TUTOR TIME CHILD CARE/LEARNING 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 one speciality milk from the previous week in kitchen RIC. Ensure speciality milks are sent home or discarded at the end of each week and a new, unopened milk is sent in at the beginning of each week.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed hot water around 112-113F in Toddler room. Ensure hot water accessible to children is between 80-110F.

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 hot water at 126F in infant room. Observed hot water in majority of classrooms reach 120F and above but then go back down to 112-113F. Ensure hot water accessible to children is between 80-110F.

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 cabinet underneath sink in Pre-K room in need of cleaning. Keep clean.

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 chipped/peeling walls in various classrooms throughout center. Keep walls in good repair.

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 dust buildup around ceiling vents in Preschool/Pre-K classrooms. Keep clean.

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.- Observed in Two’s classroom refrigerator, there is individual carton of milk opened without labeling with name and date opening. Milk was provided by the center. Ensure to label with name of the individual and date that is opened.

REPEAT: 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilet bowl in both restrooms in school age, soiled at the bottom of toilet foot in Two’s restroom, soiled toilet bowl and loose toilet seat in Preschool 2. All need cleaning and keep clean. Fix the loose toilet seat.

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 lotion/cream in a basket on shelving stored less than 5ft in supplies closet at the front. Observed Vaseline in drawer PreK stored less than 5ft. Ensure to keep all non hazardous 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 soap container stored in cabinet at the bottom shelf less than 5ft in EP classroom. Store the item at 5ft or higher at all times.

15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed cots in PreK, Preschool 1 need update with correct labeling. There are duplicate numbers on several cots. Clean old number and put one number for each cot. Provide the cot chart if use number system.

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 dust cover on AC vents on ceiling in Preschool 1 and 2. Light shield cover filled with dead bugs/dusts in Preschool 1 and 2, PreK. Details cleaning needed. Keep clean.

REPEAT 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 Two’s refrigerator with name and date “Dec 8-12”. 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.

REPEAT 15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair.- Observed soiled the inside of refrigerator in Two’s classroom. Detail cleaning needed. Keep all refrigerators clean.

PROVISIONAL ITEM: REPEAT 15A NCAC 18A .2815 (e) (e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use.- Observed at 3 compartment sink kitchen, hot water measured at the beginning at 115F, then gradually come down to 107F. At the final inspection walkthrough, checked again the temperature of hot water. This time measured at 95F and stayed. Hot water at 3 compartment sinks in the kitchen must provide at least 120F at anytime. NOTE: Hot water in the kitchen sink must be at least 120F or higher. Hot water in classrooms and everywhere is accessible to children must be between 80F-110F.

REPEAT: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled (black building up, dust) hand sinks, surfaces and all around counters, faucets in some classrooms including throughout the center. Detail cleaning needed and keep clean. Observed several hand sinks throughout the center need new caulking/repair broken seals along edges. Keep all surfaces in good repair for easily cleaning and clean look after cleaning. Observed several hand sinks throughout the center in need of detail cleaning around faucet and basin (black build up, dust buildup). Keep clean. Observed slow draining at hand sink in restroom twos. Repair needed. 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilet in school age, hallway restroom, and preschool 2. Cleaning needed and keep clean. Observed disrepair toilet in Preschool 2 and PreK. Observed loose toilet seat in Two’s. Repair needed.

REPEAT 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 several classrooms with broken or disrepair drawers/cabinets (Two’s and school age), repair needed. Observed some cabinets underneath the sinks in many classrooms, all around surfaces and countertops need cleaning and wipe down. Keep clean and good repair.

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 refrigerator kitchen without date, specialty milk in two’s classroom without name and date. 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 .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 bag of classroom snack stored in Two’s cabinet. Ensure to keep or stored any leftover snack in resealable bag or container 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 without date. Ensure to label both name and date on items send from home for the day.

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 soiled refrigerator, trays/containers inside in needed of cleaning in two’s classroom and infant 2. Keep clean.

PROVISIONAL ITEM: 15A NCAC 18A .2815 (e) (e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use.- Observed kitchen hot water measured 102F at three compartment sink. Provide hot water at least 120F at three compartment sink in the kitchen at all time.

REPEAT: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled (black building up, dust) hand sinks, surfaces and all around counters, faucets in some classrooms including throughout the center. Detail cleaning needed and keep clean. Observed several hand sinks throughout the center need new caulking/repair broken seals along edges. Keep all surfaces in good repair for easily cleaning and clean look after cleaning. Observed several hand sinks throughout the center in need of detail cleaning around faucet and basin (black build up, dust buildup). Keep clean. 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilet in school age, hallway restroom, and preschool 2. Cleaning needed and keep clean. Observed disrepair toilet in Preschool 2 and PreK. Observed loose toilet seat in Two’s. Repair needed.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.- Observed no soap available in dispenser restroom in Two 1/2. Observed no paper towels in dispenser in restroom school age. Ensure to provide all hand washing supplies at all hand sinks at all time. NOTE: Observed broken lid of trashcan in some classrooms. If use the trashcan that has a lid at hand sink, ensure the trashcan lid works properly to avoid hand touching the lid when throwing paper towel away after hand washing.

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 several classrooms with broken or disrepair drawers/cabinets. Observed some cabinets underneath the sinks in many classrooms, all around surfaces and countertops need cleaning and wipe down. Keep clean and good repair.

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 ceiling AC vents, light shield with dead bugs inside in need of cleaning. Keep clean.

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 inside and around surfaces of water cooler in several classrooms. According to teacher and director, the coolers get clean (wash/rinse/sanitize) daily. Clean items shall stay clean especially inside where it protected.

15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed chlorine sanitizer solution bottle measure more than 250 ppm/less than 500 ppm. Ensure to provide correct concentration of chlorine solution at anytime between 50-200 ppm.

REPEAT: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled (black building up, dust) hand sinks, surfaces and all around counters, faucets in some classrooms including throughout the center. Detail cleaning needed and keep clean. Observed several hand sinks throughout the center need new caulking/repair broken seals along edge. Keep all surfaces in good repair for easily cleaning and look clean. Observed several hand sinks throughout need detail cleaning around faucet and basin (black/pink build up) especially in restroom. Observed very low water pressure at hand sinks in school age restroom, and early preschool. Repair needed.

15A NCAC 18A .2819 (d) Use approved diapering methods as follows: 1) gather supplies, 2) wear disposable gloves (if needed), 3) use a disposable moist towelette to clean child, wiping front to back, 4) dispose of gloves if used and soiled towelettes, 5) wiping the employee's hands and the child's hands with a separate disposable towelette, 6) slide clean diaper under child and apply diapering products if needed using approved methods, 7) fasten diaper and place clothing on child, 8) wash child's hands, 9) and 10) clean and disinfect diapering surface using approved methods, 11) employee washes their hands.- Observed teacher is changing diaper and missing steps #3, 5, 11, necessary to keep dirty from clean procedures. Proper diaper changing procedures discussed in detail with teacher and director at the time of inspection. Poster was posted in classroom. NOTE: Proper hand washing procedures shall be followed correctly. “Turn off the faucet knob with paper towels, NOT bare hands.

15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children.- Observed in 2’ classroom, children’s cots shall be placed apart at least 18 inches while sleeping. 15A NCAC 18A .2821 (f) Linens shall be large enough to cover the bed, cot, or mat's sleeping surface.- Observed in 2 classroom and Pre-K, linen sheet shall be provided and tight fit on a surface of a child’s cot during napping.

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 ceiling vents, light shield, ceiling throughout a center (dust and fungal growth). Detail cleaning needed and keep clean.

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 in SP1, teacher washing her hands less than 20 seconds and turn off faucet knobs with bare hands after helping students from using toilets. The center has hand washing procedures posted at all hand sinks. Proper hands washing discussed with teacher and director at the time of inspection. Ensure that staff and students follow proper hands washing at all time.

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. All human milk, formula, and other bottled beverages shall be sent home with the child whose name is on the label or discarded at the end of each day.- Observed in infant refrigerator, 3 prepared bottles dated yesterday 3/13, and one bottle without a date. EHS discussed how important for proper labeling the bottle with teachers and director at the time inspection. Ensure to label name and date that was received at the center.

PROVISIONAL ITEM: 15A NCAC 18A .2815 (e) (e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use.- Observed hot water temperature in kitchen at 3 compartment sinks measured at 115F. The center shall resolve the issue, the minimum temperature shall be at least 120F.

REPEAT: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled (black building up, dust) hand sinks, surfaces and all around counters, faucets in some classrooms including throughout the center. Detail cleaning needed and keep clean. Observed several hand sinks throughout the center may need new caulking/repair broken seals along edge. Keep all surfaces in good repair for easily cleaning and look clean. Observed broken faucet knob at hand sink in preK restroom. Observed very low water pressure at hand sinks in school age restroom, and early preschool. Repair needed. 15A NCAC 18A .2817 (a). All toilet fixtures shall be kept clean and in good repair.- Observed toilets in school age and preK need detail cleaning. Keep clean.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed parking sign, classroom chair, cubby fabric bucket stored inside a toilet room in unused play room. Observed various different toys store on top of diapers changing table in 2’ classroom. Allow only toileting related items to be stored where toileting spaces are.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed all different hazardous items (baby oil, disinfectant spray, etc, ..) and aerosol cans in big basket in unlock teacher supplies room, little spray can of air freshener in unlock drawer in infant 2, different aerosol spray cans in unlocked cabinet in PreK. Ensure to store all hazardous items in a locked cabinet/storage at all times. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time**

15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observed couple classrooms, cots without name/number, different cot has same number labeled, name and number does not match the chart. Ensure to label individual cots clearly and visibly. If use number system, please have a list available and update.

REPEAT: 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 broken drawers/cabinet doors, repair needed in some classrooms including 2’ classroom. Observed disrepair little brown sofa couches in several classrooms need repair or replace. Keep all furniture in good repair.

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 ceiling vents (dust and fungal growth) throughout the center need detail cleaning and keep clean.

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 gate without lock to prevent access to HVAC units outside playground. Install a lock on both sides of the units.

REPEAT: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled hand sinks, surfaces and all around counters, faucets in some classrooms including (Preschool, school age, PreK, Preschool1). Detail cleaning and keep clean. Some hand sink may need new caulking for easily cleaning and look clean.

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 concentration measured at about 250ppm. Ensure that solution concentration is at least 500 ppm and no more than 800 ppm at all time.

15A NCAC 18A .2819 (d) Use approved diapering methods as follows: 1) gather supplies, 2) wear disposable gloves (if needed), 3) use a disposable moist towelette to clean child, wiping front to back, 4) dispose of gloves if used and soiled towelettes, 5) wiping the employee's hands and the child's hands with a separate disposable towelette, 6) slide clean diaper under child and apply diapering products if needed using approved methods, 7) fasten diaper and place clothing on child, 8) wash child's hands, 9) and 10) clean and disinfect diapering surface using approved methods, 11) employee washes their hands.- Observed teacher is incorrectly changing diaper and missing steps necessary to keep dirty from clean procedures. Proper diaper changing procedures discussed in detail with teachers and director at the time of inspection. Poster provided.

REPEAT: 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 detailed cleaning needed inside cabinets/drawers/under sinks throughout the center including (School age, Preschool 2, Toddlers, Infant). Observed broken drawers/cabinet doors, repair needed in some classrooms including pre school, 2’ classroom.

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 snack of a child in personal drawer in infant room without date. Ensure to label name and date received on any 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 big bags of crackers in cabinet, school age, need to be stored properly in resealable bags or containers for proper storage.

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 the classrooms need detail cleaning and keep clean.

PROVISIONAL ITEM: 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 in staff lounge, there is water machine that has hot water measured 168F. Hot water need to be cut off or install lock door for this staff lounge room.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilet in pre school1, need cleaning and keep clean. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled hand sinks and all around counters and surfaces throughout the center need detail cleaning. Keep clean. Some hand sink may need new caulking, counter surface strips were peeling from the surface, repair needed. Observed broken soap dispenser in Toddler 2, pre school 1, repair or replace needed.

General Comment: 15A NCAC 18A .2817 (a) In child care centers, toilet tissue paper shall be provided in each toilet room and stored in a clean, dry place.- Observed no toilet paper in one of the restrooms in school age. Ensure to provide toilet tissue paper at all toilet rooms. 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 in one of the restrooms in school age. Ensure to provide all hand washing supplies at all hand sinks at all time.

General Comment: 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 was right almost there at 500 ppm. Ensure that solution concentration is at least 500 ppm and no more than 800 ppm at all time.

PROVISIONAL ITEM- REPEAT: 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 containers of Clorox, dish detergent containers in the kitchen cabinet with broken lock. Observed wipe-out container at the computer front desk. Observed bug spray in broken lock cabinet in Toddler 1. Observed aerosol cans and other hazardous items in a basket in unlock supply room near front desk. All hazardous items shall be stored in a 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. Store/keep keys/magnets at least 5ft or higher at all time.**

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 bottles stored less than 5ft on the counter front desk, in unlock supplies room at the front, in drawer in 2-2 classroom. 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 stored in unlock cabinet under hand sink less than 5ft in infant 1. 15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher bag stored less than 5ft in cabinet under the sink in 2-2 classroom. NOTE: **Ensure to store all non hazardous items at 5ft or higher at all time.**

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 some damage cots in couple classrooms. Ensure to repair or replace. Keep all cots in good repair.

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 detailed cleaning needed inside cabinets/drawers/under sinks throughout the center. Observed broken drawers/cabinet doors, repair needed in some classrooms including pre school 2, 2-2 classroom.

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 cleaned at a diaper sink inside the classroom. Teacher rinse the toys with water and put then in sanitizer bucket, and let them air dry. Proper toys cleaning discussed with teacher and director/director assistant 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. Toys shall be cleaned at the food prep sink, not a diaper sink in the classroom. Before cleaning toys, sink shall be cleaned and disinfected as part of the sink conversion/change of use.

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 dust covered on restrooms ceiling vents, classrooms AC ceiling vents. Cleaning needed and keep clean.

15A NCAC 18A .2812 (e) Multi-service articles, including highchair feeding trays, shall be washed, rinsed and sanitized in the child care center kitchen after each use. -Observed high chair tray need better cleaning at the back crevices. According to teacher the top trays get clean at the sink in the classroom and the big base trays send to the kitcken at the end of the day. 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. Proper cleaning of high chair trays discussed with teachers and director at the time of inspection.

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 measured at 500 ppm. Ensure to provide the correct concentration of sanitizer between 50-200 ppm of chlorine.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed toilet room in village play room used as a storage for dresser, chairs, supplies and buckets. Remove all items that are not toileting related out of the toilet room.

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

REPEAT 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 containers of Clorox, dish detergent containers in the kitchen cabinet under the sink not being lock. Hazardous items and how to store them discussed with chef and director at the time of inspection. Observed disinfectant spray in aerosol can in unlock cabinet in school age room. Director took the item out and disposed at the time of inspection. NOTE: **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device.**

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 bottles stored less than 5ft on the counter front desk, in unlock supplies room at the front, in outside bag on teacher desk in school age room, on the window between kitchen and school age 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 containers stored in unlock cabinet less than 5ft in school age room. 15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher bag stored on the floor in village play room. NOTE: **Ensure to store all non hazardous items at 5ft or higher at all time.**

General Comment: 15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children.- Observed children are napping close to each other ay 8” apart in classrooms. Ensure to place children apart at least 18” apart while napping.

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 2’s classroom wash hands and turn off the faucet knob with bare hands. EHS educated teacher and hand washed again properly at the time of inspection.

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 Toddlers refrigerator dated 12/12. EHS, kitchen staff, 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 .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 children’s bottle water in preK, some have name and date. Some have only date no name. Ensure to put both name and date on all the item send from home.

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 kitchen without the thin probe thermometer. Obtain the thermometer.

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 rubber bib gets clean and hang dry in classroom. According to director rubber bibs get clean at the sink in the classroom, and high chair trays get send to the kitchen at the end of the day. 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 .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 measured at 500 ppm. Ensure to provide the correct concentration of sanitizer between 50-200 ppm of chlorine.

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 very low water fountain pressure, the director stated that they do not use it. Ensure to cut the water off adjust at the proper pressure where is not allow mouth contacts.

General Comment: 15A NCAC 18A .2816 (b) (1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation. Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets. The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection. -Observed the facility last water testing was 10/30/2020. The director went to RTI website and registered the session scheduled for today 12/21/23 at 3:30 pm. The facility will follow the required procedures and will update the results at the next inspection.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. -Observed toilet in restroom in preschool need cleaning. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand washing sinks throughout the facility need details cleaning. There are black buildup around corners, surfaces, and peeling surfaces. Some maintenance works, caulking maybe needed. Observed very slow drain at hand sink in restroom in preK, need repair.

15A NCAC 18A .2820 (b).Keys used to access hazardous item or non hazardous items storage must be out of reach of children (5 ft above the floor) and stored separately from lock.- Observed keys to unlock the cabinet throughout the facility, teachers stored them in the unlock drawer less than 5ft. Ensure to store all Keys at 5ft or higher at all time. 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 container of Clorox in the kitchen not being lock away in the storage room. Hazardous items and how to store them discussed with chef and director at the time of inspection.

General Comment: 15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed several classrooms stored their bulk soap containers in the cabinet less than 5ft. Put all bulk soap at 5ft or higher when storing them.

