DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE SCHOOL DISTRICT

002301084

(816) 521-5468

15208 E 39TH ST S
INDEPENDENCE
MO  64055

INDEPENDENCE SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050-2513

MASTERS, REBEKAH LEA

REBEKAH_MASTERS@ISDSCHOOLS.ORG

Incorporated

ROMENA FOX

5 YEARS - 11 YEARS

130

SCHOOL AGE

 
Inspection Information

09/30/2019

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2365433948


DocumentDocument-Date
LINES OF ADMINISTRATIVE AUTHORITY 10/17/2011
DIRECTOR'S JOB RESPONSIBILITIES 10/17/2011
DAILY SCHEDULE 10/17/2011
CHILD CARE PRACTICES 06/17/2013
DISCIPLINE POLICIES 10/17/2011
POLICIES 10/17/2011
JOB RESPONSIBILITIES 10/17/2011
DIRECTOR'S QUALIFICATIONS 09/29/2011
SAMPLE WEEKLY MENU 10/17/2011
SAMPLE FORMS 10/17/2011
DIAGRAM/OUTDOOR 07/06/2011
DIAGRAM/INDOOR 07/06/2011
APPLICATION 08/01/2019
EQUIPMENT LIST 08/22/2019
STAFF SHEET 08/22/2019




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
Compliance
19 CSR 30-62.052 License Renewal
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Martha Johnson, Hannah Faustlin, Kendra West, Shelby Littrell, Marietta Spratt, and Dr. Dale Herl within 60 days prior to the expiration of the license.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (2) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within sixty (60) days prior to the expiration of the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all staff member(s) within sixty (60) days prior to the expiration of the license.

Correction Verification
Submit Documentation

Compliance Date
9/13/2019
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Dr. Dale Herl.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (3) states: The facility owner(s), board president or chairperson, and the center director or group day care home provider, shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
9/13/2019
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Martha Johnson and Kendra West.
Licensing Rule Reference
19 CSR 30-62.052 License Renewal (4) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
9/20/2019
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Violation
 Provider Comments
Violation
Individual storage space requirements were not met as evidenced by there was no space for each child's belongings.
Licensing Rule Reference
19 CSR 30-62.082 Physical Requirements of Group Day Care Homes and Day Care Centers (2) (B) 1. F. states: Each child shall be provided individual space, accessible to the child, for storage of each childs' clothing and other personal belongings.
Correction Required
The facility shall provide accessible, individual space for each child's belongings.

Correction Verification
Submit Documentation

Compliance Date
9/24/2019
19 CSR 30-62.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Compliance
19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Britney Clifton and Ethan McAuley on March 5, 2019 (corrected). Medical examination report did not include a completed Risk Assessment for Tuberculosis form for Virginia Ramsay on August 22, 2019.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (B) states: Medical examination reports shall include a “Risk Assessment for Tuberculosis” form, included herein, completed and signed by a health care professional, as provided by the Missouri Department of Health and Senior Services (MDHSS). If the person has signs or symptoms of tuberculosis, or risk factors for tuberculosis, then testing for tuberculosis shall occur.
Correction Required
TB reports shall be on file as required

Correction Verification
Submit Documentation

Compliance Date
9/24/2019
Violation
A school-age child's health report was not on file at the time of enrollment as evidenced by one (1) child's file was not checked "yes" or "no" to indicate whether the child has any health problems or concerns.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (2) (D) states: The parent(s) of a school-age child shall provide a report at the time of enrollment indicating the child's health history, any current health problems, and any restrictions necessary for the child's care.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/13/2019
19 CSR 30-62.132 Admission Policies and Procedures
Violation
 Provider Comments
Violation
An individualized plan for specialized care for a child with special physical, developmental or behavioral needs was not on file.
Licensing Rule Reference
19 CSR 30-62.132 Admission Policies and Procedures (6) states: A child who has a special physical, developmental or behavioral need shall have on file an individualized plan for specialized care from a professionally qualified source.
Correction Required
An individualized plan from a professional source shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/20/2019
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
Three (3) child(ren) records did not include home 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
9/13/2019
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance