MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT

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Facility Information

Facility Name
YMCA-JEFFERSON COUNTY BRANCH-PEVELY ELEMENTARY

Facility DVN
001012684

Phone
(314) 598-1568

Physical Address
30 MAIN ST
PEVELY
MO 63070

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
1303 YMCA DR
FESTUS
MO 63028

Provider/Director
HOLDINGHAUSEN, CYNTHIA LOUISE

E-mail Address
cindy.holdinghausen@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
BRITTNEY RALPH

Age Range
5 YEARS - 12 YEARS

Capacity
48

Facility Type
SCHOOL AGE GHC

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
12/31/2025

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2506016897

Document	Document-Date
ARTICLES OF INCORPORATION	10/05/2006
LINES OF ADMINISTRATIVE AUTHORITY	08/19/1997
SAMPLE WEEKLY MENU	08/19/1997
SAMPLE FORMS	08/19/1997
JOB RESPONSIBILITIES	08/19/1997
CHILD CARE PRACTICES	08/19/1997
DAILY SCHEDULE	08/19/1997
POLICIES	08/19/1997
LOCAL FIRE DEPARTMENT NOTIFICATION	09/11/2013
REGISTERING FICTITIOUS NAMES	09/04/2013
CERTIFICATE OF GOOD STANDING	12/02/2025
DISASTER AND EMERGENCY PREPAREDNESS PLAN	04/11/2012
DIRECTOR'S JOB RESPONSIBILITIES	08/01/1997
DISCIPLINE POLICIES	08/19/1997
APPLICATION	10/11/2019
STAFF SHEET	10/24/2019
EQUIPMENT LIST	12/02/2025
ANNUAL DECLARATION	12/02/2025
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	12/02/2025

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.