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
002432200

Phone
(816) 521-5483

Physical Address
2020 QUAIL DR
INDEPENDENCE
MO 64057-3429

Owner
INDEPENDENCE 30 SCHOOL DISTRICT

Mailing Address
201 N FOREST AVE
INDEPENDENCE
MO 64050-2513

Provider/Director
NICHOLSON, CHLOE MARIE

E-mail Address
YOUTH_DEVELOPMENT@ISDSCHOOLS.ORG

Incorporated

Child Care Specialist
MADELINE L DUMERCY

Age Range
5 YEARS - 11 YEARS

Capacity
60

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
12/07/2020

Arrival Time
4:10 PM

Departure Time
4:57 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2389246456

Document	Document-Date
SAMPLE WEEKLY MENU	09/16/2013
SAMPLE FORMS	09/16/2013
POLICIES	09/16/2013
JOB RESPONSIBILITIES	09/16/2013
DISCIPLINE POLICIES	09/16/2013
DIRECTOR'S QUALIFICATIONS	09/17/2012
DIRECTOR'S JOB RESPONSIBILITIES	09/16/2013
DAILY SCHEDULE	09/16/2013
CHILD CARE PRACTICES	09/16/2013
APPLICATION	01/23/2019
EQUIPMENT LIST	04/23/2019
STAFF SHEET	04/23/2019

Inspection determined facility to be in compliance with 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 3

Total Children 10

Staff	Child	Class Age	Note
3	10	SCHOOL AGE	Chloe Nicholson (Director), Emily Reynolds (staff), and Salma Billgas (staff) are with 10 school age children between five to eleven years old