MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT

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Facility Information

Facility Name
NORTHSIDE YOUTH AND SENIOR SERVICE CENTER, INC.

Facility DVN
000335720

Phone
(314) 723-3069

Physical Address
1224 S 14TH ST
ST LOUIS
MO 63104

Owner
NORTHSIDE YOUTH AND SENIOR SERVICE CENTER, INC.

Mailing Address
4120 MAFFITT AVE
ST LOUIS
MO 63113

Provider/Director
AVANT, DOMINIQUE ALVIN

E-mail Address
davant@nsyssc.com

Incorporated
Incorporated

Child Care Specialist
TARA D BURNETT

Age Range
5 YEARS - 12 YEARS

Capacity
50

Facility Type
SCHOOL AGE GHC

Limitations
AFTER SCHOOL CARE ONLY

Inspection Information

Date
11/05/2025

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2503114530

Document	Document-Date
DIRECTOR'S JOB RESPONSIBILITIES	04/10/2007
DAILY SCHEDULE	04/10/2007
SAMPLE WEEKLY MENU	04/10/2007
SAMPLE FORMS	04/10/2007
POLICIES	04/10/2007
DISCIPLINE POLICIES	04/10/2007
LINES OF ADMINISTRATIVE AUTHORITY	04/10/2007
JOB RESPONSIBILITIES	04/10/2007
DIRECTOR'S QUALIFICATIONS	03/31/2015
ARTICLES OF INCORPORATION	03/16/2007
CHILD CARE PRACTICES	04/02/2007
STAFF SHEET	01/30/2017
APPLICATION	02/11/2019
EQUIPMENT LIST	04/01/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	04/01/2025
ANNUAL DECLARATION	04/01/2024
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/04/2019

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.

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 Violation
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 Violation
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Violation
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