CADENCE ACADEMY PRESCHOOL, MALLARD

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 baby bottle in infant refrigerator some without date, and other date unclear. Ensure to label clearly both name and date on items sent from home 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 children’s lunch box without date. Put both name and date received at the center on items send 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 in young 2’ leftover and opening graham crackers bag in drawer. Ensure to keep/store all leftover snack in reasealable bag or containers to prevent pests. 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 specialty milk in kitchen refrigerator dated 3/2, 3/31, and some without date received. 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 week either opened or unopened containers.

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 center without working thin probe food thermometer in the kitchen. Obtain a food thin probe thermometer and have available.

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 measure less than 50 ppm. Ensure to provide correct chlorine sanitizer solution concentration between 50-200 ppm at anytime. NOTE: The facility is out of testing strips, Please obtain testing strips for sanitizer and disinfectant.

General Comment: 15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair.- Observed rusted shelves inside kitchen refrigerator. Repair or replace shelving needed. Observed debris at the bottom of that refrigerator needs cleaning and keep clean.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed several sinks in restrooms need new caulking, repair and keep in good condition. Some loose faucets need repair.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed Meck 2 stored their toys inside the restroom shelving. Ensure to keep/store only toilet related items in the restroom at anytime.

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 sanitizer solution spray bottle throughout the center hanging down the shelves less than 5ft. Ensure to keep items at 5ft or higher at all time. 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 refill soap container stored on top counter at front desk less than 5ft. Keep the items at least 5ft at anytime.

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 unwanted toys and stuff piling up in the HVAC/ or on playground. Clearing the space is necessary . Keep free of clutter.

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 bottle dated 11/26 in infant refrigerator. Ensure to label correctly on item sent from for today date (12/2). 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, some with name and without date received. Some with name and dated 10/21, 11/10. EHS, director and chef 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 week either opened or unopened containers.

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 throughout the center measured at 1000 ppm. Ensure to provide correct concentration of the sanitizer solution between 50- 200 ppm at anytime.

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 center measured at 1000 ppm. Provide correct concentration of disinfectant solution between 500-800 ppm at anytime.

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 unlocked cabinet where chemical stored in the kitchen. The lock was broken. CDI- The chemical was removed and put in the lock laundry closet outside in the kitchen at the time of inspection. Hazardous items and how to store them discussed with director and a chef at the time of inspection.

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 hanging on the hooks in several classrooms touching each other. Ensure to keep each individual items separate and not allow contact while storing at anytime.

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 soiled looking sheets on cots while children are napping in toddler. Ensure to change and clean the sheets when needed and when is visibly soiled.

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 dated 5/29 in infant refrigerator. Ensure to put correct date received labeling on items send from home. 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, some with name and without date received. Some with name and dated 5/5, 5/8, 5/14, 5/19. EHS, director and chef 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 week either opened or unopened containers. 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 snacks in infant room some without name and date, some without date in cabinet. Observed saved snacks that were left over from a party without labeling in toddler. Ensure to label with name whom items belong to and date that items was received at the center.

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 teacher refill water bottle for student to drink at faucet hand sink in classroom P3A. Ensure to provide drinking water in pitcher/cooler to each classroom at the beginning of a day.

15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed soiled water fountains at a drain basin and spout. Detail cleaning needed and keep clean.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed a gap along the edge of hand sink in PreK3, repair needed.

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 sanitizer spray bottles stored less than 5ft in P2. Put all sanitizer bottles at 5ft or higher at all time. 15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed a bulk soap container stored in cabinet under counter less than 5ft in PreK3. Ensure to store all bulk container of soap 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 several classrooms missing/fading/incorrect numbers on their cot. Relabeling, make it clear and legible. If needed have a cot list available and current/correct.

General Comment: 15A NCAC 18A .2826 (b).Windows and window treatments shall be kept clean and in good repair. All ventilation equipment, including air supply diffusers, return grilles, and fans shall be kept clean and in good repair.- Observed several AC/ceiling vents in classroom/restroom need cleaning and keep clean.

REPEAT 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 teachers washed their hands less than 20 seconds and turn off the faucet knob with bare hands. EHS provide education to teachers and director at the time of inspection how to properly wash hands. Hand washing signs provided to the center again at the time of inspection.

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 a child sippy cup in toddler room without name and date, and some has dated 11/21, 11/13 in the beginner refrigerator. Ensure to put both name and correct date received labeled on items send 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 leftover bulk bag of snack/crackers in infant 2, closed with blue tape. Ensure to store all leftover bulk food in resealable bags/container. 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 half gallon of milk in a dorm refrigerator in beginner. All bulk milk shall be stored in a full size refrigerator or where is approved at all time. 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, 2 without date received. EHS, director and director assistant 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 soiled high chair trays in infant 1. When asked teacher stated that the tray was cleaned and no one in this class really using it. All clean items must be cleaned to sight and touch. 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 bottle warmer in infant 2. Cleaning needed and keep clean.

General Comment: 15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair.- Observed refrigerator in classrooms in need of cleaning and keep clean.

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 and incorrectly/missing steps. Follow proper procedures and ensure that everyone is washing their hands at the end correctly and use the diaper hand washing sink to wash hands after diaper changing procedures. EHS, teachers and director discussed detail at the time of inspection, diaper procedures poster provided to the center.

General Comment: 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.- Observed emergency medication for seizure in the red bag hanging down the hook less than 5ft in beginner. Ensure all the bag and string attached is up 5ft or higher at all time.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed an GOO GONE spray container in unlock cabinet in infant 1, air freshener spray bottle in unlock staff restroom, ice pack in red bag infant 1, many and different type of chemical in unlock laundry room door. Hazardous items and how to store them properly discussed in detail with director and teacher at the time of inspection. Ensure to lock any hazardous items that has labeled “Keep out of reach of children” and extra “caution” or “warning”. When locking the doors, please ensure that it is fully lock by pulling it and check. The center has a poster on how to store non hazardous or hazardous items posted in some classrooms. 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 .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 wash soapy water, rinse and 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.

REPEAT 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 water damage on popcorn ceiling from leaks in Meck 3, paint are peeling off, same looking from last inspection. According to last report work order to be completed and submitted on 5/20/24. Director stated that the technician is coming out to address the issue today.

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 the gate with no lock around the utility equipment (HVAC), HVAC fence near the kitchen has outdoor hot and cold water spigot. Install/put a lock on the gate, make it inaccessible to children. The work order to be completed and submitted on 5/24/24 according to last report. However there is no lock on those gate today inspection.

REPEAT 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 in Beginner washed hands and turn off the faucet knob with bare hands. CDI- EHS asked the teacher to proper wash hands again. Hand washing signs provided at the time of inspection.

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 baby bottles without date received and “wrong” date 5/29 for the other child in infant 1. Ensure to keep all name and correct date received labeled on items. 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 “wrong” date 5/29 on a child’s lunch box in MeckPK2. Ensure to double check the correct date when item 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 bulk bag of snack/crackers in infant 2, closed with blue tape. Properly store all leftover bulk food in resealable bags/container.

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 soiled at the back of high chair trays in infant rooms. Need better cleaning. Rubber bibs in Toddler room need to be cleaned in kitchen after each use.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. -Observed around hand washing sink in Meck 3, may need some caulking and keep clean/good repair. Observed very soiled diaper hand washing sink in Toddler. Need better cleaning and keep clean.

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 disinfectant wipes in drawer at front desk less than 5ft. Keep non hazardous items at 5ft or higher.

15A NCAC 18A .2821 (f). Linens shall be laundered between users, when soiled, and otherwise once per week in rooms with children 1 year old or greater.- Observed soiled cot sheets in Toddler and P3A classroom. Cleaning needed when visibly soiled.

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 water damage on ceiling from recent leaks in Meck 3. Work order to be completed and submitted on 5/20/24.

REPEAT 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 the gate with no lock around the utility equipment (HVAC). Install lock and make it inaccessible to children. The work order to be completed and submitted on 5/24/24.

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 teacher in Meck 2 washed hands less than 5 seconds and turn off the faucet knob with bare hands. CDI- EHS asked the teacher to proper wash hands again.

General Comment: 15A NCAC 18A .2806 (h) The temperature of potentially hazardous food provided by the child care center for consumption by children shall be 45 degrees Fahrenheit or below, or at 135 degrees Fahrenheit or above at all times, including field trips, catering events, and outdoor service, except during periods of preparation and service immediately prior to consumption.- Observed cut water melons in lunch container in book bag in child cubby Meck 3, temperature measured at 65F. Ensure to maintain cold temperature of all potential hazardous foods at 45F or below at all time. Proper way to handle the situation discussed in detailed with director at the time of inspection. NOTE: 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.- If use thermos containers, obtain the parent permission form and keep for record.

