CADENCE ACADEMY PRESCHOOL, KENTON

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmers in infant 1 and 3 in need of 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 no paper towels available at diaper sink in Pre2, and Meck 1 restroom sink. 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 disinfectant solution throughout the facility measure at about 100 ppm. Provide correct concentration of disinfectant solution between 500-800 ppm at anytime.

General Comment: 15A NCAC 18A .2820 (d).Medications, including prescription and non-prescription items, shall be stored in a locked cabinet or other locked container and shall not be stored above food.- Observed Benadryl stored with Abuterol in same bag in Pre 1. All medications (prescribed or over the counter) must kept in lock storage or cabinet at anytime. NOTE: Abuterol (Emergency medication) can be stored at 5ft or higher for emergency access. 15A NCAC 18A .2820 (d).Designated emergency medications shall be kept inaccessible to children, 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.

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 sippy cup of milk in Beginner refrigerator without date. Ensure to label name and date received on item as they come in for the day. 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed goldfish in ziplock bag without name and date in Infant 2 cabinet. Ensure to label both name and date on any items that was sent from home.

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed very low pressure of hot water faucet in toddler restroom. Water pressure needs to be adjusted and give adequate pressure for proper hand washing. Observed slow draining at hand sink in Pre 2, toddler. Repair needed. Keep all fixture in good repair.

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 throughout the facility measure less than 500 ppm. Ensure to provide correct concentration between 500-800 ppm at anytime.

15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed bulk soap containers in Pre3, Pre 2. Keep all bulk soap containers at least 5ft or higher at anytime.

REPEAT 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 bag and jackets are hanging on hooks next to and touching each other in several classrooms throughout the center. Ensure to keep all individual items separate and not allow contact while storing 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 in Meck 1, cots without/missing labels. Ensure to keep labels each cots with either name or number. If number use, please provide the cot chart. 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users.- Observed laundry basket sit on top of cot with sheet in Meck 1, Pre 3. Observed in Pre 2, cot was facing each other/touching clean side while storing. Ensure to keep separate soiled items and clean items. Not allow contact for any possible contamination at anytime.

General Comment: 15A NCAC 18A .2804 (k) Hot foods that a child brings from home to the child care center in double-walled, insulated thermos containers may be stored outside of refrigeration at the child care center with the written permission of the child's parent or guardian.- Observed fish stick, bread and fries in plastic food container sitting on the kitchen counter. According to teacher, parent wants the food to be served at the room temperature. EHS suggests the proper way to care to the situation. Keep food in double-walled, insulated thermos container and obtain parent’s permission and have available upon request.

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 B dated 4/12. Ensure to put correct date that items was received at the center. 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed lunch container without date that was received at the center. Put both name and date on items sent from home.

REPEAT 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 very soiled inside of water coolers, need better cleaning throughout crevices in and out daily. Item needs to be cleaned to sight and touch. 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmers in infant rooms. Detail cleaning needed and keep clean.

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed very low pressure of hot water faucet in toddler restroom. Water pressure need to be adjusted and give adequate pressure for proper hand washing. Observed loose faucets at hand sink in Pre 2. Repair needed. Keep all fixture in good repair.

REPEAT 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. - Observed art crafts, learning items, toys, picnic mat stored inside restroom shared restroom Pre4. Ensure to store only permitted items in the toileting room.

General Comment: 15A NCAC 18A .2820 (d).Medications, including prescription and non-prescription items, shall be stored in a locked cabinet or other locked container and shall not be stored above food.- Observed a tube teething gel and Neosporin ointment in a container in the outside red bag in Pre4. All medication items shall be stored in lock cabinet/storage 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**

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed items sit out unlock on shelf/cabinet (essential oil and in Meck 1. Super glue in Beginner). All hazardous items which has labeled “Keep out of reach of children “ Warning” “Caution” shall be kept in lock cabinet or lock storage 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 .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 in Meck 1 storing on a shelf less than 5ft. Ensure to keep all non hazardous items at 5ft or higher at all time.

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 bag, jackets hanging on a hook touching each other. Ensure to keep all individual items separate and not allow contact while storing at anytime. NOTE: ***15A NCAC 18A .2820 (f). Coat hooks not in individual cubbies or lockers must be 12 horizontal inches apart.***

General Comment: 15A NCAC 18A .2804 (d) Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below.- Observed during lunch time, gallon of milk and specialty milk storing in the hand sink in beginning class. Milks removed from the sink, temperature measured at 51F -55F. Ensure to keep and maintain all TCS food at required cold temperature of 54F or below at all time.

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 at the back of highchair trays need better cleaning throughout crevices front and back. Item needs to be cleaned to sight and touch when already clean.

