MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
INDEPENDENCE SCHOOL DISTRICT

Facility DVN
001814031

Phone
(816) 521-5443

Physical Address
1403 W LINDEN AVE
INDEPENDENCE
MO 64052

Owner
INDEPENDENCE SCHOOL DISTRICT

Mailing Address
201 N FOREST AVE
INDEPENDENCE
MO 64050

Provider/Director
BATES, CATHERINE LOUISE

E-mail Address
chelsea_hamann@isdschools.org

Incorporated

Child Care Specialist
JANA BARTON

Age Range
5 YEARS - 11 YEARS

Capacity
20

Facility Type
SCHOOL AGE

Limitations

Inspection Information

Date
08/22/2017

Arrival Time
8:05 AM

Departure Time
9:14 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2312217876

Document	Document-Date
STAFF SHEET	08/18/2016
EQUIPMENT LIST	08/10/2016
APPLICATION	08/10/2016
SAMPLE FORMS	09/04/2014
DIRECTOR'S QUALIFICATIONS	09/11/2014
SAMPLE WEEKLY MENU	03/21/2012
POLICIES	03/21/2012
LINES OF ADMINISTRATIVE AUTHORITY	03/21/2012
JOB RESPONSIBILITIES	03/21/2012
DISCIPLINE POLICIES	03/21/2012
DAILY SCHEDULE	03/21/2012
DIRECTOR'S JOB RESPONSIBILITIES	03/21/2012
CHILD CARE PRACTICES	03/21/2012

Inspection determined facility to be in compliance with licensing rules.

Open Violations: 1

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 8

Staff	Child	Class Age	Note
2	8	SCHOOL AGE