REPEAT 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 Gerber baby food sent from home without date that was received in infant rooms. Ensure to put both name and date that items was received at the center. 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, all of them had name and date that was received at the center (5/15, 5/16, 4/30). EHS, kitchen staff, and director assistant 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 .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.- According teachers and director in infant room, they are practicing 1-2 hours rule that was in their training from CDC. EHS and director and their center regional personnel discussed the rules in details and going forward, the center will follow the notated rule above, and inform their employees and parents about proper way to handle the feeding process.

General Comment: 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed Bottle warmer need better cleaning and keep clean.

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 diaper sink in infant 1, water temperature at 72F. Provide tempered water.

General Comment: 15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed soiled water fountains all around surfaces, crevices, spouts. Need details cleaning and keep clean.

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 spray bottle measured less than 500 ppm in infant 1. Ensure to receive fresh prepared bottle each morning.

PROVISIONAL ITEM: 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 Emetrol Liquid “Rapid nausea relief” medication in unlock cabinet in beginner classroom. Keep items in lock cabinet or storage at all time. 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.- Observed emergency medication in the outside bag hanging on the hook in classrooms less than 5ft vertical distance from the floor to the bottom of the bag. Ensure to keep item at 5ft or higher at all time. 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.**

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 air freshener aerosol can inside the drawer at front desk, Observed ice packs in outside bag that has label of “warning” and poison control in some classrooms. Observed baby oil in cabinet with child prof lock in Meck 2. Observed broken magnet lock cabinet in the kitchen where Clorox was kept. Ensure to keep all hazardous items lock at all time. 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.**

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, wash liquid soap for child diapering stored less than 5ft (infant 2, front desk, beginner) Keep non hazardous items at 5ft or higher. 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 less than 5ft with child prof lock in Meck 2 and 3. 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 staff bag/purse stored on the floor/ drawer/ chair (front desk, Meck 3)

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 Meack 4 need an updated cot chart, and Pre 4 has missing/fading numbers on their cot.

General Comment: 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 was filled at the beginning of the day for center. And according to teacher it gets dump at the end of the day. Proper way to handle the water play station discussed in detailed with teacher and director at the time of inspection.

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 the gate with no lock around the utility equipment (HVAC). Install lock and make it inaccessible to children.

General Comment: 15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. - Observed children arriving into Infant 1 classroom without hand washing upon arrival before engaging in the activity. Ensure that children wash hands upon arrival each time.

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 package of snack in Meck 2, not being stored properly in the container or resealable bag. 15A NCAC 18A .2810 (f) Water from hand wash lavatory shall not be used for bottle warming or to prepare formula, mix dry cereals, or other foods. According to director, children would take water to drink from the food prep hand washing sink. Drinking Water needs to come from the kitchen or bottle water, not from the hand sink. 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 commercial package of baby food in the infant 1 with name of a child, but not the date that was received at the center. Ensure to put both name of a child and date that was received at the center.

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 infant rooms need better cleaning at the back crevices and all around surfaces, and shall be sent to kitchen for wash/rinse/sanitize after each use. According to teacher the trays and rubber bibs get clean at the sink in the classroom. All multi-service articles need to be wash, rinse and sanitize properly in the kitchen after each use.

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 used for 3 compartment sinks in the kitchen without the testing device or kit to measure the correct concentration of the solution. Obtain a test kit for the solution use in the 3 compartment sinks.

General Comment: 15A NCAC 18A .2815 (f).. The water pressure of a drinking fountain shall be regulated so that an individual's mouth does not come in contact with the nozzle and so that water does not splash on the floor. - Observed water pressure at the fountains are very low. Children mouth may come in contact with the nozzle when using it. NOTE: director stated the water pressure in the building is low. So the facility will install the cup holder on the wall next to the fountain and children will use the cup to collect water to drink from the fountain instead of catching water by mouth.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed container of Clorox and aerosol disinfectant spray can in the kitchen not lock away. Director will fix the magnet lock cabinet in the kitchen and keep all hazardous items there.

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 cuts and tears at the corner of mattresses in infant rooms. Need repair or replace.

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 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 except toys that cannot not be submerged in water can be sprayed with sanitizer solution. Ensure to use correct strength of sanitizer solution when cleaning toys if using 3 steps bin for toys cleaning.

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 facility without diarrhea and vomit written plan. EHS emailed director the written plan and poster 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 several speciality milks brought from child’s home located in refrigeration located in kitchen labeled with names only. EHS educated center on notated rule. REPEAT.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed no paper towels at handsink located in restroom between 2-3’s classroom. Director supplied paper towels to handsink during time of inspection.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed sleeping cots in toddler classroom not labeled according to notated rule.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed chipping paint throughout center to include middle common area. Center is in the process of repainting all rooms per Director. Observed staining to popcorn ceiling in Pre K 1 classroom. EHS advises center to ensure no active leak is occurring and to have stained ceiling repaired.

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Observed several boxes stored outside of dumpster area. Observed debris/trash surrounding dumpster. *NOTE: Director, Michelle Segovia, was present during time of inspection. Report emailed to: director.mallard@cadence-academy.com

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 bottle brought from child's home stored in dorm refrigeration unit in infant classroom with name and no date.

Bottle warming equipment shall be cleaned and sanitized at least daily and when visibly soiled. 15A NCAC 18A .2810 (f) (1) and .2804 (d). Observed heavy debris build up inside of bottle warmer stored in infant classroom. EHS advises center to increase cleaning frequency of bottle warmer.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed storage on shelving in multiple restrooms throughout center that's not approved storage in restroom that included, toys, linen, supplies, etc. EHS advises center to remove storage from restrooms that are not used for toileting.

All cleaning and disinfectant solutions shall be properly labeled (i.e. soapy water, disinfectant). 15A NCAC 18A .2819 (c ) and .2820 (c ). Observed several spray bottles not labeled that housed water according to teachers in 3's classroom and Meck Pre K 1 classroom. EHS advises center to label all spray bottles with the name of what is housed inside of bottles.

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 3 bottles of hand sanitizer stored below 5 feet in 3's classroom. EHS relocated sanitizer to cabinet that is above 5 feet.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed touch up needed throughout center to walls. Per conversation with Director center is scheduled to be painted soon.

Keep the property free of high vegetation. 15A NCAC 18A .2831 (i). Observed tree branches hanging over fencing near outdoors swings. EHS advises center to have branches cut down over fencing. *NOTE: Director Michelle Segovia was present during time of inspection. Report emailed to her at: director.mallard@cadence-academy.com

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Observed teacher washing high chair table off in food prep sink in infant room. EHS educated Director that high chair tables should be sent to the kitchen to be washed, rinsed, and sanitized after each use.

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

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed aerosol Microban cleaner stored on top of paper towel dispenser in younger toddler classroom. Observed aerosol air freshener stored within diaper changing station in older toddler classroom and 2's classroom. EHS emailed director a hazardous storage item chart provided by Mecklenburg County environmental health department.

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 blue child sized blue couches throughout center with minor tears. Observed child sized furniture (tables) with markings throughout center.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed touch up paint needed to walls throughout center. 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 floor rug 2's restroom.

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 (Beginners) classroom in need of general cleaning; other classrooms having minor build-up on table edges were noticeable.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed small scuffs and paint missing in numerous rooms where items were removed from walls; touch-up painting needed.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed misc storage (non-toileting / diapering) stored within restrooms of (Pre-2, Pre-3-4) classrooms in need of removal.

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

REPEAT 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 sent from home with incorrect dates; (labeled 1-2-20, inspection date 1-7-20). Corrected 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 small tables with damaged surfaces on top (peeling laminate) in need of repair / replacing.

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 not properly labeled in Infant room (bottles without dates and bottles without date or name).

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seats loose in need of repair inside (Mens and Womens restroom); Inside (Toddler #1) room restroom.

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 heavy debris in need of cleaning inside (Toddler #1) classroom; Observed table top surfaces peeling off on edges inside (Toddler #1) classroom in need of repair/replacing.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed handle on faucet in infant room at diapering station leaking when turned on in need of repair.

Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f). Observed childs linen stored on cot heavily stained in need of replacing / washed.

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 book bindings damaged in Pre-school 2 room in need of removal.

Keep the property free of standing water. 15A NCAC 18A .2831 (b). Observed play ground enclosure having standing water in need of removal.

