting the director's site visits at each location at least every other week. . The attendance log was not available during inspection.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (2) (A) 1. . states: An approved certificated group child care home provider or center director shall be an adult who is responsible for planning, monitoring, and managing the facility’s daily program.
Correction Required
The director or group home provider shall be an approved, certificated adult who is responsible for the daily program.

Correction Verification
Submit Documentation

Compliance Date

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
Not Observed
5 CSR 25-500.142 Nighttime Care
Compliance
5 CSR 25-500.162 Overlap Care of Children
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
Violation
 Provider Comments
Violation
Requirements for immunization reports on file were not met as evidenced by two immunization record(s) was/were not on file .
Licensing Rule Reference
5 CSR 25-500.192 Health Care (4) (A) states: No child shall be permitted to enroll in or attend any day care facility caring for ten (10) or more children unless the child has been immunized adequately against vaccine preventable childhood illnesses specified by the department in accordance with recommendations of the Immunization Practices Advisory Committee (ACIP). The parent or guardian of the child shall provide satisfactory evidence of the required immunizations. Satisfactory evidence means a statement, certificate or record from a physician or other recognized health facility or personnel, stating that the required immunizations have been given to the child and verifying the type of vaccine and the month, day and year of administration.
Correction Required
Child immunization requirements shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Compliance
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. —
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance