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
MACIE L HERRIG

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
11/23/2022

Arrival Time
2:10 PM

Departure Time
2:33 PM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2436130783

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
EQUIPMENT LIST	11/23/2022
SANITATION INSPECTION	08/15/2022
FIRE/SAFETY INSPECTION	08/01/2022
ANNUAL DECLARATION	11/23/2022
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	11/23/2022

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.

Attendance at Time of Inspection

Total Staff 3

Total Children 8

Staff	Child	Class Age	Note
1	8	MIXED	provider G.H. present with eight children, three two-years-old and five 3-to-5-years-old
2	0	NO CHILDREN IN ATTENDANCE	additional household members include school age household member G.H. and household member S.H.


5 CSR 25-400.025 Organization and Administration Compliance
5 CSR 25-400.045 Licensing Process Compliance
5 CSR 25-400.055 Annual Requirements Compliance
5 CSR 25-400.085 Physical Requirements of the Family Day Care Home Compliance
5 CSR 25-400.086 Fire Safety Compliance
5 CSR 25-400.090 Disaster and Emergency Preparedness Compliance
5 CSR 25-400.095 Furniture, Equipment and Materials Compliance
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel Compliance
5 CSR 25-400.115 Child Care Family and Household Compliance
5 CSR 25-400.125 Medical Examination Reports Compliance
5 CSR 25-400.135 Admission Policies and Procedures Compliance
5 CSR 25-400.145 Nighttime Care Compliance
5 CSR 25-400.155 Overlap Care of Children Compliance
5 CSR 25-400.165 Emergency School Closings Compliance
5 CSR 25-400.175 Child Care Program Compliance
5 CSR 25-400.185 Health Care Compliance
5 CSR 25-400.190 Nutrition and Food Service Compliance
5 CSR 25-400.200 Transportation and Field Trips Compliance
5 CSR 25-400.210 Records and Reports Compliance
5 CSR 25-600.020 General Requirements Compliance
5 CSR 25-600.040 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