MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

SCHOOL AGE INSPECTION REPORT

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Facility Information

Facility Name
INDEPENDENCE 30 SCHOOL DISTRICT

Facility DVN
002318763

Phone
(816) 521-5453

Physical Address
1301 WINDSOR ST
INDEPENDENCE
MO 64055-1179

Owner
INDEPENDENCE 30 SCHOOL DISTRICT

Mailing Address
201 N FOREST AVE
INDEPENDENCE
MO 64050-2696

Provider/Director
CROSBY, DANA NICOLE

E-mail Address
youth_developement@isdschools.org

Incorporated

Child Care Specialist
CRYSTAL HEISER

Age Range
5 YEARS - 11 YEARS

Capacity
80

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
09/27/2023

Arrival Time
3:35 PM

Departure Time
4:09 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2455675306

Document	Document-Date
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
APPLICATION	09/24/2019
STAFF SHEET	12/02/2019
ANNUAL DECLARATION	01/03/2023
EQUIPMENT LIST	01/23/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	01/03/2023

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 3

Total Children 23

Staff	Child	Class Age	Note
1	0	NO CHILDREN IN ATTENDANCE	Director, Dana Crosby with no children in attendance.
2	23	SCHOOL AGE	2 caregivers Avery Byrd and Morgan Johnson with 23 children all school age.

Compliance List
5 CSR 25-500.032 Organization and Administration Compliance
5 CSR 25-500.042 Licensing Process Compliance
5 CSR 25-500.052 Annual Requirements Not Observed
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 Not Observed
5 CSR 25-500.112 Staff/Child Ratios Compliance
5 CSR 25-500.122 Medical Examination Reports Not Observed
5 CSR 25-500.132 Admission Policies and Procedures Compliance
5 CSR 25-500.172 Emergency School Closings Not Observed
5 CSR 25-500.182 Child Care Program Compliance
5 CSR 25-500.192 Health Care Not Observed
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 Not Observed
5 CSR 25-600.020 General Requirements Compliance
5 CSR 25-600.040 Background Screening Findings Not Observed
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. — Not Observed
RSMo 210.211. License required - exceptions - written notice of licensure status, when. Compliance