LA PETITE ACADEMY INC

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed children came into infant room, dropping off by parents. Hands are not washed before engaging in classroom activities. Ensure to wash hands when required by anyone upon entering classrooms at anytime.

15A NCAC 18A.2803 (e). Handwashing procedures shall include: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands.- Observed teacher after helping a child on diaper changing table and washing hands incorrectly. Hand washing procedures shall be followed properly to ensure clean hands.

15A NCAC 18A .2804 (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center.- Observed baby bottle on the counter in infant room without name and date of a child from toddler room. Ensure to label name and date of a child on items came from home. 15A NCAC 18A .2806 (a) Once pre-packaged food has been opened, the food shall be stored in clean, resealable bags or containers made of plastic or glass that are tightly covered and manufactured for the purpose of food storage.- Observed opened leftover of bulk bag of gold fish stored in a cabinet in 2’s classroom. REPEAT 15A NCAC 18A .2806 (d) Bulk food stored in a refrigerator shall be stored in the child care center's kitchen or in an approved food preparation area equipped with a full-size refrigerator.- Observed bulk container of milk stored in dorm refrigerator in infant room. All bulk milk shall be stored in a Full-Size refrigerator. 15A NCAC 18A .2806 (b) Food that is stored in child care center classrooms or other rooms intended for child care use, shall be limited to foods that are individually packaged unless the classroom is equipped with a food preparation area.- Observed opened a bulk bag of gold fish stored a cabinet in 2’s classroom. This classroom is not equipped with a food preparation area, therefore ONLY individual packages can be stored in the classroom.

REPEAT 15A NCAC 18A .2807 (h) Metal stem-type, thin probe, numerically scaled indicating product thermometers, accurate to ± 3 degrees Fahrenheit shall be used to ensure the maintenance of the internal cooking temperatures of all potentially hazardous foods required under this Rule.- Observed the kitchen does not have a thin prob food thermometer. Obtain a thin probe food thermometer and have available to use.

General Comment: 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children.- Observed hot water temperature measured at 77F in school age and PreK sink. 112F at toddler sink. Provide tempered water temperature between 80F -110F.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed toilet needs cleaning in school age restroom. Clean and keep clean. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at hand sink in 2’s classroom. Observed hand sinks throughout the center need better cleaning. Keep hand sinks clean and in good repair.

15A NCAC 18A .2817 (a) In child care centers, toilet tissue paper shall be provided in each toilet room and stored in a clean, dry place.- Observed no toilet tissue in PreK restroom need refill. 15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.- Observed no soap available in broken dispenser in toddler room. Ensure to provide all hand washing supplies at all hand sinks at all times.

REPEAT 15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed center without test strips for chlorine disinfectant solution. Obtain test strips for disinfectant solution that can measure the concentration between 500-800 ppm.

General Comment: 15A NCAC 18A .2820 (b) (c). All hazardous items must be stored behind lock and key. A locked kitchen is not considered to be a locked storage room or cabinet for the purpose of this rule - Observed bug spray in unlock drawer at front hallway, liquid wipe out container on the counter in infant room, laundry/disinfectant cleaner container in unlock cabinet in hallway restroom near the office. Observed containers of Clorox and dish soaps in the kitchen pantry unlock. All Hazardous items and how to store them discussed with director at the time of inspection.

15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper cream and sunscreen stored in a drawer and cabinet with childproof lock on less than 5ft in toddler room. Ensure to provide those items at 5ft or higher at anytime or lock them up. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time** 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand sanitizer bottle at the front desk upon entry. All hand sanitizer shall be stored at 5ft or higher at anytime.

General Comment: 15A NCAC 18A .2822 (a). In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. - According to teacher dirty toys were collected and get spray with disinfectant at the end of the day. Proper toys cleaning discussed with director at the time of inspection. All dirty toys shall be washed/rinsed/sanitized properly in the kitchen at the three compartment sinks. Or 3 step bins suggested, label (wash/rinse/sanitize). Some toys that cannot not be submerged in water after washed and rinsed, the sanitizer spray can be used. All toys that can be in the water shall be submerged in sanitizer solution for at least 2 minutes and let air dry after. Ensure to use/provide the correct strength of sanitizer solution in the bin for cleaning toys each day and ensure to store the sanitizer bin at 5ft or higher.

General Comment: 15A NCAC 18A .2831 (i) Grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained to prevent the harboring and breeding of pests.- Observed tree branches, bushes over the fence in the back playground need trimming and keep clear.

