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  64068-7802

HERSHBERGER, GLORIA



 

HERSHBERGER, GLORIA

GLORIAHERSHBERGER@YAHOO.COM


GREGG GILLEN

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; UP TO 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS
 
Inspection Information

05/24/2021

2:00 PM

3:11 PM

UNANNOUNCED

COMPLIANCE MONITORING

2400683753


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
SAMPLE FORMS 09/16/1997
APPLICATION 09/12/2019
FIRE/SAFETY INSPECTION 09/02/2020
SANITATION INSPECTION 09/03/2020
EQUIPMENT LIST 10/20/2010
ANNUAL DECLARATION 10/20/2020
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS 10/20/2020

Overlap Start TimeOverlap End TimeOverlap Submit Date
  3:00PM   4:00PM   9/30/2013
  7:30AM   8:30AM   9/30/2013



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 2
Total Children 8
StaffChildClass AgeNote
2 8 MIXED Connie Hershberger and Amery Hershberger were caring for eight children; 1-1 year old 1-15 month old 1-2 year old 1-3 year old 4-5 year old

 
19 CSR 30-61.025 Organization and Administration
Compliance
19 CSR 30-61.045 Licensing Process
Compliance
19 CSR 30-61.055 Annual Requirements
Compliance
19 CSR 30-61.085 Physical Requirements of the Family Day Care Home
Compliance
19 CSR 30-61.086 Fire Safety
Violation
 Provider Comments
Violation
The requirements for protective outlet covers were not met as evidenced by three outlets did not have outlet covers..
Licensing Rule Reference
19 CSR 30-61.086 Fire Safety 11 (B) states: Protective covers or inserts for electrical receptacles shall be installed in all areas occupied by children.
Correction Required
The facility shall use protective outlet covers as required.

Correction Verification
Corrected on Site

Compliance Date
5/24/2021
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 Child Care Provider and Other Child Care Personnel
Compliance
19 CSR 30-61.115 Day Care Family and Household
Compliance
19 CSR 30-61.125 Medical Examination Reports
Compliance
19 CSR 30-61.135 Admission Policies and Procedures
Compliance
19 CSR 30-61.145 Nighttime Care
Not Observed
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
Not Observed
19 CSR 30-61.200 Transportation and Field Trips
Compliance
19 CSR 30-61.210 Records and Reports
Compliance
19 CSR 30-63.020 General Requirements
Compliance
19 CSR 30-63.040 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
RSMo 210.252. Fire, safety, health and sanitation inspections, procedures - variances to rules granted when - rules authorized.
Compliance