DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE SCHOOL DISTRICT

002310681

(816) 521-5448

509 JENNINGS RD
INDEPENDENCE
MO  64056

INDEPENDENCE SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050-2513

KALBFLEISH, LINDSEY NICOLE

LINDSEY_KALBFLEISH@ISDSCHOOLS.ORG


ROMENA FOX

5 YEARS - 11 YEARS

50

SCHOOL AGE

AFTER SCHOOL CARE ONLY
 
Inspection Information

09/28/2017

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2323360341


DocumentDocument-Date
APPLICATION 12/16/2015
EQUIPMENT LIST 01/04/2016
STAFF SHEET 02/04/2016
SAMPLE WEEKLY MENU 03/05/2012
SAMPLE FORMS 03/05/2012
POLICIES 03/05/2012
LINES OF ADMINISTRATIVE AUTHORITY 03/05/2012
JOB RESPONSIBILITIES 03/05/2012
DISCIPLINE POLICIES 03/05/2012
DIRECTOR'S QUALIFICATIONS 03/05/2012
DIRECTOR'S JOB RESPONSIBILITIES 03/05/2012
DAILY SCHEDULE 03/05/2012
CHILD CARE PRACTICES 03/05/2012




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.

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Violation
 Provider Comments
Violation
The number of children was exceeded as evidenced by the program's license has the limitation of after school care only and the program is operating before school as well (8/30/17).
Licensing Rule Reference
19 CSR 30-62.042 Initial Licensing Information (3) (W) states: The number and ages of children the facility is authorized to have in care at any one (1) time shall be specified on the license and shall not be exceeded except as permitted within these rules.
Correction Required
The facility's license capacity and limitations shall not be exceeded.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
19 CSR 30-62.052 License Renewal
Compliance
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
19 CSR 30-62.090 Disaster and Emergency Preparedness
Violation
 Provider Comments
Violation
Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
Violation
Requirements of facilities participation in disaster and emergency drills were not met as evidenced by the disaster or emergency drill was not held at least one time every three months.
Licensing Rule Reference
19 CSR 30-62.090 Disaster and Emergency Preparedness (3) (A) states: The licensee shall ensure that the facility has on file documentation that, at least every three (3) months, all staff and children at the facility have participated in a disaster or emergency drill based on the facility's disaster and emergency plan.
Correction Required
Fire, tornado, and other disaster drills shall be completed and recorded as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The provider did not meet requirements for requests/results of background reviews. Reviews were missing/out of date for the following volunteers counted in staff/child ratio, caregivers or other personnel: Becky Masters (8/30/17).
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (K) states: Volunteers counted in staff/child ratios, caregivers, and other personnel shall be screened for child abuse/neglect. The screening shall be requested by the provider within ten (10) days of any individual beginning employment or volunteering in the facility. Any investigated allegation of child abuse or neglect involving these persons in which the investigator finds reasonable cause to believe that the individual is the alleged perpetrator of child abuse or neglect shall be evaluated by the department. After review, the department may prohibit the person from being present in the facility during child care hours. A copy of the screening request and the response shall be filed in the employee's record.
Correction Required
Required requests/results of current background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
9/20/2017
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Compliance
19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Compliance
19 CSR 30-62.192 Health Care
Compliance
19 CSR 30-62.202 Nutrition and Food Service
Compliance
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
The provider failed to maintain accurate records to meet administrative requirements as evidenced by Child H is missing an enrollment form (8/20/17).
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (1) states: The child care provider shall maintain accurate records to meet administrative requirements and to ensure knowledge of the individual needs of children and their families.
Correction Required
Accurate records shall be maintained.

Correction Verification
Submit Documentation

Compliance Date
9/20/2017
Violation
Five (5) (8/30/17) child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2017
Violation
One (1) child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
Violation
One (1) child(ren) records did not include name of family physician or hospital.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (D) states: Name and phone number of the family physician, hospital, or both, to be used in an emergency;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
Violation
Four (4) child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
Violation
Seven (7) (8/30/17) child(ren) records did not include address of another individual who might be reached in an emergency.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (C) states: Name, address and telephone number of another individual (friend or relative) who might be reached in an emergency when the parent(s), guardian or legal custodian cannot be reached;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2017
Violation
One (1) child(ren) records did not include employers' address of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
Violation
Two (2) child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/28/2017
Violation
One (1) (8/30/17) child(ren) records did not include work schedule of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/20/2017
Violation
Three (3) (8/30/2017) child(ren) records did not include work telephone number of parent(s), guardian or legal custodian.
Licensing Rule Reference
19 CSR 30-62.222 Records and Reports (2) (B) states: Full name of the parent(s), guardian or legal custodian, home address, employers' name and address, work schedule, and home and work telephone numbers;
Correction Required
Child enrollment information shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/21/2017
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance