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
002318781

Phone
(816) 521-5423

Physical Address
2601 N LIBERTY ST
INDEPENDENCE
MO 64050-1319

Owner
INDEPENDENCE 30 SCHOOL DISTRICT

Mailing Address
201 N FOREST AVE
INDEPENDENCE
MO 64050-2513

Provider/Director
PALMER, ADDISON KAY

E-mail Address
youth_development@isdschools.org

Incorporated

Child Care Specialist
ROBYN EMBREE

Age Range
5 YEARS - 11 YEARS

Capacity
60

Facility Type
SCHOOL AGE

Limitations
BEFORE AND AFTER SCHOOL CARE ONLY

Inspection Information

Date
10/24/2023

Arrival Time
9:46 AM

Departure Time
10:15 AM

Notice
ANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2457333276

Document	Document-Date
DAILY SCHEDULE	09/25/2014
JOB RESPONSIBILITIES	09/25/2014
POLICIES	09/25/2014
SAMPLE WEEKLY MENU	09/25/2014
DISCIPLINE POLICIES	09/25/2014
CHILD CARE PRACTICES	09/25/2014
DIRECTOR'S JOB RESPONSIBILITIES	09/25/2014
LINES OF ADMINISTRATIVE AUTHORITY	09/25/2014
DIRECTOR'S QUALIFICATIONS	04/07/2014
STAFF SHEET	08/22/2018
APPLICATION	07/02/2020
EQUIPMENT LIST	08/31/2023
ANNUAL DECLARATION	08/31/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	08/31/2023

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 2

Staff	Child	Class Age	Note
2	0	NO CHILDREN IN ATTENDANCE	Addison Palmer (director) and Rebekah Masters (youth and program specialist) present with no children in attendance for inactive facility.