SUNSHINE HOUSE,THE

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed bottle warmer in infant room need detail cleaning and keep clean.

REPEAT 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 sanitizer solution spray bottles measured at 500 ppm. Ensure to provide correct chlorine sanitizer concentration between 50-200 ppm at anytime.

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 need to be re-labeling in some classrooms, different number on same cot. Ensure to erase old number/label on the cots. If use number, be sure to provide cot list which number assigned to whom.

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 in classrooms where mouthing/dirty toys present. The dirty toys were collected and put in dirty bin and get clean at the end of the day. Teacher put toys in sanitizer solution for 2-5 minutes and take them out, rinse with water and let air dry. Proper toys cleaning discussed with teacher and 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 .2825 (a) In child care centers, the walls and ceilings, including doors and windows, of all rooms and areas, shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint.- Observed restroom vent and door frame in toddler1 need cleaning and keep clean.

REPEAT 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 sanitizer throughout facility measured at 500ppm. Ensure to provide correct chlorine sanitizer concentration between 50ppm - 200ppm.

GENERAL COMMENT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled hand sinks in afterschool room in need of detail cleaning and keep clean.

15A NCAC 18A .2822 (a) Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. Observed children’s play furniture in Toddler 2 that was peeling and no longer smooth or easily cleanable. Repair or replace the items.

General Comment: 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 student is washing her hands in room 8, rinsing the soap out of her hand quickly and turn off a faucet knob with bare hands. Center has hand washing poster posted at the sink. Ensure to teach students and educate all staff to follow proper handwashing procedures.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmer in infant. Detail cleaning needed and keep clean.

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 chlorine concentration of sanitizer solution measure between 250ppm- 500 ppm. Ensure to provide correct concentration between 50-200 ppm at all time.

REPEAT 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 at hand sink in room 7, 8, and 3. Ensure to provide handwashing supplies at all hand sinks at all time.

REPEAT 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 for a child in infant room, missing step 3, 5, 8. Proper diaper changing procedures discussed in detail at the time of inspection. Every must wash their hands at the end of the changing procedure.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed office door left unlocked where laundry detergent containers were stored at the time of inspection. Ensure to keep the office doors locked at all time. Or treat everything inside the office like a classroom.

REPEAT 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 a front desk and inside outside bag hanging down from a hook in infant less than 5ft. Ensure to put all non hazardous items at 5ft or higher at all time.

General Comment: 15A NCAC 18A .2820 (f) A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children.-Observed children book bags/jacket in room 3, 7 hanging in the cubbies and touching each other. Keep all individual items separate and not allow contact while storing at anytime.

General Comment: 15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children.- Observed children cots in room 3 placing side by side while napping less than 18”. Ensure to place all cots apart at least 18 inches while napping.

REPEAT 15A NCAC 18A .2822 (d).Water play centers shall be filled with potable water immediately before children begin a water play session. Water shall be emptied after each play session and at a minimum each morning and afternoon, or more often if no longer clean.- Observed water play station left uncleaned/emptied from last play this morning in room 5. Proper water play station discussed in detail with teacher and director at the time of inspection. Ensure to follow proper procedures and do not forget to empty/clean/sanitize at the end of each session every time.

General Comment: 15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered.- Observed dumpster door left open while not in use. Ensure to keep all lids and doors close to prevent insects/rodents.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed some toilets in the facility need better cleaning/scrubbing to get rid of the ring marks around the bowls. Keep clean. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed several hand sink in the classrooms need better cleaning/scrubbing and keep clean.

General Comment: 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 and paper towels at hand sink in toddler 1. Ensure to provide soap and paper towels at all hand sinks at all time.

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 changing diaper in toddler and missing step 5 in the process. Detail proper procedures discussed with teacher at a time of inspection. Diaper changing procedures poster provided at the time of inspection.

REPEAT 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 lotions in drawer in after school stored less than 5ft. Ensure to put all non hazardous items at 5ft or higher at all time.

REPEAT 15A NCAC 18A .2822 (d).Water play centers shall be filled with potable water immediately before children begin a water play session. Water shall be emptied after each play session and at a minimum each morning and afternoon, or more often if no longer clean.- Observed water play station left unclean from last play in preK. Proper water play station discussed in detail with teacher and administrator at the time of inspection. Ensure to follow proper procedures and do not forget to empty/clean/sanitize at the end of each session every time.

General Comment REPEAT: 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 in classroom where mouthing/dirty toys present. The dirty toys were collected and put in dirty bin and get clean at the sink in the classroom throughout the day. Teacher spray sanitizer solution on toys and let them air dry. Proper toys cleaning discussed with teacher and 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 .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 bottled dated “wrong” 5/31 in the refrigerator. Ensure to check for correct date before putting items for storage.

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 teacher is rinsing the bottles at the hand sink in classroom. 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. 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottles warmer in infant room, need cleaning and keep clean.

General Comment: 15A NCAC 18A .2820 (b). 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 containers of Clorox and chemicals in the unlock cabinet in the kitchen. Hazardous items and how to store them discussed director assistant at the time of inspection. A lock mechanism will be installed to keep the chemical cabinet lock in the kitchen going forward. Observed bug spray inside a lock box that has a long lock device. This type of lock is still allow the lock box to be opened wide enough to put a hand inside and take items out. Proper lock to be installed discuss with director assistant and teacher at the time of inspection. NOTE: **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keep the key at 5ft or higher**

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 inside outside bag hanging down from a hook in classrooms, inside the closet in empty room below 5ft. Ensure non hazardous items stored right at 5ft or higher.

15A NCAC 18A .2822 (d).Water play centers shall be filled with potable water immediately before children begin a water play session. Water shall be emptied after each play session and at a minimum each morning and afternoon, or more often if no longer clean. -Observed water play station was filed and played this morning according to teacher, it will be clean at the end of the day. Proper way to handle the water play station discussed in detailed with teacher and director assistant at the time of inspection.

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 in classroom where mouthing/dirty toys present. The dirty toys were collected and put in dirty bin and get clean at the end of the day. Teacher spray sanitizer solution on toys and let them air dry. Proper toys cleaning discussed with teacher and 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.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. - Observed a child entered the 2’ classroom during circle time without washing her hands before joining the group. EHS asked a teacher and director, a child washed hands properly and return back to the group activity.

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 without thin probe thermometer. Obtain a thin probe thermometer.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. - Observed water temperature at every hand sinks throughout the facility is within required range. Except in the infant room, water temperature at diaper hand sink measured at 112F and the food prep hand sink water temperature at 128F. If these two sinks will not provide the temperature within the range like every other sinks. Recommend to get a separate water temperature control (mixing) valve installed.

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 pre school classroom missing names of children. Label all cots that belong to each individual child. 15A NCAC 18A .2821 (f).Linens shall be kept clean, in good repair, and stored with the mat or cot that the linens are assigned to or stored apart from the mattress or cot in a manner that keeps the linens used for each child separate from the linens belonging to other children. - Observed cuts and tears sheet on a cot in pre school classroom. Need repair or replace.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Observed food debris under high chair trays in infant classroom.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed 1 loose toilet seat in boys restroom located in after school classroom.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed cribs labeled on the wall and not the actual cribs in infant classroom. EHS encourage center to label actual crib with child’s name.

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 detailed cleaning needed to flooring of cabinets under handwashing sinks throughout center.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed baseboard laminate peeling from wall in 4’s classroom. Observed markings on wall behind handsink in 4’s classroom. Observed minor staining to some floor rugs throughout center. EHS advises center to touch up paint where needed throughout center. *NOTE: Director, Jessica Helmes was present during time of inspection, report emailed to her at: center45@sshouse.com

Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed opened package of cookies in toddler 1 closet not properly resealed.

Liquid soap and disposable towels shall be provided and accessible at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed no liquid soap or paper towels at hand sink in toddler 2 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 NCAC 18A .2820 (a). Observed general organizing needed to storage closets in classrooms throughout center.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed blue mats fraying throughout center.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed stained ceiling tile outside of PreK/after school classroom. Observed touch up paint needed to walls and baseboards throughout center. Per conversation with Director center is currently in the process of repainting. Observed minor staining on some floor rugs within center.

Keep dumpster lids and doors closed to prevent insect and vermin nuisances. 15A NCAC 18A .2830 (d). Observed dumpster lids opened during time of inspection. *NOTE: Director Mrs. Jackie was present during time of Inspection, report emailed to center at: center45@sshouse.com

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Per conversation with Director, highchair feeding trays are cleaned in place after each use. EHS educated center on rule 15A NCAC 18A .2812 (e).

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed cribs in infant room labeled on the wall and not actual cribs. Per conversation with Mrs. Jackie she is aware and will relabel cribs. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed cribs mats fraying in 2's classroom. EHS advises center to replace or repair mats.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed stained ceiling tile at the end of main hallway. EHS advises center to ensure no active leak is occurring and to replace stained ceiling tiles.

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

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 table edges collecting debris build-up in need of detailed cleaning inside (2's) classroom. Observed a few books with ripped covers and bindings, pull out of circulation as needed.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed wall behind trash cans becoming scuffed due to lid repeatedly hitting wall. (notable) in classroom (3-4's).

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 table edges collecting debris in need of cleaning in older aged classrooms from (toddlers on up).

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed water damaged ceiling tiles in several rooms in need of replacing.

Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f). Observed cot sheets in poor repair in use in 2's classroom in need of changing / replacing.

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 edges of tables (used by children when eatting) in older toddlers classroom, having old food build-up in need of detailed cleaning.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed scuffed walls in some classrooms in need of touch-up painting.

REPEAT Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed vents inside classrooms in need of general cleaning (Infant, young toddlers).

Observed bag of pretzels left open in the kitchen to the after school room. Observed Cheerios in plastic bag rolled up in the cabinet in room 6. Cheerios were to be used for art project. Ensure that food are stored in a resealable bag/container to reduce the chance of pests. **Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)

Observed sanitizer around 500ppm initially throughout inspection. Sanitizer was replaced at appropriate concentration. **Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed a loose toilet seat in room 7. Needs to be tightened. Observed outside of toilet in need of cleaning around the base in the girls' restroom in the school age room. **Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a).

Observed diaper changing pad torn in room 7. Needs to be replaced. **Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b).

Observed dust build up on vent covers throughout inspection. Have vent covers cleaned. **Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed dead insects in the light shields in the kitchen. Needs to be cleaned. **Keep all light fixtures clean and in good repair. 15A NCAC 18A .2826 (a).

Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d) Observed sanitizer above 200ppm in waddlers room. CDI: New sanitizer made and bottles refilled.

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 reaching only 75F in infant room and 56F in prek/afterschool room.

Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7). Observed disinfectant too high in 3's room and in waddlers room. CDI: New disinfectant made and bottles refilled. Observed disinfectant in 3/4 room to be at 200ppm. Sanitizer was placed in a bottle labeled disinfectant. CDI: proper labeling provided.

Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b). Observed diapering mat in waddlers and 2's rooms to be worn and damaged on corners. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed employee not wipe her hands or the child's hands with a wipe before donning a clean diaper. Each diaper changing station shall have a diaper changing sign and a handwashing sign posted. 15A NCAC 18A .2819 (h). Observed no diaper changing sign in waddlers 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 vinyl blocks in infant room and waddler room in need of replacing. Observed damaged books throughout facility. Observed cardboard blocks in 3/4 and after school rooms in need of replacing. Observed detail cleaning needed on most toys as a film has built up on them. REPEAT VIOLATION

All play ground equipment must be kept clean and in good repair. 15A NCAC 18A .2832 (c ). Observed several tricycles with rust. Observed damaged ball (holes in it) on playground. CDI: ball discarded. Observed several other pieces of equipment that were in severe disrepair.

Observed build-up in the cracks and crevices of bottle warmers in infant room. **Bottle warming equipment shall be cleaned and sanitized at least daily and when visibly soiled. 15A NCAC 18A .2810 (f) (1) and .2804 (d).

Repeat Observed build-up on the faucet on the infant room diaper changing hand sink and on the faucet in the after school girls bathroom. Observed cleaning needed on the base of toilets in bathrooms throughout. Observed missing screw cap on the base of the toilet in the boys after school bathroom. Caulking has improved since last inspection. Caulking still needed on several hand sinks where the basin meets the counter top and where counter tops meet back splashes. **Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). **Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Repeat Observed cleaning needed on large interactive toys in several rooms including but not limited to the "kitchen" in the 3/4 room and the foosball table in the after school room. Observed damage under sink in 3/4 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).

REPEAT Observed black build-up around the hallway water fountain. **Keep water fountains clean at all times. 15A NCAC 18A .2815 (f).

