DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT
Facility Information

INDEPENDENCE 30 SCHOOL DISTRICT

002310690

(816) 521-5513

2611 S LEES SUMMIT RD
INDEPENDENCE
MO  64055-1940

INDEPENDENCE 30 SCHOOL DISTRICT

201 N FOREST AVE
INDEPENDENCE
MO  64050-2513

LEWALLEN, ASHLEY DANIELLE

YOUTH_DEVELOPMENT@ISDSCHOOLS.ORG


JANA BARTON

5 YEARS - 11 YEARS

60

SCHOOL AGE

 
Inspection Information

02/08/2023

3:40 PM

4:43 PM

UNANNOUNCED

COMPLIANCE MONITORING

2438376506


DocumentDocument-Date
STAFF SHEET 02/22/2021
DIRECTOR'S QUALIFICATIONS 05/15/2017
DIRECTOR'S JOB RESPONSIBILITIES 01/06/2012
JOB RESPONSIBILITIES 01/06/2012
CHILD CARE PRACTICES 01/06/2012
DISCIPLINE POLICIES 01/06/2012
LINES OF ADMINISTRATIVE AUTHORITY 01/06/2012
DAILY SCHEDULE 01/06/2012
POLICIES 01/06/2012
SAMPLE FORMS 01/06/2012
SAMPLE WEEKLY MENU 01/06/2012
APPLICATION 09/27/2019
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 01/03/2023
ANNUAL DECLARATION 01/03/2023
EQUIPMENT LIST 01/17/2023




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 2
Total Children 26
StaffChildClass AgeNote
2 26 SCHOOL AGE staff Catherine Gitlin and Tory Douglas

 
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: Ashley Lewallen, Catherine Gitlin, Tory Douglas.
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

Violation
Background screening information was not available for review for Ashley Lewallen, Catherine Gitlin, Tory Douglas.
Licensing Rule Reference
5 CSR 25-500.102 Personnel (1) (Q) states: Background screening information received by the provider shall be retained in the individual’s file in a confidential manner and available for review.
Correction Required
Background screening information shall be available and kept confidential.

Correction Verification
Submit Documentation

Compliance Date

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