MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
HERSHBERGER, GLORIA

Facility DVN
000312790

Phone
(816) 781-3551

Physical Address
8409 ORCHARD CIR
PLEASANT VALLEY
MO 64068-7802

Owner
HERSHBERGER, GLORIA

Mailing Address

Provider/Director
HERSHBERGER, GLORIA

E-mail Address
GLORIAHERSHBERGER@YAHOO.COM

Incorporated

Child Care Specialist
MICHELLE RENEE TRUSSELL

Age Range
BIRTH - 12 YEARS

Capacity
10

Facility Type
FAMILY HOME

Limitations
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

Date
11/15/2021

Arrival Time
N/A

Departure Time
N/A

Notice
N/A

Inspection Type
COMPLIANCE VERIFICATION

Inspection ID
2412481205

Document	Document-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	08/16/2021
SANITATION INSPECTION	07/25/2021
EQUIPMENT LIST	10/05/2021
ANNUAL DECLARATION	10/05/2021
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/05/2021

Overlap Start Time	Overlap End Time	Overlap 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.