Observed sanitizer at 300 ppm chlorine throughout classrooms. Ensure sanitizer is being tested for proper concentration. **Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

REPEAT Observed baby wipes and other items being stored under the diaper changing table hand sink in infant room. **Hand washing sinks must be free of storage. 15A NCAC 18A .2818 (a).

REPEAT Observed organizing needed in several storage closets where items are being stored on the floor. Relocate items from floor to shelving. Observed cleaning needed in the door tracks and in storage area of diaper changing tables. **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).

REPEAT Observed cleaning needed in the cracks and crevices of large blue sofas. Observed one blue sofa with ripped vinyl in multipurpose room. Repair or replace. Observed tape residue in classroom cabinets and on shelving throughout. Observed cleaning needed on stepping stools. Observed soiled pillow cover in toddler 2. Clean covers when needed. Observed washer with rust. Observed blue foot-stool with staining in school age area. Observed debris build-up in book shelf of preschool 1. **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 cleaning needed on floor behind diaper changing table in toddler 2 room. Observed cracked floor tile in preschool 1, in the bathroom of preschool 3, and by the door in preschool 5. Observed cleaning needed on the floor at the base of diaper changing tables. Observed tape residue on several areas of tile floor in preschool 1. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed employee change diaper and don new diaper without wiping her hands or the child's hands with a wipe.

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 torn pillows in preschool 4 and in preschool 5. Observed vinyl couch in preschool 1 with a tear. Observed vinyl block in toddler 2 with a tear. Observed large pillow in school age with tear. Observed washing machine to be rusted.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed wall damage in laundry room. Observed baseboards in need of painting in preschool 3. Observed ceiling damaged in kitchen. REPEAT VIOLATION

1- Observed pitchers of used milk for breakfast stored in reach in coolers. Milk shall be discarded after use and should not be stored to be used again. / Serving containers may be used to dispense milk for food service provided the unused milk is discarded. 15A NCAC 18A .2808 (a) 2- Observed ice exposed to elements in reach in freezer. Cover ice bin or place at highest self to prevent contamination. / Ice shall be made, handled, transported, and dispensed in such a manner as to be protected against contamination. 15A NCAC 18A .2808 (b). 3- Observed baby bottles labeled with dates of 2/2 on 2/7. Bottles must be labeled everyday from home. The establishment should not be labeling product once its received. / 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) 4- Observed salads being prepared but not cooled down prior to being sent to classrooms. Ensure that product is being cooled down properly. / Potentially hazardous food requiring refrigeration shall be cooled to an internal temperature of 45°F or below in a manner consistent with rule 15A NCAC 18A .2806 (h) (2). 5- Observed a container of coconut milk labeled with name but not date in the kitchen reach in. Ensure all products brought from home are properly labeled. / Label all food brought from home with the child’s name and the date that the food was brought into the facility. 15A NCAC 18A .2804 (f)

- Observed hot water at wash machine reading 59F. Assess and repair Hot water supplied to clothes washing. machines shall be 120°F or above. 15A NCAC 18A .2815 (e).

Repeat - Observed several toilet seats loose throughout restrooms assess all. Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a).

1. - Observed cleaning and re-organization needed in storage rooms of all classrooms. // Observed diapers and clothing stored under sewer lines of hand sink in diaper stations. // Observed chemicals stored above clothing and toys in storage closets (locked). Ensure they are stored below. / 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). 2. - Observed clean linen stored in soiled container. Ensure that items are placed in proper containers. // Store soiled linen and soiled toys out of reach of children. / Soiled laundry shall be handled and stored separately from clean laundry using cleanable containers. 15A NCAC 18A .2820 (a).

- Observed several toys in need of cleaning in hard to reach areas for dust build up. Observed some blocks in need of repair. Piano keys are rusting in several rooms and outdoors. Observed book shelves chipping in areas. Reseal. Observed books damaged. Replace. / Observed debris build up in rocking chair of infant room, lounging areas, high chair, and other seating areas. 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 cleaning needed along baseboards, behind and under equipment, and floors in all rooms. Chipping observed on baseboards. // Observed wall damage in laundry room. Repair. // Wall cleaning needed in areas where dust is collecting (door frames). Recaulking needed at hand sinks in restrooms to ensure they are flush to wall. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Repeat non-compliance: Observed damaged cook top on one stove, oven door hinge damaged on the other stove. Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f)

Repeat non-compliance: Observed sink drain collecting residue on older side of multipurpose area. Observed loose toilet seat in multi purpose area restroom on left side. Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a).