General Comment: 15A NCAC 18A .2806 (d) Bulk food stored in a refrigerator shall be stored in the child care center's kitchen or in an approved food preparation area equipped with a full-size refrigerator.- Observed bulk milk cartons stored in dorm size refrigerator in infant room. Items removed and store in kitchen refrigerator at the time of inspection.

General Comment: 15A NCAC 18A .2807 (h) Metal stem-type, thin probe, numerically scaled indicating product thermometers, accurate to ± 3 degrees Fahrenheit shall be used to ensure the maintenance of the internal cooking temperatures of all potentially hazardous foods required under this Rule.- Observed no food thin prob thermometer available at the kitchen. Obtain a thin probe food thermometer and have available.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed disrepair toilet in PreK restroom in need of repairing. Keep in good repair. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at hand sink in infant diaper sink. Repair needed.

REPEAT 15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed disinfectant solution measured over 1000 ppm. Observed center without test strips for chlorine disinfectant solution. Obtain test strips for disinfectant solution that can measure the concentration between 500-800 ppm.

15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper cream stored underneath diaper table in two’s classroom less than 5ft. Ensure to keep all diaper cream at 5ft or higher at all time.

15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher purse inside unlocked cabinet and hanging less than 5ft in two’s classroom. Put all purses and personal belongings that contain no hazardous items at 5ft or higher at all time.

REPEAT 15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed cots in toddler classroom without number/name assignment. Ensure to assign and label each cot to the individual. If needed, provide chart list if numbers use and have it available upon request.

General Comment: 15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair.- Observed no light (out of order) in preschool restroom. Repair needed.

15A NCAC 18A .2810 (f). Water from a handwash lavatory shall not be used for bottle warming or to prepare formula, mix dry cereals, or other foods.- Observed in infant room, a bottle was warming in a plastic cup with warm water comes from hand washing food prep sink. Water use for food prep need to come from the kitchen or bottle water, not from the hand sink.

General Comment: 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children.- Observed hot water measured 116F in hallway restroom, 112F in toddler sink, 115F in pre school restroom, 74F in school age sink. Ensure to provide tempered water between 80F -110F.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilet in PreK, preschool, school age restroom need cleaning and keep clean. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled hand sink around the base/faucet here and there in the center. Detail cleaning needed and keep clean.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed classroom chairs store in toddler toilet room.

15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed center without test strips for chlorine disinfectant solution. Obtain test strips for all solution use for cleaning.

General Comment: 15A NCAC 18A .2819 (d) Use approved diapering methods as follows: 1) gather supplies, 2) wear disposable gloves (if needed), 3) use a disposable moist towelette to clean child, wiping front to back, 4) dispose of gloves if used and soiled towelettes, 5) wiping the employee's hands and the child's hands with a separate disposable towelette, 6) slide clean diaper under child and apply diapering products if needed using approved methods, 7) fasten diaper and place clothing on child, 8) wash child's hands, 9) and 10) clean and disinfect diapering surface using approved methods, 11) employee washes their hands.- Observed teacher is changing diaper incorrect/missing steps 3, 5. Ensure to follow correct procedures for diaper changes at all time.

General Comment: 15A NCAC 18A .2820 (b).Keys used to access hazardous item storage must be out of reach of children (5 ft above the floor) and stored separately from lock.- Observed key to unlock the storage room in infant 2 hanging less than 5ft. The storage room contains diaper cream inside stored less than 5ft. 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed unlocked laundry room that contains chemicals, paint buckets inside. Ensure to keep the door lock at all time. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time**

15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed cots in several classrooms without number/name assignment, or missing labeling. Ensure to assign and label each cot to the individual. If needed, provide chart list and have it available upon request.

15A NCAC 18A .2832 (a). Child care center premises, including the outdoor learning environment, shall be kept clean, drained to minimize standing water, free of litter and hazards, and maintained in a manner which does not create conditions that attract or harbor pests.- Observed fire ant piles on playground. Keep playground clear and safe from pest. Observed tall grass here and there on the playground throughout. Keep grass cut short, neat and clean.

REPEAT 15A NCAC 18A .2804 (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center.- Observed bottles in refrigerator infant without date/invisible/illegible date mark, and the other one is with incorrect date 8/13. Ensure to put current date of the day that items come in, both name and date clearly and legibly. 15A NCAC 18A .2804 (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration.- Observed baby bottle was return back in the refrigerator infant after feeding, and waited to be sent home with a child at the end of the day. Ensure to not put back any leftovers/used items back into the refrigerator to avoid any cross contamination.

