DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE 30 SCHOOL DISTRICT

002318763

(816) 521-5453

1301 WINDSOR ST
INDEPENDENCE
MO  64055-1179

INDEPENDENCE 30 SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050-2696

LITTRELL, SHELBY RAE

SANDRA_DEMPSEY@ISDSCHOOLS.ORG


ROMENA FOX

5 YEARS - 11 YEARS

80

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

02/26/2021

8:00 AM

9:57 AM

UNANNOUNCED

COMPLIANCE MONITORING

2394066921


DocumentDocument-Date
APPLICATION 09/24/2019
STAFF SHEET 12/02/2019
ANNUAL DECLARATION 01/29/2021
SAMPLE WEEKLY MENU 02/08/2012
POLICIES 02/08/2012
JOB RESPONSIBILITIES 02/08/2012
DISCIPLINE POLICIES 02/08/2012
DIRECTOR'S JOB RESPONSIBILITIES 02/08/2012
CHILD CARE PRACTICES 02/08/2012
SAMPLE FORMS 02/08/2013
LINES OF ADMINISTRATIVE AUTHORITY 02/08/2012
DIRECTOR'S QUALIFICATIONS 12/19/2011
DAILY SCHEDULE 02/08/2012
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 02/26/2021
EQUIPMENT LIST 02/26/2021




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 11
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 1
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE Director Shelby Littrell with no children present

 
19 CSR 30-62.032 Organization and Administration
Compliance
19 CSR 30-62.042 Initial Licensing Information
Not Observed
19 CSR 30-62.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Shelby Littrell, Jacob Juliana, Kaylee Culbertson and Dr. Dale Herl 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
2/26/2021
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
Violation
 Provider Comments
Violation
The facility orientation did not included a review of the facility's child care practices as evidenced by the orientation checklist does not include procedures for discipline and guidance.
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 facility orientation did not included a review of the duties and responsibilities of staff as evidenced by the orientation checklist does not include 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

Violation
The facility orientation did not included a review of the location of children's records as evidenced by the orientation checklist does not include a review of 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 each caregiver's mandated responsibility to report suspected child abuse or neglect as evidenced by the orientation checklist does 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

19 CSR 30-62.112 Staff/Child Ratios
Not Observed
19 CSR 30-62.122 Medical Examination Reports
Compliance
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

19 CSR 30-62.172 Emergency School Closings
Compliance
19 CSR 30-62.182 Child Care Program
Not Observed
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 A and Child G'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

Violation
Child D, Child F and Child H'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 D and Child G'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 B, Child C, Child F and Child G'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 G's child(ren) records did not include employers' name 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 G's 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

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