CADENCE ACADEMY PRESCHOOL, NORTHLAKE

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 bulk milk with no date. Ensure speciality milks are labeled properly.

General Comment: 15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed no soap or paper towels in Toddler/3s classrooms. Ensure every handwashing sink is supplied with soap and paper towels. Director stated that these bathrooms aren’t used due to being in diaper changing classrooms.

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 around ~200ppm. Ensure disinfectant solution is between 500-800ppm.

General Comment: 15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed in infant room, a parent came into a room to drop off baby bottles, did not wash her hands before putting the bottles in the refrigerator for a teacher. For sanitation purposes and to prevent any cross contamination. Please ensure parents wash their hands upon entering if wish to help with any tasks in the classrooms.

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, top surfaces and back/side crevices where high touch occurs from little hands. Ensure to receive only throughly clean trays after washed 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 concentration measured at 500 ppm or more throughout the center. Some classroom have correct concentration in the sanitizer bottle, and not in the toy sanitizer bucket. Or vice versa. Observed in 108, there is 0.00 ppm of sanitizer in the toy bucket. Ensure to provide correct sanitizer concentration between 50-200 ppm at anytime.

General Comment: 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children.- Observed hot water temperature throughout the center measure at 113F -114F in most sinks. Ensure to provide tempered water where is accessible to children.

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 due to broken dispenser in infant 2, no paper towels available due to something wrong with dispenser at small sink in toodler 2, no paper towels available in dispenser in restroom 110 and 109, no soap at small sink and paper towels at diaper sink available in 108. Ensure to provide all hand washing supplies at all hand sinks at all time.

REPEAT 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper creams unlocks in black box and under diaper sink cabinet in toddler 2. Ensure to keep items at 5ft or higher, or keep lock at all time.

REPEAT 15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher purse stored in the unlock cabinet less than 5ft in toddler 2, purse in unlocked drawer in infant 1. Purse on a chair in front office. Ensure to keep all personal belongings/purses that contain no hazardous items at 5ft or higher at any time. 15A NCAC 18A .2820 (f) A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children.- Observed in 110, children jackets are laying on top of each other on top of cubby. Ensure to keep all individual items separate and not allow contact while storing at anytime.

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 in 109, 110 classroom needs to update name/number cot chart. Rewrite number/name legibly to easily identify. Use one system across all cots either number/name/stickers all in same colors. Have correct and updated chart available. 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 sheet on cot in 109, provide clean sheet. Observed laundry basket stored on top of sheet on cot in 109. Ensure to not store anything on the cots unless there is a protection to prevent contamination.

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 in 108, counter at food prep sink need cleaning and keep clean.

REPEAT 15A NCAC 18A .2804 (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center.- Observed bottles in infant 2 refrigerator without date received. Ensure to have both name and date on items send from home at all times. 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 couple containers of specialty milk in kitchen refrigerator without date received. Ensure to put name and date received on specialty milk. Ensure to receive the unopened container at the beginning of the week, send home or discard at the end of the end either opened or unopened containers.

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed several hand washing sinks in some classrooms in need detail cleaning all around the basin, faucets. Keep clean. 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed several soiled toilets in need of detail cleaning in toddlers, preschools. Damaged/stained toilet seats in preschools. Repair/replacement of toilet seats needed.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed couching, toys and decor stored on shelves in restroom Toddler and preschool 3B. Ensure not to store any items in the restrooms except toileting related items at anytime.

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 at front desk less than 5ft. Items was removed into office. Ensure to keep all emergency medication at 5ft or higher at all any times.

General Comment: 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper creams stored in unlocked cabinet under sink in infant 1. Teacher forget to lock the cabinet after task. Ensure to keep the cabinet door lock at all time or keep items at 5ft or higher at anytime.

REPEAT 15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher purse stored in a cabinet less than 5ft in infant 2. Keep all personal belongings/purses that contain no hazardous items at 5ft or higher at any time.

REPEAT 15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed several classroom needs to update name/number cot chart. Rewrite number/name legibly to easily identify. Use on system across all cots either number/name/stickers all in same colors. Have correct and updated chart available.

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 in infant 1, the back/arms/side of higher hair need better cleaning and keep clean.

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. - Observed couples classroom have dirty toys soaking in the toy cleaning bins. The water looks old and filled with residue. Ensure to clean toy daily.

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 oat milk container sat on the counter during breakfast time in Toddler 1. Milk measured 51F. Observed lunchable in children lunch box in school age store inside the closet, not refrigerated. The center must ensure to maintain correct temperature for potential hazardous cold holding at 45F or below at all time. Milk, and lunches take to the kitchen to be held properly to maintain temperature at the time of inspection.

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 Lunch box in school age without date. Ensure both name and date is on any food 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 one container of specialty milk in kitchen refrigerator without date. Every one of them have both name and date for the week. Ensure to check after parents before putting in the refrigerator, have items labeled both name and dated that was received at the center.

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

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed most of hand washing throughout the facility need detail cleaning and keep clean. All around basin and base of the faucet (Meck 2, P1, school age). Some sink area may need fresh caulking along edge leaving no gap visible and to maintain area for easily cleanable (Meck 3). Observed slow drained at hand sink in 3B. Observed clogged/slow drain at hand sink in preschool 1, Repair needed. Observed very soiled underneath diaper sink cabinet, need cleaning in P2. Keep clean.

General Comment: 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper cream stored inside unlocked cabinet underneath diaper table in P1. The child prof lock device doesn’t count as lock. Ensure to store items at 5ft or higher at all time. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time. Store/keep key at 5ft **

15A NCAC 18A .2820 (g).Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock.- Observed teacher purse stored in a lock closet on the shelf less than 5ft. The key to unlock the closet is hanging down with long gray string next to the closet less than 5ft, made it accessible to the key to easily unlock the closet in 3A. Ensure to put purse at 5ft or higher. **Key to unlock any cabinet/storage shall be kept at 5ft or higher at all times.

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 several classroom needs to update name/number cot chart. Some cot has two different number, mix and match. Rewrite number/name legibly to easily identify. Have correct and updated chart available.

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 couple unlock gates where HVAC units and mop sink in playground. Lock the gates and keep areas 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 parent dropping off a child in infant room. No hand washing was observed before a child engaging in play activities in the room. Ensure to wash hands upon arrival.

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 baby foods sent from home in infant rooms without date received. Ensure to put both name a date received any items send from home.

General Comment: 15A NCAC 18A .2810 (f) If food is prepared in a child care center classroom, then the classroom shall be equipped with a food preparation area. This food preparation area shall contain a countertop that is kept clean and in good repair, a handwash lavatory, and refrigeration when items are stored that require refrigeration- Observed in toddler 1 refrigerator is located inside the gate area where diaper station. (diaper changing table and diaper hand sink right across the refrigerator). Food prep hand sink is on the other side of the wall outside the gate. Remove the refrigerator and put in the food prep area not the diaper station area.

REPEAT 15A NCAC 18A .2812 (e) Multi-service articles, including highchair feeding trays, shall be washed, rinsed and sanitized in the child care center kitchen after each use.- According to teacher spoons in the infant room get clean at the sink in the classroom. All multi-service articles (high chair trays, spoons, plates/bowls, rubber bibs) shall be wash, rinse and sanitize properly in the kitchen after each use. 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmers in infant rooms, need detail cleaning and keep clean.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed most of hand washing throughout the facility need detail cleaning and keep clean. Some sink area may need fresh caulking, maintain area for easily to clean. Observed slow drained at hand sink in 3B. Observed clogged hand sink in preschool 2, and underneath diaper cabinets, need cleaning. Keep clean.

REPEAT 15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.- Observed paper towels is not available from the dispenser at hand sink (toddler 1, preschool 1, 3B, summer camp, preschool 4, PreK). Ensure to provide all hand washing supplies at all hand sinks at all time.

15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed disinfectant solution measured at concentration 250ppm. Ensure to provide correct concentration between 500-800 ppm.

General Comment: 15A NCAC 18A .2820 (b) (c). All hazardous items must be stored behind lock and key. A locked kitchen is not considered to be a locked storage room or cabinet for the purpose of this rule - Observed container of Clorox in the kitchen not being lock away in the storage room. Hazardous items and how to store them discussed with the cook and director at the time of inspection. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device**

15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed bulk soap stored food supply cabinet with child prof lock less than 5ft in toddler 2 and preschool 2. Ensure to keep items at 5ft or higher and separate from the food supply to prevent any possible contamination.

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 classroom needs to update name/number cot chart. Rewrite number/name legibly to easily identify.

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 table filled and left water standing in summer camp classroom. Proper procedures for water play station discussed in detail with director at the time of inspection.

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 bathroom vents covered with dust, need cleaning. Observed black buildup on AC vents in toddler 2. Detail cleaning needed 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 unlock gates where HVAC units and mop sink in playground. Lock the gates and areas inaccessible from children.

15A NCAC 18A .2806 (j) (1) Each refrigerator shall be provided with a numerically scaled indicating thermometer that is accurate to ± 3 degrees Fahrenheit and located to measure the air temperature in the warmest part of the refrigerator. Recording thermometers that are accurate to ± 3 degrees Fahrenheit may be used in lieu of indicating thermometers.- Observed no indicator thermometer inside the refrigerator in Toddler 1. Obtain an indicator thermometer. 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 facility kitchen without thin probe thermometer to measure foods. The one is available is not working.

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.- According to teacher in Infant 2, the high chair trays get clean in the classroom with soapy water, rinse, and sanitize spray. 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 need details cleaning in Infant 2. Keep clean.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.- Observed jammed paper towel dispensers in several classrooms (School age, pre school 1/2, pre school 3A/3B, Meck 2/3). Paper towels dispenser need repair or replace.

General Comment: 15A NCAC 18A .2820 (d).Medications, including prescription and non-prescription items, shall be stored in a locked cabinet or other locked container and shall not be stored above food.- Observed Benadryl and Zyrtec OTC medication stored in outside bag along with the emergency medication in Pre school 3A and Pre school 1. Items shall be stored in lock cabinet/container. **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 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper creams stored in a black box with the key lock combination, left unlock under diaper cabinet with the child proof lock in Infant 2 and Toddler 2. **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.** Ensure to lock items at all time or keep items at 5ft or higher.

General Comment: 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand lotion stored in the cabinet with child proof lock on it in Infant 1. Ensure to keep all non hazardous items at 5ft or higher at all time.

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 sheets for cots in Preschool 1. Need cleaning.

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. -According to teachers, toys are washed in diapering hand washing sink. Ensure to keep diaper sink for only diapering tasks. Toy can be washed in the kitchen sinks or food prep sinks in the classroom.

General Comment: 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child bring from home to the childcare center containing potentially hazardous foods shall be refrigerated at 45 degrees Fahrenheit or below and stored in the child care center kitchen or approved food preparation area. Observed meatballs and spinach in a food container store in the cabinet out of refrigeration. Facility stated that parents want food to stored at room temperature. EHS educated on storage of potential hazardous foods. No point deducted.

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 water temperature at hand sink (Toddler 1-2) 108, 109, 110 measured at 111F- 112F. New water heater was installed recently and need to be adjusted to a correct temperature range. No point deducted.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed low batteries or jammed paper towel dispensers causing paper towel not to be available in classroom hand sink/restroom (109, 110, 111). Director fixed some of them and provide paper towel at the time of inspection.

REPEAT 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed mattress, mat, and stuff animal stored in the restroom 106, 111. Remove some of items out of restroom during inspection. 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed utensils stored in hand sink in infants room and art supplies in hand sink in room 109. Items shall not be stored in hand sink.

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 in toddler room, staff changes a child diapers missing removing gloves and wiping staff and child’s hands after disposing of dirty diaper and washing hands hands after diaper change. A director corrected staff during the changing process. Observed in classroom 108, another staff changes diapers and misses step between dirty and clean procedures. And at the end, used sanitizer instead of disinfectant to spray diaper surface. EHS corrected staff and discuss the correct procedure.

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 peeling cabinet in room 106. Observed dust, taps residues, and debris in bookshelves and shelving in numerous classrooms. Need cleaning and maintain clean.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed paper towel dispensers inside (toddler / pre school #1) classrooms not functioning during inspection.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed storage (tables / chairs / cushions) inside group bathroom inside (toddler) classroom in need of removal. (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 cabinet door surfaces damaged in need of resurfacing / repair in (#2's, #3's) classrooms.

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 numerous classrooms having damaged book bindings in need of replacing; Observed tape residue on wooden cubbies in several classrooms in need of removing; Observed card board blocks damaged inside room (#110) in need of replacing.

Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed laminate peeling from cabinets inside #103 classroom; Observed damaged books inside #3A classroom in need of removal / replacing.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed air return grates collecting debris in need of general cleaning inside NC PRE K; Observed bathroom vent in need of cleaning inside #111 classroom.

Observed sanitizer 500ppm in classrooms. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed hand sink missing paper towels in women's restroom and at 1 hand sink in Pre 4 class (sinks closest to shared Pre K restrooms). Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed damaged cot in school age class and torn cot cover in toddler 2 class. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a).

Observed ants on Pre K class and fruit flies in toddler 1 class. Keep the facility free of rodents, insects and vermin. 15A NCAC 18A .2831 (b).

Observed sanitizer reading above 200ppm per county supplied strips. Strips used in facility is water works. Please follow instructions on the bottle to ensure proper sanitizer range. Disinfectant is at proper strength. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed paper blocks in Pre 2 and toddlers 2 peeling. Observed throw pillows in Pre 4 spilt/torn and blue couch with small rips in Pre 3B. 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).

