MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
INDEPENDENCE 30 SCHOOL DISTRICT

Facility DVN
002301075

Phone
(816) 521-5398

Physical Address
17302 E R D MIZE RD
INDEPENDENCE
MO 64057-1819

Owner
INDEPENDENCE 30 SCHOOL DISTRICT

Mailing Address
201 N FOREST AVE
INDEPENDENCE
MO 64050-2513

Provider/Director
BINGHAM, ASHLEY DAWN

E-mail Address
YOUTH_DEVELOPMENT@ISDSCHOOLS.ORG

Incorporated

Child Care Specialist
MADELINE L DUMERCY

Age Range
5 YEARS - 12 YEARS

Capacity
130

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
11/10/2020

Arrival Time
4:05 PM

Departure Time
4:56 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2387741261

Document	Document-Date
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/26/2020
ANNUAL DECLARATION	10/22/2020
JOB RESPONSIBILITIES	11/04/2011
LINES OF ADMINISTRATIVE AUTHORITY	11/04/2011
DIRECTOR'S QUALIFICATIONS	08/24/2011
CHILD CARE PRACTICES	11/04/2011
SAMPLE WEEKLY MENU	11/04/2011
DAILY SCHEDULE	11/04/2011
POLICIES	11/04/2011
DIAGRAM/INDOOR	11/04/2011
APPLICATION	07/11/2019
EQUIPMENT LIST	10/29/2020
STAFF SHEET	09/09/2019

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.

Attendance at Time of Inspection

Total Staff 3

Total Children 20

Staff	Child	Class Age	Note
1	0	NO CHILDREN IN ATTENDANCE	Ashley Bingham (Director)
2	20	SCHOOL AGE	Arianna Martin (staff) and Savannah Chancellor (staff) are with 20 school age children between five to twelve years old.


19 CSR 30-62.032 Organization and Administration Compliance
19 CSR 30-62.042 Initial Licensing Information Compliance
19 CSR 30-62.052 Annual Requirements 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 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 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 Compliance
19 CSR 30-63.020 General Requirements Compliance
19 CSR 30-63.040 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