DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT
Facility Information

YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER KANSAS CITY

002358078

(816) 431-4911

1701 BRANCH ST
PLATTE CITY
MO  64079

YOUNG MEN'S CHRISTIAN ASSOCIATION OF GREATER KANSAS CITY

6901 SHAWNEE MISSION PKWY STE 300
OVERLAND PARK
KS  66202-4029

BLYTHE, LAURA CHRISTINE

ydslicensing@kansascityymca.org

Incorporated

MARY C MALOID

5 YEARS - 14 YEARS

99

SCHOOL AGE GHC

 
Inspection Information

05/22/2025

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2493818572


DocumentDocument-Date
DIRECTOR'S JOB RESPONSIBILITIES 08/02/2012
DISCIPLINE POLICIES 08/02/2012
LINES OF ADMINISTRATIVE AUTHORITY 08/02/2012
JOB RESPONSIBILITIES 08/02/2012
ARTICLES OF INCORPORATION 06/15/2012
SAMPLE FORMS 08/02/2012
CHILD CARE PRACTICES 08/02/2012
SAMPLE WEEKLY MENU 08/02/2012
DAILY SCHEDULE 08/09/2012
POLICIES 08/02/2012
DISASTER AND EMERGENCY PREPAREDNESS PLAN 05/23/2018
CERTIFICATE OF INCORPORATION 05/13/2014
DIRECTOR'S QUALIFICATIONS 03/19/2014
APPLICATION 05/27/2020
CERTIFICATE OF GOOD STANDING 05/17/2024
ANNUAL DECLARATION 04/01/2025
EQUIPMENT LIST 04/02/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 04/01/2025




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.

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
Violation
 Provider Comments
Violation
Medical examination report was not on file for Ember Poldberg 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
5/22/2025
Violation
A medical examination report did not include either a completed Risk Assessment for Tuberculosis form or a negative tuberculin skin test (TST) within 12 months of the individual's begin date at the facility for the following staff: Ember Poldberg.
Licensing Rule Reference
5 CSR 25-500.122 Medical Examination Reports (1) (B) . states: Medical examination reports shall include either a Tuberculosis (TB) Risk Assessment form, completed and signed by a health care professional, or a negative tuberculin skin test (TST) completed not more than twelve (12) months before beginning work in the facility. The Tuberculosis (TB) Risk Assessment form, revised March 2014, is incorporated by reference in this rule, as published by the Missouri Department of Health and Senior Services, PO Box 570, Jefferson City, MO 65102 and available by the Missouri Department of Health and Senior Services at https://health.mo.gov/living/healthcondiseases/communicable/tuberculosis/tbmanual/pdf/RiskAssessmentform.pdf. If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
Medical examination reports shall include Risk Assessment for Tuberculosis forms or negative tuberulin skin test (TST) as required.

Correction Verification
Submit Documentation

Compliance Date
5/22/2025
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
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