15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher bag stored under unlock cabinet under the sink in pre school. Ensure to put item at 5ft or higher or lock up.

REPEAT 15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed cots are not labeled in toddlers, pres school. Ensure labels all the cots with name or number or cot chart.

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

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 in place. EHS emailed the 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 1 container of specialty milk in domestic refrigerator located in kitchen with date and no child’s name. EHS educated center on notated rule and specialty milk was labeled with child’s name during time of inspection.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Per conversation with staff in infant classrooms, highchair feeding trays are cleaned in place (soapy water and sanitizer) and sent to kitchen monthly to be washed, rinsed, and sanitized. EHS educated center on notated rule. EHS recommends center cleans high chair trays in place and send tray to the kitchen once daily to be properly cleaned.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seats in preschool classroom. Observed general detailed cleaning needed to the outer corners of toilets in preschool classrooms.

Hand washing signs shall be posted at all hand washing areas. 15A NCAC 18A .2818 (e). Observed handwashing sign missing at handsink in the restrooms in 2’s and early preschool classrooms.

Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed hand sanitizer stored below 5 feet on main check in desk. Hand sanitizer was relocated above 5 feet 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 cots not individually labeled with child’s name sporadically throughout center.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed stained ceiling tiles in toddler and preschool 1 classroom. EHS advises center to ensure no active leak is occurring and to have stained ceiling tiles replaced.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed general cleaning needed to ceiling vents throughout center. Improvement has been made from previous inspection report. *NOTE: Assistant Director, Andrea Cummings, was present during time of inspection. Report reviewed with her and Director, Shakita Robinson. Report emailed to center at: 6045@tutortime.com

Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed opened package of cereal and cookies stored in cabinet in infant classroom not properly sealed. EHS educated center on notated rule.

Provide a numerically scaled metal stem-type thermometer accurate to 2°F. 15A NCAC 18A .2807 (h). Observed metal stem thermometer not accurate within 2F of EHS calibrated thermometer. EHS advised center to acquire a new thermometer.

Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f). Observed debris build up inside of microwave in toddler classroom. Observed refrigerator in toddler classroom in need of detailed cleaning on flooring under pull out drawers and inside of freezer.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed one loose toilet seat in 2’s restroom and one in 3’s restroom. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed black build up surrounding caulking/laminate in at food prep sinks throughout center.

Hard plastic toys may be washed, rinsed, and sanitized in a dishwasher, food preparation handwashing sink, or in the kitchen sink. 15A NCAC 18A .2822 (a) and .2810 (f). Observed toys being cleaned in diaper changing sink in toddler classroom. EHS educated teachers and director on notated rule.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed stained ceiling tile in 2’s and 3’s classroom. EHS advises center to ensure no active leak is occurring and to have stained ceiling tile replaced. Observed flooring under refrigerator in toddler classroom in need of detailed cleaning. During time of inspection center was in the process of being painted/renovated (in the evenings when children are not present and over the weekends).

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed AC ceiling vents throughout center with dust accumulation.

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

Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed cheese puffs and cereal opened and not properly resealed in toddler classroom. Assistant Director voluntarily discarded of snacks.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Per converation with staff and assistant director, high chair feeding trays are cleaned in place after each use. EHS educated center on notated rule.

Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3). Observed debris build up inside of refrigerator located in toddler classroom. EHS advises center to increase cleaning frequency of non food contact surfaces throughout center.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed air freshener in spray bottle stored on high shelving in toddler classroom. Observed disinfectant deodorizer spray stored behind gated diapering area in pull out drawer. Both items stated "Keep out of Reach of Children" with additional warning. Assistant Director removed hazardous items and locked them behind lock and key. If violation is observed during next inspection demerits will be taken.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed sleeping cots not labeled throughout multiple classrooms within center. EHS advises center to label sleeping cots with individual children names accordingly.

Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f). Observed some cribs sheets in infant rooms with holes. EHS advises center to replace linen that is no longer in good repair.

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 child sized furniture throughout center with markings and tape residue. EHS encourages detailed cleaning to toys throughout center.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed chipped floor tile under refrigerator door in toddler classroom. Observed stained ceiling tile in toddler classroom. Observed touch up paint needed to walls throughout center. *NOTE: Assistant Director and Director were present during time of inspection, report emailed to center at: Shakita Robinson and Andrea Cummings: 6045@tutortime.com

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seats very loose in need of tightening inside (2's) classrooms.

