DHSS MO
MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT
Facility Information

HERSHBERGER, GLORIA

000312790

(816) 781-3551

8409 ORCHARD CIR
PLEASANT VALLEY
MO  64068

HERSHBERGER, GLORIA ELIZABETH



 


GLORIAHERSHBERGER@YAHOO.COM


CONSTANCE FERRO

BIRTH - 12 YEARS

10

FAMILY HOME

IF ONLY 4 CHILDREN PRESENT, ALL CHILDREN MAY BE UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 10 CHILDREN IN CARE NO MORE THAN 2 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER
 
Inspection Information

09/12/2019

10:30 AM

11:55 AM

ANNOUNCED

RENEWAL

2364119350


DocumentDocument-Date
POLICIES 09/16/1997
DIAGRAM/OUTDOOR 11/01/1997
DIAGRAM/INDOOR 11/01/1997
DAILY SCHEDULE 09/16/1997
SAMPLE WEEKLY MENU 10/28/1997
OWNER/PROVIDER REFERENCES 09/29/1997
CHILD CARE/DISCIPLINE POLICIES 09/16/1997
ASSISTANT APPROVAL REQUEST 02/18/2015
ASSISTANT REFERENCES 02/09/2015
APPLICATION 09/12/2019
EQUIPMENT LIST 09/12/2019
SAMPLE FORMS 09/16/1997
SANITATION INSPECTION 07/19/2019
FIRE/SAFETY INSPECTION 08/15/2019




Inspection determined facility to be in compliance with licensing rules.
Open Violations: 3
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 4
StaffChildClass AgeNote
2 4 MIXED includes two (2) I/T's in care

 
19 CSR 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Initial Licensing Information
Compliance
19 CSR 30-61.055 License Renewal
Violation
 Provider Comments
Violation
The provider did not meet requirements for a criminal background check. Results were missing for: Seth Hershberger, Ian Hershberger and Brennen Green.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal (3) states: Child care staff members shall have qualifying background screening results on file as required by 19 CSR 30-63.020 General Requirements, prior to renewal of the license.
Correction Required
Required results of criminal background checks shall be on file.

Correction Verification
Submit Documentation

Compliance Date

Violation
The Family Care Safety Registry check was not conducted for Gloria Hershberger, Amery Hershberger, Sarah Hampton, Seth Hershberger, Ian Hershberger and Brennen Green within 60 days prior to the expiration of the license.
Licensing Rule Reference
19 CSR 30-61.055 License Renewal (2) states: The child care provider shall conduct a Family Care Safety Registry check for all child care staff members within sixty (60) days prior to the expiration of the license.
Correction Required
Required Family Care Safety Registry checks shall be conducted for all staff member(s) within sixty (60) days prior to the expiration of the license.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Violation
 Provider Comments
Violation
The facility's outdoor space was not safe/well-maintained for children's activities as evidenced by bunches of leaves up against fence line.
Licensing Rule Reference
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home 3 (A) 5 states: The play area shall be safe for children's activities, well-maintained, free of hazards such as poisonous plants, broken glass, rocks or other debris and shall have good drainage.
Correction Required
The outdoor play area shall be clean, safe and well-maintained as required.

Correction Verification
Submit Documentation

Compliance Date
9/12/2019
19 CSR 30-61.086 Fire Safety
Compliance
19 CSR 30-61.090 Disaster and Emergency Preparedness
Compliance
19 CSR 30-61.095 Furniture, Equipment and Materials
Compliance
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel
Violation
 Provider Comments
Violation
Requirements for safe sleep training were not met as evidence by the assistant(s), Seth Hershberger and Brennan Green, did not complete safe sleep training within the past three years.
Licensing Rule Reference
19 CSR 30-61.105 The Day Care Provider and Other Day Care Personnel (5) . states: Safe Sleep Training. Every three (3) years the provider and assistant(s) in a family child care home licensed to provide care for infants less than one (1) year of age shall successfully complete department-approved training regarding the American Academy of Pediatrics (AAP) safe sleep recommendations contained in the American Academy of Pediatrics Task Force on Sudden Infant Death Syndrome. Technical report – SIDS and other sleep-related infant deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment, by Moon RY, which is incorporated by reference in this rule as published in PEDIATRICS Volume 138, No. 5, November 1, 2016 and available at ttp://pediatrics.aappublications.org/content/pediatrics/early/2016/10/20/peds.2016- 2938.full.pdf. This rule does not incorporate any subsequent amendments or additions.
Correction Required
The child care provider and assistant(s) shall complete department approved safe sleep training as required.

Correction Verification
Submit Documentation

Compliance Date

19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Violation
 Provider Comments
Violation
Requirements for infant-toddler/preschool child medical examination reports on file were not met as evidenced by there was no medical examination report on file within 30 days of admission - the admission date(s) was/were 9-2-18.
Licensing Rule Reference
19 CSR 30-61.125 Medical Examination Reports 2 (A) states: The provider shall require, within thirty (30) days following the admission of each infant, toddler or preschool child, a medical examination report signed by a licensed physician or registered nurse who is under the supervision of licensed physician and completed not more than twelve (12) months prior to admission.
Correction Required
Child medical requirements shall be completed and on file as required.

Correction Verification
Submit Documentation

Compliance Date
9/12/2019
19 CSR 30-61.135 Admission Policies and Procedures
Compliance
19 CSR 30-61.145 Nighttime Care
Compliance
19 CSR 30-61.155 Overlap Care of Children
Compliance
19 CSR 30-61.165 Emergency School Closings
Compliance
19 CSR 30-61.175 Child Care Program
Compliance
19 CSR 30-61.185 Health Care
Compliance
19 CSR 30-61.190 Nutrition and Food Service
Compliance
19 CSR 30-61.200 Transportation and Field Trips
Compliance
19 CSR 30-61.210 Records and Reports
Compliance
19 CSR 30-63.040 Background Screening Findings
Compliance
RSMo 210.003 Immunizations of children required, when, exceptions--duties of administrator, report--notification of parents, when.
Compliance
RSMo 210.1080 Background checks required--definitions--procedures—ineligible for employment, when--exemption, when--emergency rules.
Compliance
RSMo 210.211.  License required - exceptions - written notice of licensure status, when.
Compliance
RSMo 210.252 Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance