DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE GHC INSPECTION REPORT
Facility Information

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

002942669

(417) 427-3249

4709 CHOUTEAU DR
NEOSHO
MO  64850-9123

TRI-STATE FAMILY YOUNG MEN'S CHRISTIAN ASSOCIATION

4701 CHOUTEAU DR
NEOSHO
MO  64850-9123

FERGUSON, TINA RAE

tina@tristatefamilyymca.org

Incorporated

LORI SCHUMER

5 YEARS - 13 YEARS

64

SCHOOL AGE GHC

 
Inspection Information

03/19/2026

9:17 AM

10:23 AM

UNANNOUNCED

COMPLIANCE MONITORING

2510191819


DocumentDocument-Date
APPLICATION 01/27/2022
CERTIFICATE OF GOOD STANDING 03/25/2022
CHILD CARE PRACTICES 03/25/2022
DAILY SCHEDULE 03/25/2022
DIAGRAM/INDOOR 03/25/2022
DIAGRAM/OUTDOOR 06/09/2022
DIRECTOR'S QUALIFICATIONS 06/09/2022
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/25/2022
DISCIPLINE POLICIES 03/25/2022
JOB RESPONSIBILITIES 03/25/2022
POLICIES 03/25/2022
SAMPLE WEEKLY MENU 03/25/2022
LINES OF ADMINISTRATIVE AUTHORITY 06/09/2022
LOCAL BUILDING APPROVAL 06/14/2022
LOCAL FIRE DEPARTMENT NOTIFICATION 06/14/2022
LOCAL ZONING APPROVAL 06/14/2022
ANNUAL DECLARATION 02/02/2026
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/02/2026
FIRE/SAFETY INSPECTION 12/10/2024
SANITATION INSPECTION 01/13/2025
EQUIPMENT LIST 02/02/2026




Inspection determined facility to be in compliance with licensing rules.
Compliance Licensing Rules
Open Violations: 2
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 11
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Misty Renfro was in the building but not in ratio.
1 11 SCHOOL AGE Elizabeth Martinez was in ratio with eleven children ages 5-9-years-old.

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
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Rachel Baugh, Autumn Coffman, Cassandra Ellison, Tina Ferguson, Elizabeth Martinez, Hayle Matheny, Misty Renfro, Dillion Wellesley, and Alexander Woodward within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Submit Documentation

Compliance Date

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
 Provider Comments
Violation
Documentation of caregiver completion of the facility orientation was not on file for the following staff: Autumn Coffman and Cassandra Ellison.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.
Correction Required
Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department.

Correction Verification
Submit Documentation

Compliance Date

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
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
Violation
 Provider Comments
Violation
Four child(ren) records did not include child's full name, address, date of birth and date care begins and ends.
Licensing Rule Reference
5 CSR 25-500.222 Records and Reports (2) (A) states: The child's full name, address, birth-date and the date care begins and ends;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Corrected on Site

Compliance Date
3/19/2026
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