Replace broken/damaged gasket on refrigeration unit in infant 2 and toddler 1 class. Clean gasket on refrigeration unit door in toddler 1 class. Defrost and clean ice from freezer section of refrigeration unit in infant 2 class and toddler 1 class. Thoroughly clean bottle warmer in infant 1 and toddler 1 class. Clean ice from two door up-right freezer unit in kitchen and address issue causing ice to form in base of freezer unit. Bottle warming equipment shall be cleaned and sanitized at least daily and when visibly soiled. 15A NCAC 18A .2810 (f) (1) and .2804 (d). Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed single service articles not properly stored in school age room and several other rooms. Store single service articles in enclosed clean bin, original sleeving or some type of sealabe bag(ziploc). Wipe/clean shelving in cabinet area where single service articles are stored. Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b).

Provide soap and paper towels at all hand washing sinks at all times! Soap missing from several dispensers in bathrooms that are not being used. Repair damaged soap and paper towel dispensers in classrooms and bathrooms. Observed paper towels stuck in dispensers and not dispensing. Observed soap in some dispensers, but not properly dispensing. PROVIDE SOAP AND PAPER TOWELS AT ALL HAND WASHING SINKS AT ALL TIME AND MAKE SURE SOAP AND PAPER TOWEL DISPENSERS ARE PROPERLY OPERATING! Liquid soap shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed damaged crib mattresses in infant 1 and infant 2 classroom. Discard and replace damaged crib mattresses. Observed tape adhesive and old tape on corner of sleeping cots. Thoroughly clean old tape and tape adhesive from corners of sleeping cots. Discard and replace damaged sleeping cot in pre k room. Highly recommend using the name and number system on sleeping cots. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a).

Repair leg on utility sink in laundry room. Clean area around lid on clothes washer machine. Repair rusted area around lid on clothes washer machine using appliance paint. Clean stain on pillow in toddler 1 room. Replace books in classrooms with damaged spine(toddler 2) and anywhere else needed. Replace all damaged vinyl chairs in all classrooms and common area near kitchen! Observed vinyl chairs damaged and tape being used to repair almost entire surface of chairs. Clean base of toy bins and lower toy shelving in classrooms. Replace damaged covers to cover cots in classrooms. Discard and replace damaged toy and sensory table bin in pre school 4 room. Discard any cracked or damaged toy bins or toys in rooms. Clean exterior of cabinet and doors. Tightly secure loose laminate on cabinet doors. 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).

Clean ceiling around/near ceiling ventilation in classrooms. Tightly secure loose molding around glass on door to school age room. Clean walls in bathroom in school age room. Clean wall under window in toddler 2 room and repaint. Secure loose rubber cove base molding beside hand washing sinks in classroom and behind toilets in bathroom between classrooms. Thoroughly clean lower section of wall in boys school age bathroom and under toilet paper dispenser in bathroom between pre k class and pre school B. Clean doors to bathrooms, walls in bathroom, bathroom door framing light switch and area around light switch. Repaint window sill in pre school 4 class. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Clean grounds around dumpster area. Keep dumpster door closed at all times. Solid wastes shall be disposed of in a manner that prevents insect breeding and public nuisances. 15A NCAC 18A .2830 (d).

Keep bins covered on the playground so they do not hold or collect water. Repair or replace damaged tarp used to cover sand boxes on playground area. Keep the property free of standing water. 15A NCAC 18A .2831 (b). Sand boxes must be covered when not in use and kept clean. 15A NCAC 18A .2832 (c ) (2).

Observed baby bottles not labeled with child's name or date in infant 2 refrigeration unit. Observed specialty milk for child in kitchen refrigeration unit and name and date on carton of milk was for June 7, 2017. Properly label and date mark baby bottles. Return specialty milk provided by parents at end of week carton/container of milk was brought to center. 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 sanitizer solution in spray bottle too strong throughout in classrooms. Sanitizer(chlorine) shall be 50ppm-200ppm. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Thoroughly clean bottle warmer in infant 2 classroom or replace bottle warmer. Defrost and clean ice from freezer section of refrigeration unit in infant 2 room. Replace broken/damaged gasket on refrigeration unit in infant 1 and infant 2 refrigeration unit. Repair water dripping near door area on two door up-right refrigeration unit in kitchen area. Thoroughly clean pivot on legs and base of high chair in infant 2 room. Observed pivot area on legs and base of chair soiled. Bottle warming equipment shall be cleaned and sanitized at least daily and when visibly soiled. 15A NCAC 18A .2810 (f) (1) and .2804 (d). Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f) Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed single service articles not properly stored in outside emergency bags. Observed single service articles(cups) stored loosely in emergency bags taken out to the playground. Store single service articles in ziploc bag. Store single service articles inverted down in kitchen. Observed case of single service articles stored on the floor and was informed cases of single service articles came in yesterday. Store cases of single service articles off the floor and work deliveries up as soon as possible! Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b). Do not store food service equipment on the floor. 15A NCAC 18A .2814 (a) and (b).