Observed cleaning needed on the base of toilets in bathrooms throughout center. Observed several toilet screw caps missing from toilets. Observed damaged base of toilet in the school age room. Observed damage and cleaning needed under hand sinks in classrooms throughout. Observed caulking needed around several backsplashes and at the base of hand sinks. **Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). **Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed white out in a high cabinet in the infant room. Observed can of purple hair spray in the back of a cabinet in the gym. Observed two containers of disinfectant wipes out on the table in the unlocked and unused back room. **All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).

Observed stained and soiled linens in infant room cribs. **Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f).

REPEAT Observed dust and debris build-up in the cracks and crevices of toys in classrooms. Observed cracked plastic toy container with sharp edges in the school age room. Observed cleaning needed on foot stools in classrooms. Observed cleaning needed on child safety locks in the infant and toddler rooms. Observed cleaning and caulking needed in the crack of several diaper changing tables. Observed dust build-up on keyboards in 3's and 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 a care giver in the infant room cleaned up a child's "spit-up" off of a rug and did not wash her hands. **Wash hands when required. 15A NCAC 18A .2803 (a)

Observed the kitchen utensil drawers with crumbs and food residue, the cabinet and microwave in the school age kitchenette needed cleaning. **Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f) **Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed the hallway water fountain with a buildup pf black residue. **Keep water fountains clean at all times. 15A NCAC 18A .2815 (f).

Observed the toilet base with dried urine, and the sink was clogged in the school age kitchenette area. **Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). **Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed a purse was stored below 5ft in an unlocked cabinet in the infant room. **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).

Observed caregiver wash hands and turn off water with bare hands. Handwashing 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 sanitizer in 3 compartment sink at 100 ppm. Quaternary Ammonium sanitizing solutions shall be maintained between 200 - 400 ppm. 15A NCAC 18A .2812 (b)(5)(D)

Observed residue collecting in drawers next to oven. Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed walls dirty in hallway and school age room. Observed discolored floors in restrooms throughout. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Repeat non-compliance: Observed water fountain missing metal nozzle and collecting residue in hallway.Keep all water fountains clean and in good repair

Observed disinfectant solution in 2's classroom between 250 and 500 ppm.Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed several damaged toy shelves in pre K classroom. Observed one damaged table in school age classroom. Observed damaged vinyl couch in toddler 2 classroom, and one damaged toy kitchen sink. Observed toy table in 2's classroom with finish damage.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 water fountain collecting residue in hallway.Keep water fountains clean at all times. 15A NCAC 18A .2815 (f).

Observed hand lotion unlocked in the infant room drawer. Keep water fountains clean at all times. 15A NCAC 18A .2815 (f).

Observed toy plastic couch damaged in pre k 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).

Repeat noncompliance: Observed vent in boys bathroom in pre k.Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed caregiver in infant room turn off water with bare hands.Handwashing 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 cups going to classroom not air dried. Observed cups drying with tape on exterior of cup from previous use.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)

Observed caregiver in infant room not wipe hands after cleaning child before placing clean diaper on child.Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d).

Observed several damaged mats in 2's classroom.Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a).

Observed dusty vents in classroom throughout facility.Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed fence on playground 3's 4's playground damaged, wire loose and fence pole not secured. Observed gate damaged on after school playground.All play ground equipment must be kept clean and in good repair. 15A NCAC 18A .2832 (c ).

Observed no thermometer in refrigerator in staff lounge with child care food present.**All thermometers in refrigerators shall be stored in the warmest part of the refrigerator and located to be easily readable. See rule .2806 (h) (1).

Observed cups wet stacked in kitchen. Observed commercial dish machine not sanitizing. Observed can opener blade collecting residue.**Completely air-dry all equipment and utensils before stacking or storing the items. See rule .2812 (h). **Multi-service utensils must be washed, rinsed, and sanitized after each use. See rule .2812 (e)

Observed sanitizer over 200 ppm in kitchen.**Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. See rule .2812 (d)

Observed disinfectant over 1000 ppm in classrooms throughout facility.**Prepare disinfectant between 500-800 ppm chlorine daily. See rule .2819 (c ) and .2801 (7).

Observed caregiver in room 7 not remove gloves and wipe hands prior placing clean diaper on child.**Follow the correct diaper changing procedure as described in rule .2819 (d).

Observed debris collecting behind oven in kitchen.**Keep all floors, walls, and ceilings, clean and in good repair. See rule sections .2824 and .2825.

Observed vents collecting dust in care rooms throughout facility.**Keep all ventilation related equipment clean and in good repair. See rule .2826 (b).