MISSOURI DEPARTMENT OF ELEMENTARY AND SECONDARY EDUCATION

OFFICE OF CHILDHOOD

FAMILY HOME INSPECTION REPORT

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Facility Information

Facility Name
BERHORST, GINA

Facility DVN
000785959

Phone
(573) 288-3510

Physical Address
17974 310TH AVE
CANTON
MO 63435

Owner
BERHORST, GINA

Mailing Address

Provider/Director
BERHORST, GINA

E-mail Address
gdberhorst13@gmail.com

Incorporated

Child Care Specialist
BETHANY CARREL DUCKWORTH

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 10 CHILDREN IN CARE NO MORE THAN 4 CHILDREN UNDER AGE 2 WITH 2 ADULT CAREGIVERS; UP TO 6 CHILDREN IN CARE NO MORE THAN 3 CHILDREN UNDER AGE 2 WITH 1 ADULT CAREGIVER

Inspection Information

Date
05/16/2024

Arrival Time
11:23 AM

Departure Time
11:47 AM

Notice
UNANNOUNCED

Inspection Type
COMPLIANCE MONITORING

Inspection ID
2470869288

Document	Document-Date
SAMPLE WEEKLY MENU	05/01/1996
OWNER/PROVIDER REFERENCES	04/17/1996
DAILY SCHEDULE	11/21/1996
CHILD CARE/DISCIPLINE POLICIES	11/21/1996
POLICIES	11/21/1996
DIAGRAM/OUTDOOR	06/23/1998
DIAGRAM/INDOOR	04/03/1998
APPLICATION	08/26/2019
SAFE SLEEP POLICY	03/07/2016
DISASTER AND EMERGENCY PREPAREDNESS PLAN	02/23/2012
ASSISTANT APPROVAL REQUEST	09/04/2007
ASSISTANT REFERENCES	03/28/1996
SANITATION INSPECTION	08/14/2023
EQUIPMENT LIST	10/17/2023
ANNUAL DECLARATION	10/17/2023
LISTING OF CHILD CARE STAFF/HOUSEHOLD MEMBERS	10/17/2023
FIRE/SAFETY INSPECTION	07/07/2023

Overlap Start Time	Overlap End Time	Overlap Submit Date
2:30PM	4:30PM	9/23/2019

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 1

Total Children 7

Staff	Child	Class Age	Note
1	7	MIXED	Staff: Gina Berhorst. Age range 2 years through 6 years. Zero children under 2 years old.

Compliance List
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 Not Observed
5 CSR 25-400.095 Furniture, Equipment and Materials Compliance
5 CSR 25-400.105 The Child Care Provider and Other Child Care Personnel Not Observed
5 CSR 25-400.115 Child Care Family and Household Not Observed
5 CSR 25-400.125 Medical Examination Reports Not Observed
5 CSR 25-400.135 Admission Policies and Procedures Not Observed
5 CSR 25-400.145 Nighttime Care Not Observed
5 CSR 25-400.155 Overlap Care of Children Not Observed
5 CSR 25-400.165 Emergency School Closings Not Observed
5 CSR 25-400.175 Child Care Program Compliance
5 CSR 25-400.185 Health Care Not Observed
5 CSR 25-400.190 Nutrition and Food Service Not Observed
5 CSR 25-400.200 Transportation and Field Trips Not Observed
5 CSR 25-400.210 Records and Reports Not Observed
5 CSR 25-600.020 General Requirements Not Observed
5 CSR 25-600.040 Background Screening Findings Not Observed
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