Repeat non-compliance: Observed walls dirty throughout facility, wall paper wall covering may need deep cleaning or replacement. Observed baseboards dirty, damaged, and chipping paint throughout. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Repeat non-compliance: Observed milk brought from home not labeled or dated. 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)

Repeat non-compliance: Observed damaged cook top on one stove, oven door hinge damaged on the other stove. Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f)

Observed storage in restrooms in todd 2 and 2's restrooms. Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a).

Observed lock on laundry room not functioning. Observed shaving cream unlocked in school age classroom. All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).

Observed toy shelves with tape residue in multiple classrooms. Observed toy shelf with damaged finish in todd 2 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 non-compliance: Observed walls dirty throughout facility, wall paper wall covering may need deep cleaning or replacement. Observed baseboards dirty, damaged, and chipping paint throughout. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed caregiver in infant room and in kitchen turn off water with bare hands. Observed caregivers in infant room and kitchen with short durations. 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 multi use cups behind manually dried with rag. Completely air-dry all equipment and utensils before stacking or storing the items. 15A NCAC 18A .2812 (h) Observed several dirty scoops in kitchen stored as clean. Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Repeat non-compliance: Observed hand lotion stored below 5 feet in infant 2 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 sanitizer over 200 ppm in kitchen. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed hazardous items stored unlocked in infant 2, laundry room, and in pre 5 classroom. All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).

Observed hand sanitizer unlocked under 5 feet in pre 4 classroom. Observed hand lotion stored unlocked in pre 5 classroom, 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).

Repeat non-complianc: Observed dusty vents in classrooms throughout. Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed gallons of milk in classrooms going back to the kitchen not on ice. Observed grits taped closed.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).Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)

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

Observed disinfectant at 250 ppm.Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed vents collecting dust in several classroom.Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed tape labels on sippy cup lids stored clean. Observed damaged sippy cup lids around mouth area.Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Observed disinfectant in infant room at 250 ppm.Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed toys shelves with finish damage throughout facility. Observed top boarder to coat racks damaged throughout facility.Observed washer and dryer with finish damaged on exterior.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 holes in front of dumpster, dumpster side door open.Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d).Keep dumpster and garbage containers free of holes and in good repair to prevent insect and vermin nuisances. 15A NCAC 18A.2830 (d).

Observed caregivers in infant room and preschool 2 classrooms 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 pretzels in bag that is not resealable, left open. Observed rice puff cereal in kitchen in zipper lock bag not closed. Observed bottle in infant room not labeled. Observed bottle next to sink in infant room.Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)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 refrigerator gasket collecting debris in infant room. Observed ice buildup in classroom and kitchen freezers. Observed microwave in Preschool 1 classroom collecting residue. Observed oven handles collecting residue in kitchen.Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f)

Observed no paper towels at hand sink in preschool 5 classroom.Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed children napping least hand 18 inches apart in toddler 2 classroom.Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e).Observed no sheets on cots, children sleeping, in preschool 4.Individual linen shall be provided for all beds, cots, or mats. 15A NCAC 18A .2821 (c ).

Observed trash collecting around dumpster. Observed holes in front of dumpster.Keep dumpsters and garbage containers free of holes and in good repair to prevent insect and vermin nuisances. 15A NCAC 18A .2830 (d).Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d).

Observed board on playground from fence left on playground, nails on backside of board.Keep the premises clean and free of dilapidated structures and broken play equipment. 15A NCAC 18A .2832 (a).

Observed thermometer in kitchen not calibrated.Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12).

Observed single service cups in Pre 5 uncovered in drawer, in contact with drawer.Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b).

Observed base boards damaged in rooms throughout facility. Observed dust collecting on window sills in Pre 1.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Caregiver stated that hand sink in toddler I classroom (currently infant room) for food prep hand washing was used for general hand washing.**Sinks for food perpetration hand washing must be cleaned and disinfected after each use and area only permitted to be used for emergency hand washing.

Observed hand sanitizer below 5 feet in office area.**Keep all hand sanitizer at 5 feet or above.

Observed dust collecting on vents in classrooms throughout facility.**Keep all HVAC vents clean and in good repair.

Observed trash on ground behind dumpster.**Keep dumpster area clean.