REPEAT Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed misc storage stored underneath hand washing sinks inside (2's, SA1) classrooms.

Approved non-hazardous products must be stored 5ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed diaper creams stored below 5ft inside unlocked drawer inside (infant room).

Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Observed cots spaced within 18 inches inside (2's, Toddlers) classrooms.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seats inside (pre-k / 2's) classroom bathrooms in need of repair. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed faucet very loose in need of repair inside (pre-k) classroom.

REPEAT Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed numerous hand washing sinks having storage underneath drain lines in need of removal.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed water damaged ceiling tiles in several classrooms in need of replacing; Observed base board peeling off wall near changing area inside (Toddler) classroom in need of repair.

Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e). Observed water at washing sinks measuring 67F in all classrooms. (director stated that work order was placed numerous times).

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed misc storage underneath drain lines of handwashing sinks inside (infant room, Early Pre classroom)

Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Observed children spaced within 18 inches inside 2's classroom.

REPEAT Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed laminate in side infant room damaged in need of repair.

Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d) Observed numerous baby bottles without dates and / or wrong dates inside Infant and Toddler classrooms.

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seat loose inside bathroom in (Pre-school 2) classroom.

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 handles on cabinets above diaper changing areas rusty in need of repair / replacing in (Infant) classroom.

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seats in need of repair in School Age / 2's / Pre-school classroom restrooms. Toilets shall be cleaned and disinfected at least daily and when visibly soiled. 15A NCAC 18A .2817 (b). Observed toilet surfaces soiled in need of cleaning in School Age classroom.

REPEAT Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed laminate peeling from most counter tops in classrooms throughout center.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls scuffed in need of touch-up painting throughout; Observed half walls in infant room missing paint in need of touch-up painting. Observed flooring between stand up refrigerators and counter tops / cabinetry collecting debris debris in need of cleaning in classrooms that have them; Observed debris collecting around bottom of gates in rooms that have gates leading into diaper changing area.

Observed bottles in infant room refrigerator with names but no dates. One set of bottles had a date of 1/2 the caregiver stated was not correct. **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 Observed cleaning needed on the base of toilets in pre-k and two's bathroom. Observed black and pink build-up on the underside of sink faucets in bathrooms throughout classrooms. Observed cleaning needed under hand sinks throughout classrooms in food prep and diaper changing areas. Observed drain area of food prep hand sink with black build-up in toddler classroom. **Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

REPEAT Observed teachers purse being stored in low cabinet in two's 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).

REPEAT Observed wood shelving and wooden toys with ware and tape residue on them throughout center. Observed debris build-up in the cracks and crevices of legos, kitchen interactive toys, and musical toys in infant room. Observed debris build-up in book shelf of toddler room. Observed cabinet handles with ware where the metal is showing in several classrooms. Observed several foot stools in need of cleaning in classrooms. Observed brown couches in the pre-k and school age room with ripping. **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 cleaning needed on FRP board in bathrooms of older kids classrooms and on the vent in the school age bathroom. Observed finger prints and build-up on the doorways to food prep areas in classrooms. Observed water stained ceiling tiles in infant room. Observed baseboard peeling away from wall in school age play area. Observed cleaning and touch-up paint needed on window sills and door ways to outside. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

REPEAT Observed dead bugs collecting in light shields in classrooms and hallway. **Keep all light fixtures clean and in good repair. 15A NCAC 18A .2826 (a).

Observed several food items in the kitchen that were stored in rolled down bags. Ensure all food items are stored in resealable bags. REPEAT PIC stated water for classrooms is obtained from kitchen hand sink. Ensure that all drinking water is obtained from the three compartment sink. **Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a) **Water from hand washing sinks shall not be used to prepare formula, mix dry cereals, or other foods. Food shall be free from spoilage, filth, or other contamination. 15A NCAC 18A .2804 (a) and .2810 (f).

