DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE SCHOOL DISTRICT

002318825

(816) 521-5438

1525 N NOLAND RD
INDEPENDENCE
MO  64050

INDEPENDENCE 30 SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050

ANCELL, TAYLOR ELIZABETH

ROBIN_CAYTON@ISDSCHOOLS.ORG


ROMENA FOX

5 YEARS - 11 YEARS

60

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

02/11/2021

8:25 AM

9:32 AM

UNANNOUNCED

COMPLIANCE MONITORING

2393207834


DocumentDocument-Date
ANNUAL DECLARATION 01/29/2021
STAFF SHEET 12/03/2019
EQUIPMENT LIST 12/03/2019
SAMPLE FORMS 01/24/2012
LOCAL FIRE DEPARTMENT NOTIFICATION 01/24/2012
JOB RESPONSIBILITIES 01/24/2012
DISCIPLINE POLICIES 01/24/2012
DIRECTOR'S JOB RESPONSIBILITIES 01/24/2012
CHILD CARE PRACTICES 01/24/2012
SAMPLE WEEKLY MENU 01/24/2012
POLICIES 01/24/2012
LINES OF ADMINISTRATIVE AUTHORITY 01/24/2012
DIRECTOR'S QUALIFICATIONS 11/25/2011
DAILY SCHEDULE 01/24/2012
APPLICATION 11/01/2017




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 16
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 30
StaffChildClass AgeNote
2 17 SCHOOL AGE Director Taylor Ancell and Caregiver Salma Villegas with seventeen children, all school age
1 13 SCHOOL AGE Caregiver Karlie Henthorne with thirteen children, all school age

 
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
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Dr. Herl, Taylor Ancell, Hamdi Collins, Karlie Henthorne and Salma Villegas within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (2) (C) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within thirty (30) days prior to the anniversary date as printed on the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all child care staff member(s) within thirty (30) days prior to the anniversary date.

Correction Verification
Corrected on Site

Compliance Date
2/11/2021
Violation
The staff sheet was not fully completed as evidenced by two staff members were present who were not listed on the staff sheet.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (D) states: A current staff sheet.
Correction Required
The facility shall submit a current staff sheet as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
The equipment list was not submitted.
Licensing Rule Reference
19 CSR 30-62.052 Annual Requirements (1) (C) states: A current list of available equipment.
Correction Required
The facility shall submit an equipment list as required.

Correction Verification
Submit Documentation

Compliance Date

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

19 CSR 30-62.092 Furniture, Equipment and Materials
Compliance
19 CSR 30-62.102 Personnel
Violation
 Provider Comments
Violation
The facility orientation did not included a review of the facility's child care practices as evidenced by the checklist did not include child care practices, discipline and guidance policies.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) 2. C. states: The facility’s written child care practices, including procedures for medication administration, child illness, discipline, and guidance policies;
Correction Required
Each caregiver shall have a facility orientation that shall include a review of the facility's child care practices.

Correction Verification
Submit Documentation

Compliance Date

Violation
The requirements for obtaining 12 clock hours each calendar year were not met. The staff listed need the following information: Taylor Ancell is missing eight (8) hours of training for 2020.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (3) (A) states: The center director, group day care home provider, all other caregivers, and those volunteers who are counted in staff/child ratios shall obtain at least twelve (12) clock hours of child-care related training during each calendar year. Clock hour training shall be approved by the department.
Correction Required
Required training hours shall be documented for each employee.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility orientation did not included a review of the each caregiver's mandated responsibility to report suspected child abuse or neglect as evidenced by the checklist did not include mandated reporter responsibility.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) 2. J. states: The mandated responsibility to report any suspected child abuse or neglect to the Children’s Division at the toll-free number 1-800-392-3738 or online at https://apps.dss.mo.gov/OnlineCanReporting /default.aspx.
Correction Required
Each caregiver shall have a facility orientation that shall include a review of their mandated responsibility to report suspected child abuse or neglect.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility orientation did not included a review of the location of children's records as evidenced by the checklist did not include the location of children's records.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) 2. G. states: The location of children’s records;
Correction Required
Each caregiver shall have a facility orientation that shall include a review of the location of children's records.

Correction Verification
Submit Documentation

Compliance Date

Violation
The facility orientation did not included a review of the duties and responsibilities of staff as evidenced by the checklist did not include the duties and responsibilities of staff.
Licensing Rule Reference
19 CSR 30-62.102 Personnel (1) (J) 2. E. states: The assigned duties and responsibilities of staff;
Correction Required
Each caregiver shall have a facility orientation that shall include a review of the duties and responsibilities of staff.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-62.112 Staff/Child Ratios
Compliance
19 CSR 30-62.122 Medical Examination Reports
Violation
 Provider Comments
Violation
Medical examination report was not on file for Salma Villegas as evidenced by a medical examination was not on file within 30 days of an individual beginning to work with children.
Licensing Rule Reference
19 CSR 30-62.122 Medical Examination Reports (1) (A) states: All persons working in a day care facility in any capacity during child care hours, including volunteers counted in staff/child ratios, shall be in good physical and emotional health with no physical or mental conditions which would interfere with child care responsibilities. These persons shall have a medical examination report, signed by a licensed physician or registered nurse who is under the supervision of a licensed physician, on file at the facility at the time of initial licensure or within thirty (30) days following employment.
Correction Required
Medical reports shall be on file as required.

Correction Verification
Submit Documentation

Compliance Date

Violation
A school-age child's health report was not on file at the time of enrollment as evidenced by Child D and Child E's health reports do not have the "yes" or "no" checked at the top.
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

19 CSR 30-62.132 Admission Policies and Procedures
Compliance
19 CSR 30-62.172 Emergency School Closings
Not Observed
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
Not Observed
19 CSR 30-62.212 Transportation and Field Trips
Compliance
19 CSR 30-62.222 Records and Reports
Violation
 Provider Comments
Violation
Child B and Child D's 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

Violation
Child A, Child C and Child E's 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

Violation
Child C's 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

Violation
Child B, Child C and Child E's 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

Violation
Child B's 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

Violation
Child F's 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

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