DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT
Facility Information

BUTLER Y-CLUB

003090275

(660) 679-6591

4 N HIGH ST
BUTLER
MO  64730-1332

OSAGE PRAIRIE YOUNG MEN'S CHRISTIAN ASSOCIATION, INC.

500 W HIGHLAND AVE
NEVADA
MO  64772-1067

LEFHOLZ, JACKIE

SMCCULLOUGH@OPYMCA.ORG

Incorporated

KRYSTAL WILLIAMS

5 YEARS - 12 YEARS

60

SCHOOL AGE GHC

 
Inspection Information

08/21/2025

3:40 PM

4:41 PM

UNANNOUNCED

POST LICENSING

2499038289


DocumentDocument-Date
SAMPLE FORMS 10/29/2024
DISCIPLINE POLICIES 10/29/2024
DAILY SCHEDULE 10/29/2024
EQUIPMENT LIST 01/15/2025
CHILD CARE PRACTICES 10/29/2024
DISASTER AND EMERGENCY PREPAREDNESS PLAN 01/15/2025
SAMPLE WEEKLY MENU 10/29/2024
POLICIES 10/29/2024
LICENSING ORIENTATION 03/17/2025
ARTICLES OF INCORPORATION 10/07/2024
LINES OF ADMINISTRATIVE AUTHORITY 01/15/2025
LOCAL ZONING APPROVAL 12/31/2024
DIAGRAM/OUTDOOR 01/15/2025
DIAGRAM/INDOOR 10/31/2024
DIRECTOR'S QUALIFICATIONS 01/21/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/21/2025
JOB RESPONSIBILITIES 10/29/2024
REGISTERING FICTITIOUS NAMES 04/08/2025
CERTIFICATE OF GOOD STANDING 04/08/2025
APPLICATION 04/11/2025




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 3
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 10
StaffChildClass AgeNote
2 10 SCHOOL AGE Patricia "Gains" Waren and Jackie Lefhotz with ten children, all school-age

Compliance List
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Violation
 Provider Comments
Violation
Posting requirements were not met as evidenced by the license was not posted near the entrance.
Licensing Rule Reference
5 CSR 25-500.042 Licensing Process (12) states: Once granted, the license shall be posted near the entrance of the facility where it may be seen easily by parents or others who visit.
Correction Required
The official license shall be posted.

Correction Verification
Corrected on Site

Compliance Date
8/21/2025
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
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
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
5 CSR 25-500.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

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
Violation
 Provider Comments
Violation
Child B, C, D, E, F child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the 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
Submit Documentation

Compliance Date

5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for Jackie Lefholz.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

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