General Comment: 15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed the center without test strips for QAC sanitizer use. Obtain test strips.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled black ring around toilet bowl in preschool restroom need cleaning and keep clean. Observed broken soap dispenser causing no soap to be available in 3’s restroom, item needs to be repair or replace. Provide soap bottle for hand washing at that sink.

General comment: 15A NCAC 18A .2806 (d) Specialty bulk milk that is sent from home for consumption by a child while at the child care center may be stored as set forth in the 2800 rules when the child's parent or guardian provides written permission and the specialty bulk milk is sent to the child care center at the beginning of each week unopened, labeled with the date received by the child care center, and labeled with the name of the child to whom the bulk specialty milk belongs. Any remaining bulk specialty milk shall be sent home at the end of the week with the child to whom the bulk specialty milk belongs.- Observed speciality milks in the kitchen refrigerator without date that was received at the center. EHS, director discussed proper way to handle specialty milks at the time of inspection. Ensure to receive the unopened container of specialty milks at the beginning of the week, put name and date that was received, send home or discard at the end of the end either opened or unopened containers.

15A NCAC 18A .2812 (e) Multi-service articles, including highchair feeding trays, shall be washed, rinsed and sanitized in the child care center kitchen after each use. - Observed high chair tray need better cleaning at the back crevices. Observed teacher is cleaning the trays stationary in the classroom after feeding. All multi-service articles (high chair trays, spoons, plates/bowls, rubber bibs) shall be wash, rinse and sanitize properly in the kitchen after each use.

General Comment: 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. -Observed hot water in toddle room measure 115F and 3 classroom measured at 117F. Ensure to provide tempered water where is accessible to children.

15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed very soiled water fountains in need of deep cleaning and keep clean.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair.- Observed slow drain of the hand sink in 2 classroom, need repair. -Observed throughout the center toilets and hand washing sink need better cleaning and keep clean.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.- Observed throughout the facility some missing soap in the dispenser and paper towels dispenser was not working properly causing no paper towels to be available. Ensure to provide soap and paper towels at all hand washing sinks at all time.

15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed the center was using sanitizer solution for disinfectant. Corrected during the inspection and solution concentration was measured 1000 ppm. Ensure to provide disinfectant solution at the concentration between 500-800 ppm.

General Comment: 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand sanitizer bottle behind a front desk stored less than 5ft, hand lotion and bulk container of soap in the cabinet in front restroom less than 5ft. Ensure to stored all non hazardous items at 5ft or higher at all time.

General Comment: 15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed cots with no name or number system labeling. Ensure to put name or number chart of cots assignment.

General Comment: 15A NCAC 18A .2822 (a). In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. - According to teacher dirty toys were collected and put in dirty bin and get clean at the end of the day. Teacher spray sanitizer solution on toys (that cannot not be submerged in water) after washed/rinsed. EHS discussed with teacher and director, all toys that can be in the water should be submerged in sanitizer solution for at least 2 minutes and let air dry after. Ensure to use correct strength of sanitizer solution when cleaning toys.

15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met. - Observed no quat sanitizer test strips present in facility. Quat sanitizer is used in three compartment sink for cleaning dishes.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. - Observed water temp of 74F in back school aged room (4 year olds occupying room at time of inspection). Increase water temperature to between 80-110F while children under the age of 5 occupy the room. Also observed water temperatures peak at 113-114F in toddler and infant rooms before quickly decreasing and holding between required tempered temperatures of 80-110F. Lower water temperatures to prevent peak temperatures reaching above 110F.

15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm). - Observed chlorine disinfectant solutions used in multiple rooms with concentrations beneath 500ppm. - CDI - PIC made new disinfectant solutions at proper chlorine concentrations.

15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. - Observed multiple rooms lacking cot charts throughout facility. - CDI - PIC created cot charts for all rooms lacking cot charts and labeled all cots.

Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d); Observed snippy cups / bottles missing dates in infant and toddler classrooms. CDI dates provided during inspection.

Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed diaper creams stored below 5ft not behind lock and key inside infant and toddler classrooms. CDI diaper creams stored at 5ft until proper locks can be installed.

Adequate space shall be provided for the storage of equipment, furniture, toys, clothes, linens, backpacks, book bags, diaper bags, beds, cots, mats, and supplies and shall be kept clean. 15A NCAC 18A .2820 (a); Observed clothes and equipment and misc items stored under hand washing sink drain lines inside majority of classrooms.

Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed hand creams and lotions stored inside unlocked drawers inside many classrooms; CDI all approved hazardous items stored above 5ft.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed tape residue stuck to walls throughout (toddler) classroom in need of removal.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seat inside (EPS) classroom bathroom very loose in need of repair.

REPEAT Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed disinfectant wipes stored below 5ft in several rooms behind child safety locks. All approved non-hazardous products stored above 5ft and/or locked up during inspection.

Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed changing table surface underneath changing pad collecting heavy debris in need of general cleaning; (note) recommend removing pad after cleaning and disinfecting to allow surface to dry and to observed if surface is in need of cleaning.

Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed sanitizers / disinfectants / diaper creams all stored below 5 ft throughout all classrooms.

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Solid wastes shall be disposed of in a manner that prevents insect breeding and public nuisances. 15A NCAC 18A .2830 (d). Observed multiple bags of trash stored inside play ground enclosure (bags ripped open with trash collecting on ground); Observed large uncovered trash bin located in back play ground enclosure over flowing onto ground in need of removal. Remove solid waste from play grounds and keep receptacles covered.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Linens shall be large enough to cover the entire sleeping surface of mats, cots, and crib mattresses and in good repair. 15A NCAC 18A .2821 (f). Observed sheet cover for cot having rips / holes in need of replacing in (2's) class; Observed cot surface damaged inside (2's) classroom.

Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed underneath counter surface of changing mat collecting debris in need of proper cleaning inside (toddler) classroom.

Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d) Observed numerous bottles inside (infant room) missing dates and having wrong dates.

Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e). Observed hot water inside (infant room) measuring 115F at hand washing sink; Observed hot water turned off in Toddlers classroom with only 67F water provided.

REPEAT Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed tape residue stuck to surfaces of equipment throughout infant rooms; Observed edges of tables collecting debris inside (2's) class.

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seats throughout classroom restrooms in need of repair.

REPEAT Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed laminate peeling from counter tops in 2's room; Observed tape residue on wooden cubbies throughout class rooms.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seats in need of repair throughout classrooms. (general comment last inspection)

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed (Goo Gone) corrosive agent stored in unlocked closets and in cabinets with only child safety lock in Infant room and Early Pre-school; Observed fish parasite treatment containing multiple warnings in need of storage behind lock and key stored inside unlocked cabinet. Observed adult restroom having multiple gallon sized paint buckets, spray paint and hazardous air freshener pump spray stored inside on shelving. (#29 general comment taken on last inspection) >PROVISIONAL STATUS ISSUED >PROVISIONAL GUIDELINES DOCUMENT EMAILED TO DIRECTOR. >RE-INSPECTION WILL BE CONDUCTED WITHIN 7 CALENDAR DAYS OF TODAYS DATE OF 1/3/2019.

REPEAT Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed changing table surfaces underneath clean changing mat collecting large amounts of misc debris in need of cleaning in Early Pre-school classroom; Observed tape residue on wooden cubbies in need of removal in Early Pre-school classroom.

Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7). Observed disinfectant in all rooms to be below 500 ppm.

Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed couch in junior kindergarten to be severely damaged. Observed a vinyl block in toddler room with tears. Observed toys in need of detail cleaning throughout center. Observed books in severe disrepair throughout center. Obseved vinyl block/ball in after school room with a tear. Observed changing table in early preschool room with debris under mat and in corners.

Wash hands when required. 15A NCAC 18A .2803 (a) Observed employee not wash hands before changing diaper. REPEAT VIOLATION

Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b). Observed diaper changing mat in infants and two's to be torn. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed employee change diaper during inspection. Employee did not wipe her hands or the child's hands with a wipe after discarding diaper. CDI: Employee educated during inspection.

Observed caregiver in toddler room change diaper and then release child back to playing without washing hands. Caregiver did not wash their hands either. Ensure caregiver hands and the hands of children who are able to support their heads are properly washed after all diaper changes. **Wash hands when required. 15A NCAC 18A .2803 (a)

Observed rusted toy instrument in the 2s room. Observed fraying area rug in the pre-k room. Observed large interactive play equipment with debris collecting in the crevices. It is advised that play toys go through a detailed cleaning. Observed debris on vinyl blocks in 2s room. **Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed several care givers improperly washed their hands. Bare hands were used to turn off the water after washing hands, and lather was less than 15 seconds. **Hand washing procedure shall include: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails and between fingers; (4) rinsing well for 10 seconds; (5) drying hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands. 15A NCAC 18A .2803 (c).

