DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE 30 SCHOOL DISTRICT

002318825

(816) 521-5438

1525 N NOLAND RD
INDEPENDENCE
MO  64050-1951

INDEPENDENCE 30 SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050

MITCHELL, ASHLYN

YOUTH_DEVELOPMENT@ISDSCHOOLS.ORG


PENNY SNODGRASS

5 YEARS - 11 YEARS

60

SCHOOL AGE

BEFORE AND AFTER SCHOOL CARE ONLY
 
Inspection Information

09/19/2022

N/A

N/A

N/A

COMPLIANCE VERIFICATION

2431124208


DocumentDocument-Date
ANNUAL DECLARATION 01/29/2021
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
STAFF SHEET 12/03/2019
EQUIPMENT LIST 12/03/2019




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.

 
5 CSR 25-500.032 Organization and Administration
Compliance
5 CSR 25-500.042 Licensing Process
Compliance
5 CSR 25-500.052 Annual Requirements
Compliance
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
Violation
 Provider Comments
Violation
Documentation of caregiver completion of the facility orientation was not on file for the following staff: Adonis Akhtar and Alexis Reynolds.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (L) states: The child care provider shall ensure that documentation of caregiver completion of the facility orientation is maintained and on file for review by the department.
Correction Required
Documentation of caregiver completion of the facility orientation shall be maintained and on file for review by the department.

Correction Verification
Submit Documentation

Compliance Date
9/9/2022
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
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
5 CSR 25-500.132 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
9/9/2022
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
Violation
 Provider Comments
Violation
One (1) child(ren) records did not include telephone number of family physician or hospital.
Licensing Rule Reference
5 CSR 25-500.222 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
9/7/2022
Violation
Two (2) child(ren) records did not include full name, home address, employers name and address, work schedule and home and work telephone numbers of the parent(s), guardian or legal custodian.
Licensing Rule Reference
5 CSR 25-500.222 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
9/7/2022
5 CSR 25-600.020 General Requirements
Violation
 Provider Comments
Violation
Criminal background check results were not on file for McKenzie day and Cora Hendrix.
Licensing Rule Reference
5 CSR 25-600.020 General Requirements (1) states: Prior to the employment or presence of a child care staff member in a licensed, regulated, or registered child care facility not exempted by section 210.1080.13, RSMo, the child care provider shall request the results of a criminal background check for such child care staff member from the department.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date
9/7/2022
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