MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT

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Facility Information

Facility Name
YMCA-ST. CHARLES BRANCH-JEFFERSON INTERMEDIATE

Facility DVN
002053816

Phone
(636) 443-4421

Physical Address
2660 ZUMBEHL RD
ST CHARLES
MO 63301-1134

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
3900 SHADY SPRINGS LN
ST PETERS
MO 63376-6467

Provider/Director
SMITH, DARRIS JAVON

E-mail Address
darris.smith@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
AMY MUSSELMAN

Age Range
9 YEARS - 12 YEARS

Capacity
32

Facility Type
SCHOOL AGE GHC

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
10/14/2025

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2501753037

Document	Document-Date
LINES OF ADMINISTRATIVE AUTHORITY	08/09/2007
DISCIPLINE POLICIES	08/09/2007
DIRECTOR'S JOB RESPONSIBILITIES	08/09/2007
DAILY SCHEDULE	08/09/2007
CHILD CARE PRACTICES	08/09/2007
DIRECTOR'S QUALIFICATIONS	08/27/2012
ARTICLES OF INCORPORATION	08/09/2007
JOB RESPONSIBILITIES	03/24/2015
POLICIES	03/24/2015
SAMPLE WEEKLY MENU	08/09/2007
SAMPLE FORMS	03/24/2015
CERTIFICATE OF INCORPORATION	01/20/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/09/2017
APPLICATION	03/06/2019
STAFF SHEET	02/28/2023
CERTIFICATE OF GOOD STANDING	03/20/2024
REGISTERING FICTITIOUS NAMES	03/20/2024
ANNUAL DECLARATION	09/30/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	09/30/2025
EQUIPMENT LIST	03/21/2024
LOCAL ZONING APPROVAL	12/05/2024
LOCAL BUILDING APPROVAL	12/05/2024

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.