Observed no soap or paper towels were supplied in the employee restroom, and no paper towels at a hand washing sink in Threes room. **Liquid soap and disposable towels shall be provided and accessible at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed decoration/art was stored in the Toddler restroom (REPEAT). **Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed toys were stored inside the sink in the Toddler room, and warming milk bottlers were stored inside the sink in the infant room. **Hand washing sinks must be free of storage. 15A NCAC 18A .2818 (a).

Observed damaged sink cabinets in classrooms throughout facility. Observed attached cubbies in school age room with bare wood, needing paint. Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Repeat non-complaince: Observed white out cleaner in infant room, aerosol shaving cream in school age room, and betco disinfectant unlocked in rooms throughout. All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).

Observed damaged mattresses in infant room. Individual linen shall be provided for all beds, cots, or mats. 15A NCAC 18A .2821 (c ).

Observed disinfectant at 50 ppm. To clean and disinfect diapering surface: 1) Spray soapy water onto surface 2) Wipe off soapy water 3) Spray disinfectant onto surface until surface is glistening wet 4) Let disinfectant sit for at least 2 minutes or until air dry. 15A NCAC 18A .2819 (d).

Observed wound cleaning wipes stored over 5 feet in classrooms throughout. All medications must be stored behind lock and key. 15A NCAC 18A .2820 (d).

Observed aerosol sunscreen stored below 5 feet in toddler classroom and in junior K. All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).

Observed hand lotion and hand sanitizer stored below 5 feet in preschool. Observed non-prescription diaper creams stored under diaper table secured with child safety lock in toddler classroom. Observed purse stored below 5 feet in cubbie in toddler classroom. Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f). Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d).

Observed box of goldfish crackers not sealed. Observed eggs stored over milk in refrigerator.Store all foods in approved re-sealable bags or containers once opened. 15A NCC 18A .2806 (a)All food shall be stored and handled in a manner that protects it from contamination. 15A NCC 18A .2806 (d),(f), .2807 (b), and .2808 (e).

Repeat non-compliance: Observed broom and dust pan stored in bathroom in school age classroom.Adequate space shall be provided for the storage of equipment, furniture, toys, clothes, linens, backpacks, book bags, diaper bags, beds, cots, mats, and supplies and shall be kept clean. 15A NCC 18A .2820 (a).

Observed several toy basins damaged in toddler classroom. Observed toy roller bookshelf with finish damage in toddler classroom. Observed side of countercoup next to diaper changing hand sink damaged.Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed dumpster area collecting trash.Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d).

Observed fence not secure at right side of play area.Keep the premises clean and free of dilapidated structures and broken play equipment. 15A NCAC 18A .2832 (a).

Observed water collecting in domestic white refrigerator in kitchen. Observed gasket damaged in domestic white refrigerator in kitchen.Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f)

Repeat non-compliance: Observed storage of chairs and other items in bathroom in toddler/infant restroom.Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a).

Observed hand sanitizer wipes in outside bag under 5 feet.Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d).

Observed damaged vinyl couches repaired with tape, tape is loose around edges. Observed damage to corner of vinyl play equipment in toddler classroom.Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed sippy cup lids with stickers left on clean in toddler classroom. Observed worn sippy cup lids around mouth areas. Observed can opener blade collecting residue.Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Observed storage of new toys in 3's & 4's classroom restroom.Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a).

Observed damaged vinyl chairs repaired with tape, tape peeling in 2's room and in unused classroom at rear right of facility. Observed damaged toy shelf cabinet in school age room at bottom. Observed cubbies missing bottom shelf in school age room.Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed wall damaged in school age room below cubbies, section of baseboard missing.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed box of infant cereal boxes on floor in infant room. Observed food not properly sealed in school age room.Keep all food stored off the floor and in a manner that permits easy cleaning of the storage area. 15A NCAC 18A .2806 (d)Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)

Observed wet stacked bowls in kitchen. Observed wet sippy cups going out to toddler room, caregiver stated that they clean the cups brought from home. Observed labels still on cups.Completely air-dry all equipment and utensils before stacking or storing the items. 15A NCAC 18A .2812 (h)Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e) Labels must be removed prior to washing to ensure adequate sanitizing of utensils.

Observed refrigerator gasket collecting residue and debris in infant and toddler rooms.Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed single service cups and bowls stored in school age room. Observed single service bowls stored face down drawer in 2 room, drawer collecting debris.Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b).

Observed light shield damaged in school age restroom near staff lounge. Observed light shield displaced in infant room. Observed light out in pre K restroom.Keep all light fixtures clean and in good repair. 15A NCAC 18A .2826 (a). Observed HVAC return vent on wall in toddler room collecting residue.Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).