REPEAT Observed black build-up around the drains in hand sinks, build-up under faucet handles in bathroom hand sinks, and caulking needed in several areas behind sinks and backsplashes. Observed toilet screw caps missing from toilets in 3's and in the school age bathroom. Observed cleaning needed in cabinets under hand sinks. **Sinks shall be cleaned and disinfected **Sinks shall be cleaned and disinfected at least daily, when visibly soiled, and when the designated use of the hand washing sink has been changed. 15A NCAC 18A .2818 (c). **Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). **Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

REPEAT Observed wood shelving and wooden toys with ware and tape residue on them throughout center. Observed debris build-up in the cracks and crevices of legos, kitchen interactive toys, and several other toys throughout. Observed paper blocks with damage in the 2's room. Observed cabinet handles with ware where the metal is showing in several classrooms. Observed several foot stools in need of cleaning in classrooms. Observed brown couches in the pre-k and school age room, and a green couch and a blue couch in the 2's room with rips and tears. **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 kitchen cabinets. Observed fan with dust build-up in the kitchen. Observed can opener with build-up in kitchen. Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

REPEAT Observed black build-up around the drains in hand sinks, build-up under faucet handles in bathroom hand sinks, and caulking needed in several areas behind sinks and backsplashes. Observed toilet screw caps missing from toilets in 3's and in the school age bathroom. Observed cleaning needed in cabinets under hand sinks. Observed missing stopper on the diaper changing hand sink in the toddler room. **Sinks shall be cleaned and disinfected at least daily, when visibly soiled, and when the designated use of the hand washing sink has been changed. 15A NCAC 18A .2818 (c). **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 (CRITICAL VIOLATION) Observed 2 aerosol air-freshener dispensers on the wall, unlocked, in the infant room and on in the 3's room. Observed diaper cream and white out being stored in an upper cabinet, unlocked, in the 2's room with "keep out of reachof children label." **All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).

Observed purse being stored in an unlocked low cabinet in the toddler room. **Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f).

Observed cribs in the infant room without child's name on it. Child was in crib. Observed green mats in the preschool room stacked on top of each other floor side to sleep side. Observed mat in the preschool room with blue floor side touching red sleep side. **All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). **Store all sleeping mats so that the floor side of the mats are only touching. 15A NCAC 18A .2821 (d).

REPEAT Observed wood shelving and wooden toys with ware on them throughout center. Observed tape residue on furniture and toys throughout. Observed cabinet handles with ware where the metal is showing throughout classrooms. Observed cleaning needed on the exterior of cabinets in classrooms. Observed several foot stools in need of cleaning in classrooms. Observed brown couches with rips and tears in the pre-k and school age room. **Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

REPEAT Observed chipping paint on window sills, walls/doors in need of touch-up paint, and floors in need of cleaning in the cracks where they meet the walls throughout building. Observed stains on the carpet in the infant room. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12). Observed thermometer start at 50F, can't calibrate using ice method. Dead battery in digital thermometer.

Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3). Observed cabinets edging in disrepair in kitchen. Microwave with rusted interior and dried food debris. Undersides of high chair trays with dried food build-up.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed moldy caulking around hand sinks at diaper changing table, toddler room. Observed cabinets below sinks need wiping out throughout facility. One sink not working in unused classroom.

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed toys, learning activities and single service stored below hand sinks in several classrooms. Do not store items below sink plumbing.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed incorrect diaper changing procedure in toddler room. Gloves were removed at end of diaper change when it was time to wash hands. CDI through verbal instruction.

Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Observed children napping in cribs spaced less than 18 inches apart, no plexiglass barrier. Children napping less than 18 inches apart in 2 year old class.

Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed tape residue on furniture throughout center. Damaged vinyl couch in unused classroom. Hard plastic toys may be washed, rinsed, and sanitized in a dishwasher, food preparation handwashing sink, or in the kitchen sink. 15A NCAC 18A .2822 (a) and .2810 (f). Observed toys/art brushes in several diaper changing sinks to be washed. Do not wash toys in diaper changing sinks.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed chipped paint in several classrooms. Stained ceiling tiles in infant room and village. Dusty window areas in unused classrooms.

Observed caregiver wipe hands with towel used to turn off water. 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 bag of sugar not properly sealed in kitchen. Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a) Observed food thawing in container of water in hand sink. Properly thaw all food products. 15A NCAC 18A .2807 (i). In third compartment under running water not to exceed 70 degrees F. Corrected during inspection.

Observed cups stored clean with labels still on sides, stacked inside other cups. Observed can opener blade collecting residue. Multi-service utensils must be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e)

Observed disinfectant solution over 1000 ppm. Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed purse stored below 5 feet in preK 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).

Observed dusty vents throughout facility. Observed lights in lamps in infant room not shielded or shatterproof. Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed perpackaged cooked chicken and broccli on countertop thawing in ktichen.Properly thaw all food products. 15A NCAC 18A .2807 (i).

Observed sanitizer at kitchen 3 compartment hand sink below 200 ppm.Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

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

Observed hand sanitizer below 5 feet in preschool 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).