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. - Observed hand sinks in Meck 1& 2, pre 1, 2, 3 need detail and better cleaning and keep clean.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. - Observed art crafts, learning items, wallpaper, noodle tubes stored inside restroom shared restroom Pre4. Ensure to store only permitted items in the toileting room.

15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed bulk soap stored in cabinet under 5ft in pre4. Keep all bulk soap at least 5ft or higher while storing.

General Comment: 15A NCAC 18A .2821 (f) Linens shall be large enough to cover the bed, cot, or mat's sleeping surface.- Observed in Meck1, several children sleep on a cot directly without fitted sheet. Provides sheet while using cot for sleeping. 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users.- Observed damage cots in Meck2. Repair or replace needed. Remove damage cots.

General Comment: 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 tear on blue coach, damaged diaper table in Beginning classroom, repair/replace needed. Observed debris at the back of diaper pad and around corners diaper table in Beginning, Pre1. Ensure to clean properly throughout the surfaces front/back/all around.

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 the teachers, toys get wash and rinse and lastly spray with sanitizer. Proper toys cleaning discussed with teacher and directors 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.

REPEAT 15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed no lock on gates where accessible to HVAC units in the playground. Put/install lock on gate and made inaccessible to children.

15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed no date that was received on baby snack items in infant room. Ensure to put both name and date received at the center. 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 leftover cracker in classroom where they have food preparation area, item is in cabinet left opened in basket. Ensure to store all leftover snack in resealable bag or container.

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 kitchen 3 compartment sink is using QAC sanitizer. Obtain QAC sanitizer testing method for the solution use.

General Comment: 15A NCAC 18A .2815 (e) Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children.- Observed kitchen door left unlock. Keep kitchen door lock at all time.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. - Observed hand sinks in Meck 1& 2 need detail cleaning and keep clean.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed instant ice packs in outside bag (Beginning, P1, P3, Meck 1 & 2, front desk) labeled “Keep out of reach of children” and extra caution/warning. Observed gallon of paint in unlock closet in Meck 2 and underneath table front desk. All hazardous items shall be locked 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**

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 approve disinfectant wipe container stored in cabinet with child prof device less than 5ft. Ensure to store item at 5ft or higher at all time.

General Comment: 15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed no lock on gates where accessible to HVAC units in the playground. Put lock on gate and made inaccessible to children.

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 trays in infants room need better cleaning, underneath the tray, around the arms and handle. Observed rubber bibs that are used by children when feeding. According to teacher they are washed and sanitized in the classroom. All multi-service articles need to be properly wash/rinse/sanitize in the kitchen after each use.

REPEAT 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. - Observed pop up tent, diaper pad stored on the floor in P-3. Observed flower bag hanging on the wall, floor mat puzzle, wall pepper Amazon box, supplies bag, jackets, art/learning supplies/toy stored in both boys and girls restroom in P-4. Observed laundry/clothes baskets in Meck 1. Ensure to store only permitted items in the toileting room.

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 teachers are changing diapers incorrectly/missing step #3, 4, 5, 6. EHS discussed with teacher proper diaper changing procedures. Diaper changing procedures poster emailed to director 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 sanitizer bottle stored in the basket on the table at the young toddler playground. Hand sanitizer bottle stored on the hand washing sink in men restroom in PreK hallway. Hand sanitizer little squeeze container inside the emergency bag stored below 5ft in toddler A. Items put up 5ft at the time of inspection. Observed diapering creams stored under the changing table below 5ft in Toddler A, Beginners, Infant B, P-2. Ensure to store/put away non-hazardous items 5ft up and above.

General Comment: 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users. - Observed tears and starting to frayed at the corner of mattresses in infants rooms. Need repair or replace. 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 without name or numbers of assigned students in P-3 and Meck 1. Ensure to have name/number/chart showing which cot belongs to whom.

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 the teachers, toys get wash and rinse and lastly spray with sanitizer. In the classroom, there are 3 steps buckets for cleaning toys. EHS suggests teacher to wash/rinse and lastly soaking the toys in the sanitizer solution bucket at least 2 minutes (unless it cannot be soaked, spray is needed), then let it air dry. When cleaning toys in the classroom, ensure that the sanitizer solution get prepare with the correct strength every day. Or toys can to washed/rinsed and sanitized in the kitchen at the 3 compartment sinks or dishwasher as see fits.

General Comment: 15A NCAC 18A .2827 (d). The child care center shall have written procedures that employees shall follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the center. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, children, food, and surfaces to vomitus or fecal matter.- Observed the facility without the vomiting and diarrhea written procedures. EHS emailed the procedure and poster to director at the time of inspection.

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 speciality milk brought from children’s home labeled with name and no date in dorm refrigeration unit stored in beginners classroom. EHS advises center to store all containers of milk brought from children’s home in domestic refrigeration unit located in kitchen. Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed opened package of cereal in Pre 3 classroom not properly sealed.

Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f). Observed at 3 compartment sink in kitchen, water stuttering when hot water is turned all the way and making a loud noise. EHS advises center to have maintenance take a look at sink and ensure sink is properly functioning.

The kitchen dishwashing sink shall be supplied with hot water at 120°F or above. 15A NCAC 18A .2815 (e). Observed hot water at 97F at 3 compartment sink in kitchen. Regional Director adjusted hot water valve for kitchen during time of inspection, hot water was restored and a work order has been submitted to ensure hot water is permanently fixed. EHS advises center to ensure that the hot water in access to children is in the range of 80F-110F.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed storage in beginners classroom restroom and in Meck Pre K girl restroom.

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 teacher in older infant classroom spray diapering surface with soapy water, wipe off, then spray disinfectant onto surface, and immediately wipe off. EHS educated teacher on notated rule and diapering surface was sprayed with disinfectant and was not wiped until after 2 minutes.

All cleaning and disinfectant solutions shall be properly labeled (i.e. soapy water, disinfectant). 15A NCAC 18A .2819 (c ) and .2820 (c ). Observed soapy water bottles not labeled in Pre 2 classroom. Observed spray bottles containing sanitizer and disinfectant not labeled throughout center, instead a coloring system is being used (yellow for sanitizer, red for disinfectant). Per notated rule all cleaning and disinfectant solutions shall be labeled according to what solution is housed in spray bottle. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed teacher leave on soiled gloves throughout entire diaper changing process and not wash child’s hands after completing diaper change in older infant classroom.

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 bottles of hand sanitizer stored on front desk check in area below 5 feet. Hand sanitizer was relocated above 5 feet during time of inspection.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed touch up paint needed to walling throughout center.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed cots damaged inside (P4) in need of 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 tables edges inside older classrooms starting from (young toddler on up) in need of cleaning.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed vents / grates throughout classroom having heavy build-up in need of general cleaning.

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 and behind child safety locks inside (Pre-school) classroom. CDI wipes stored at 5ft during inspection.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed areas throughout of worn, scuffed paint in need of touch-up painting. (note) director stated that estimate was submitted for painting recently.

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 a few classrooms not behind lock and key. CDI disinfectant wipes properly stored during inspection. Observed diaper creams stored behind child safety lock below 5ft inside (Pre-2) classroom; creams properly stored during inspection.

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 books throughout center having ripped / damaged bindings in need of removal from circulation; Observed tape residue on wooden cubbies inside (Pre-K) classroom in nee of removal.

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 books bindings damaged in several rooms in need of removal / replacing. Observed chair-rail shelving inside older aged classrooms damaged (showing raw wood) in need of touch-up painting.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed vents (intake) throughout all centers and kitchen in need of general cleaning.

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 edges of tables inside classrooms (Beginners, and Toddlers A/B) having build-up in need of general cleaning.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed scuffed / damaged walls inside classroom (Beginners, Toddler A) in need of touch-up painting.

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 edges of tables collecting debris in need of cleaning in (Beginners) classroom.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls scuffed inside numerous classrooms (Beginners, Toddler A, Toddler B) in need of touch-up painting.

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 baby bottles in Infant room A missing dates and another with incorrect dates.

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 on wooden cubbies in Beginners class in need of removal; Observed broken handle on cabinet door in Pre-K room in need of repair; Observed debris collected underneath changing mats in rooms having changing tables; Observed debris collected inside surfaces of cabinets at changing table stations.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed ceilings in all classrooms around ventilation outlets collecting debris in need of cleaning. Observed water damaged ceiling in room #P4 in need of repair; Observed chair rail molding in room #P3 in need of touch-up paint.

Observed heavy build-up in bottle warmers in younger and older infant rooms. Observed caregiver state that she tries to take bottle warmer to be cleaned in the middle of the week. EHS explained that bottle warmers are to be cleaned and sanitized at least daily. **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 pink build-up around water fountain nozzles and drains. Observed left water fountain with water pressure too high where water is splashing. **Keep water fountains clean at all times. 15A NCAC 18A .2815 (f). **Water pressure at drinking fountains must be high enough so that water clears mouth nozzle, and so that water does not splash on the floor. 15A NCAC 18A .2815 (f).

