DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE SCHOOL DISTRICT

001814031

(816) 521-5443

1403 W LINDEN AVE
INDEPENDENCE
MO  64052

INDEPENDENCE 30 SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050

ROSS, BRADFORD H

YOUTH_DEVELOPMENT@ISDSCHOOLS.ORG


MICHELLE RENEE TRUSSELL

5 YEARS - 11 YEARS

20

SCHOOL AGE

 
Inspection Information

10/28/2021

10:30 AM

10:58 AM

ANNOUNCED

COMPLIANCE MONITORING

2411422272


DocumentDocument-Date
SAMPLE FORMS 09/04/2014
DIRECTOR'S QUALIFICATIONS 09/11/2014
CHILD CARE PRACTICES 03/21/2012
DIRECTOR'S JOB RESPONSIBILITIES 03/21/2012
DAILY SCHEDULE 03/21/2012
DISCIPLINE POLICIES 03/21/2012
JOB RESPONSIBILITIES 03/21/2012
LINES OF ADMINISTRATIVE AUTHORITY 03/21/2012
POLICIES 03/21/2012
SAMPLE WEEKLY MENU 03/21/2012
DISASTER AND EMERGENCY PREPAREDNESS PLAN 03/21/2012
APPLICATION 05/30/2018
EQUIPMENT LIST 08/30/2021
STAFF SHEET 08/21/2018
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 08/30/2021
ANNUAL DECLARATION 08/30/2021




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 1
StaffChildClass AgeNote
1 0 NO CHILDREN IN ATTENDANCE No children in attendance as program is not currently in operation

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Violation
 Provider Comments
Violation
The Family Care Safety Registry check was not conducted for Dale Herl within thirty (30) days prior to the anniversary date.
Licensing Rule Reference
5 CSR 25-500.052 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
10/28/2021
5 CSR 25-500.082 Physical Requirements of Group Day Care Homes and Day Care Centers
Compliance
5 CSR 25-500.090 Disaster and Emergency Preparedness
Compliance
5 CSR 25-500.092 Furniture, Equipment and Materials
Compliance
5 CSR 25-500.102 Personnel
Compliance
5 CSR 25-500.112 Staff/Child Ratios
Compliance
5 CSR 25-500.122 Medical Examination Reports
Compliance
5 CSR 25-500.132 Admission Policies and Procedures
Compliance
5 CSR 25-500.172 Emergency School Closings
Compliance
5 CSR 25-500.182 Child Care Program
Compliance
5 CSR 25-500.192 Health Care
Compliance
5 CSR 25-500.202 Nutrition and Food Service
Compliance
5 CSR 25-500.212 Transportation and Field Trips
Compliance
5 CSR 25-500.222 Records and Reports
Compliance
5 CSR 25-600.020 General Requirements
Compliance
5 CSR 25-600.040 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