Repeat non-compliance: Observed crib mattresses damaged in infant classrooms.All crib and play pens, used for sleeping, shall have an easily cleanable, waterproof, washable, firm, and tight fitting mattress that is at least 2 inches thick. 15A NCAC 18A .2821 (b).

Repeat non-complaince: Observed couch and sofa coushions damaged in 2's classrooms. Observed chair in infant classroom collecting debris around wood chair arms on seat.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 thermometer reading 24F in Twaddler B and items in fridge were not frozen. Replace thermometer.**Provide an accurate thermometer in all refrigerators. 15A NCAC 18A .2806 (h)

Repeat Non Compliance: Observed hot water at washing machine only reach 106F. **Hot water supplied to clothes washing machines shall be 120°F or above. 15A NCAC 18A .2815 (e).

Repeat Non Compliance: Observed urine residue present on toilet seat in Preschool room. Observed several sinks that had residue present underneath sinks from apparent leaks. Did not observed actual leak from sink at time, but discoloration was present on bottom surface. **Toilets shall be cleaned and disinfected at least daily and when visibly soiled. 15A NCAC 18A .2817 (b).**Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Repeat Non Compliance: Observed blue sofa in both after school rooms with rips on surface. Tear in brown couch in Pre-K; Observed stains on soft cloth pillows/toys in preschool, infant B and toddler room; Observed rips in vinyl cushions in Twaddler A. observed door off bottom right hinge in preschool room and pull out drawer at diaper changing table separating in need of glue in Twaddler A. Observed sticky tape residue on shelving in Infant Room B. Observed basket unweaving in Preschool room. Observed side laminate separating on counter next to hand sink in right after school room at hand sink. **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 dust present on window sills and blinds throughout facility. Dust build up present on bathroom vents of facility. **Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Repeat Non Compliance: Observed a water leak in the refrigerator. When pulling out bottom bins, large pool of water visible. Observed shelving storing canned goods to be chipping/disrepair towards front side. **Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f)

Observed water temperature at washing machine only reaching 107. 9F during wash cycle. Call was made to maintenance for adjustment. **Hot water supplied to clothes washing machines shall be 120°F or above. 15A NCAC 18A .2815 (e).

Observed loose toilet seats in After school 1, 3's, men's hall restroom and in back vacant room.**Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed multiple dings, dents, holes, chipping found on walls around baseboard in Pre K, baseboard peeling in 3's, paint chipping on window sill in 3's, wall divider in toddler A, hole from door swinging in back vacant room.Observed threshold taped down in corner connecting vinyl floor to carpet. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed vents in bathrooms throughout with dust deposits on outer surface, blinds and top lining of window sills with dust present. **Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

-Observed multiple sippy cups unlabeled in the Toddler A room.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 2 bags of snacks not stored to prevent from contamination. (1 bag was opened and the other was taped closed).Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)

-Observed a water leak in the refrigerator on the Infant side. The large puddles of water were beginning to ice up.Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f)-Observed the refrigerator gasket torn on the Infant side.Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed hot water not working at either diaper changing sinks in the Twaddler rooms. Per the employee working in the room, the water was working when she last washed her hands in that sink around 10:00AM. The children were moved to another diaper changing room, and per Ms. Linda, said room will be shut down until the hot water issue is fixed.Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e).

Repeat Non-Compliance: Observed a purse sitting on the counter in the Twaddler B room.Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f).

-Repeat Non-Compliance: Per several employees, toys are washed in the diaper changing sinks.**Hard plastic toys may be washed, rinsed, and sanitized in a dishwasher, food preparation handwashing sink, or in the kitchen sink. See rule .2822 (a) and .2810 (f).*Website Handout provided, and the Cleaning Guide section discussed.-Observed the counter top laminate peeling off in the Prepper room.Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed loose toilet seats in the Pre-School, women's, & Prepper's restrooms.Observed stained toilet seat in the Pre-School restroom. **Keep toilets clean and in good repair. See rule .2817 (a).

Repeat Non-Compliance: Per several employees, toys are washed in the diaper changing sinks.**Hard plastic toys may be washed, rinsed, and sanitized in a dishwasher, food preparation handwashing sink, or in the kitchen sink. See rule .2822 (a) and .2810 (f).*Website Handout proviided, and the Cleaning Guide section discussed.

Observed large jagged hole in medium sized yellow, blue, & green play structure.**All play ground equipment must be kept clean and in good repair. See rule .2832 (c ).