MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT

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Facility Information

Facility Name
TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

Facility DVN
002064402

Phone
(573) 754-9027

Physical Address
700 W ADAMS ST
BOWLING GREEN
MO 63334-2046

Owner
TWIN PIKE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

Mailing Address
614 KELLY LN
LOUISIANA
MO 63353-2409

Provider/Director
ASH, DENISE MARIE

E-mail Address
Ashley.Chamberlain@twinpikefamilyymca.org

Incorporated
Incorporated

Child Care Specialist
AMY MITCHELL

Age Range
5 YEARS - 13 YEARS

Capacity
96

Facility Type
SCHOOL AGE GHC

Limitations

Inspection Information

Date
05/13/2025

Arrival Time
2:55 PM

Departure Time
3:42 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2493163662

Document	Document-Date
SAMPLE FORMS	09/04/2007
LINES OF ADMINISTRATIVE AUTHORITY	08/27/2007
LOCAL FIRE DEPARTMENT NOTIFICATION	09/04/2007
DIRECTOR'S JOB RESPONSIBILITIES	09/04/2007
DAILY SCHEDULE	09/04/2007
CHILD CARE PRACTICES	10/02/2007
CERTIFICATE OF INCORPORATION	09/04/2007
ARTICLES OF INCORPORATION	09/04/2007
APPLICATION	02/14/2019
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/18/2025
ANNUAL DECLARATION	04/02/2025
CERTIFICATE OF GOOD STANDING	04/17/2024
EQUIPMENT LIST	01/15/2025
JOB RESPONSIBILITIES	09/04/2007
POLICIES	10/18/2016
SAMPLE WEEKLY MENU	03/20/2009
DISCIPLINE POLICIES	10/18/2016
DIRECTOR'S QUALIFICATIONS	07/22/2024

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 7

Total Children 49

Staff	Child	Class Age	Note
1	0	NO CHILDREN IN ATTENDANCE	Denise Ash (Site Director) was present during the inspection.
4	32	SCHOOL AGE	Linda Arnold, Linda Preston, Molly Grote,and Katelyn Luebrecht were in attendance with 32 children ages 5-years-old through 13-years-old.
2	17	SCHOOL AGE	Lacy McClury and Cindy Perkins were in attendance with 17 children ages 5-years-old through 13-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 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 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 25-500.162 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 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