REPEAT Observed dust and debris build-up in the cracks and crevices of larger toys throughout center. Use scrubber to remove debris from cracks and crevices. Observed build-up in the cracks and crevices of highchair seats in infant room. Observed staining on gray chairs in infant room and after school room. Observed cleaning needed on the back of blue couch in older toddler room and debris in the cracks and crevices of blue couches throughout classrooms. Observed cleaning needed in the storage section of diaper changing tables in the infant rooms. Observed heavy build-up on washer in laundry room. Observed strollers with debris build-up in the cracks and crevices. Observed tape resudue collecting debris on shelfving throughout. 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 dust build-up on several classroom ceilings. Observed water stained ceiling in after school area. Observed debris collecting near the walls in several classrooms. Observed chip in floor tile next to toilet in the gym bathroom. Observed small carpet rug being stored under hand sink in one bathroom. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. **Floors and floor coverings of all food preparation, food storage, utensil-washing areas, toilet rooms, and laundry areas shall be constructed of non-absorbent, easily cleanable material. 15A NCAC 18A .2824 (a).

Observed teacher not wash hands after diaper change. Wash hands when required. 15A NCAC 18A .2803 (a)

Observed pink residue on water fountain mouth piece. Keep water fountains clean at all times. 15A NCAC 18A .2815 (f).

Observed hard toys, such as, trucks, buses, etc. needing to be cleaned throughout classrooms. Observed tape residue on toys and shelving. 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 stained ceiling tiles in classrooms. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Wash hands when required. 15A NCAC 18A .2803 (a) Observed child not wash hands upon arrival and child's hands not washed after diaper change.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed several paper towel dispensers that were jammed, had dead batteries or were empty.

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 unlocked shampoo and hair gel in an unused classroom. Keep items properly stored/locked in unused rooms and bathrooms.

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 soiled pillows, torn pillows and tape residue on furniture.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed water stained ceiling in several areas. Repair whatever is leaking.

Observed refrigerator in toddler 1 classroom indicating 49 degrees. Milk moved or discarded. All food shall be stored and handled in a manner that protects it from contamination. 15A NCAC 18A .2806 (d),(f), .2807 (b), and .2808 (e).

Observed can opener blade collecting residue. Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Observed no paper towels available at hand sinks in Pre K/Pre 4 classroom restrooms. Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed purse and hand sanitizer pre 3 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 single service cups stored in outside bag pre 2 classroom.Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b).

Observed storage in bathrooms in pre 2 including blinds extra trash cans and a step stool.Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a).

Repeat non-compliance: Observed washer in laundry room with rust around the lid.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-compliance: Observed baseboards and wall damage in classroom throughout facility.Observed caulk damaged on toilets in pre 2 classroom.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

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

Repeat non-compliance: Observed walls with damaged paint and damaged baseboard in several classrooms.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed no drain plug in dumpster, dumpster side door open and trash around dumpster.Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d).Install dumpster drain plug to prevent insect and vermin nuisances. 15A NCAC 18A .2830 (d).

Observed can opener blade collecting residue on back side if blade, scoop and spoon collecting food debris. Observed cutting boards damaged, not cleanable.Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Observed cots stored in restroom in Pre 2A.Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a).

Observed non-prescription diaper cream unlocked in toddler 1 classroom.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).

Reeat non-compliance: Observed baseboards damaged throughout facility. Observed ceiling damaged in toddler 1 classroom. Observed residue on floors throughout facility in corners and around door jambs.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

No CCA treated lumber date since 2009, fence must be sealed every 2 years.All exterior non-painted wood installed before 1/1/05 must be sealed or stained at least every 2 years. Seal wood with either an oil-based, semi-transparent sealant, oil-based clear stain, or water-based clear stain. 15A NCAC 18A .2831 (e), (f), and (g).

Observed cups wet stacked, canopener blade collecting residue, assorted utensils dirty, and 2 damaged knives in kitchen.Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Observed damaged walls and residue collecting on doors and furniture from wax in classrooms throughout facility.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

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

Observed sandbox with no cover on playground.Sandboxes must be covered when not in use and kept clean. 15A NCAC 18A .2832 (c ) (2).

Observed residue collecting on can opener blade. Cook stated that can opener is wiped between uses and washed, rinsed and sanitized every week.Observed back side of spoon collecting food debris, spoon stored as clean.**Multi-service utensils must be washed, rinsed, and sanitized after each use. See rule .2812 (e)

Observed hand sinks throughout facility constantly dripping/running.**Keep hand washing sinks clean and in good repair. See rule .2818 (a).

Observed window sills collecting dust in todd 2, and pre k 1 classrooms. Observed baseboard damage throughout facility. Observed walls with chipping paint in care rooms throughout facility. Observed wall paper damaged in pre 4 classroom. Observed yellow stains on ceiling in pre 4 classroom. **Keep all floors, walls, and ceilings, clean and in good repair. See rule sections .2824 and .2825.