MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT

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Facility Information

Facility Name
YMCA-SOUTH CITY BRANCH-ST. AMBROSE CATHOLIC SCHOOL

Facility DVN
003019512

Phone
(314) 772-1437

Physical Address
5110 WILSON AVE
ST LOUIS
MO 63110-3110

Owner
GATEWAY REGION YOUNG MEN'S CHRISTIAN ASSOCIATION

Mailing Address
3150 SUBLETTE AVE
ST LOUIS
MO 63139-1467

Provider/Director
DECLUE, CHRISTINA

E-mail Address
christina.declue@gwrymca.org

Incorporated
Incorporated

Child Care Specialist
TARA D BURNETT

Age Range
5 YEARS - 13 YEARS

Capacity
40

Facility Type
SCHOOL AGE GHC

Limitations
AFTER SCHOOL CARE ONLY

Inspection Information

Date
01/16/2026

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2507040092

Document	Document-Date
ANNUAL DECLARATION	06/30/2025
APPLICATION	07/05/2023
CERTIFICATE OF GOOD STANDING	07/05/2023
ARTICLES OF INCORPORATION	07/05/2023
CERTIFICATE OF INCORPORATION	07/05/2023
CHILD CARE PRACTICES	08/01/2023
DAILY SCHEDULE	08/01/2023
DIRECTOR'S JOB RESPONSIBILITIES	08/01/2023
DIRECTOR'S QUALIFICATIONS	08/01/2023
DISCIPLINE POLICIES	08/01/2023
EQUIPMENT LIST	06/30/2025
JOB RESPONSIBILITIES	08/01/2023
LICENSING ORIENTATION	02/13/2022
LINES OF ADMINISTRATIVE AUTHORITY	08/01/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	06/30/2025
POLICIES	08/01/2023
SAMPLE FORMS	08/01/2023
SAMPLE WEEKLY MENU	08/01/2023
DISASTER AND EMERGENCY PREPAREDNESS PLAN	08/01/2023

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 Violation
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 Violation
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