Observed several bathrooms missing paper towels! Observed broken soap dispenser in school age bathroom. PROVIDE SOAP AND PAPER TOWELS AT ALL HAND WASHING SINKS AT ALL TIMES! Replace broken soap dispenser in bathroom. Paper towels provided in bathrooms at time of inspection. ------>General Comment #1 and #2. How are you properly washing your hands if paper towels are missing from hand washing sink and soap dispenser is broken? Liquid soap and disposable towels shall be provided and accessible at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed several to many new crib mattresses damaged on the corners in infant 1 and infant 2 classroom. Replace damaged crib mattresses. Observed several children napping on the floor in school age room. Provide mats in school age room so children do not have to nap on the floor. Observed several cots not properly labeled, missing name or child's name not on cot list. Observed children sleeping on cot too close together in pre school 1 room. Properly label cots using the name and number system or just the name. Space cots and mats at least eighteen inches apart when children are sleeping. Provide linen for mats provided in school age room. All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a).

Observed loose tape and tape adhesive on blue and red vinyl chairs throughout in rooms. Replace damaged vinyl chairs or secure tape on chairs so tape is not loose and tape adhesive is not on chairs. Clean area around lid on clothes washer machine. Paint area around lid on clothes washer where rust is present using appliance paint. Tighten loose bolts on toddler chairs throughout in rooms to eliminate pinch points on chairs. Thoroughly clean side and handle area on toddler chairs in toddler 2 room. Dust electronic device in school age room below television. Clean key board to computer in pre k 1 room

Observed hand lotion not properly stored in school age room. Store hand lotion five feet vertical distance out of reach of children. 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 paint coming off and missing from around diaper changing border in infant 1 room and toddler 2 room. Touch-up paint border on diaper changing table. Observed damaged counter top at hand washing/diaper changing area in pre school 1 room. Repair hand washing and diaper changing counter top. Thoroughly clean area around lid on washer machine. Observed area around lid on washer machine soiled!. Tighten loose legs on table in toddler 1 room, toddler 2 room and pre k room. Clean base of high chair in infant 2 room. Repair or replace damage on vinyl furniture(brown and blue vinyl chairs and soft climbing fixture). Clean brown plastic chairs throughout in rooms. REPAIR DAMAGED CUBBY IN SCHOOL AGE ROOM---->REPAIR DAMAGED LEG/CASTER(WHEEL) ON CUBBY IMMEDIATELY---->DO NOT WANT CUBBY TO FALL ONTO ANYONE! Dust top and behind fixtures in pre k 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).

Touch paint throughout in room near cot storage area and exit doors leading out onto playground area. Clean walls in toddler 2 room and pre school 1 room near hand washing sink in classroom area. Repair damaged floor tile in bathroom in school age room bathroom. Clean floor drain in kitchen. Clean floor in school age bathroom. Thoroughly clean floor in laundry room and storage rooms within room. Repair ceiling in 3b room from previous leak in attic/ceiling. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Repair light fixture in bathroom between pre k and pre 4 class Replace damaged light shield over light fixture in toddler 2 room. Keep all light fixtures clean and in good repair. 15A NCAC 18A .2826 (a). Light bulbs must be shatterproof or shielded. 15A NCAC 18A .2826 (a).

Observed damaged section of playground fencing on back side of playground. Repair damaged fencing and section of fencing. Tighten loose boards on playground fencing. Replace damaged cover over sand box/ sand play area. Repair damaged and missing pedal and seats on tricycles. All play ground equipment must be kept clean and in good repair. 15A NCAC 18A .2832 (c ). Sandboxes must be covered when not in use and kept clean. 15A NCAC 18A .2832 (c ) (2).

. Observed sanitizer solution in spray bottles throughout entire daycare too strong. Sanitizer(chlorine) shall be 50ppm-200ppm. Observed no sanitizer in vat of three compartment sink or in spray bottle within the kitchen area. Provide properly mixed sanitizer at all times within the kitchen during hours of operation of daycare. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed torn/damaged crib mattresses throughout in infant rooms. Discard and replace damaged crib mattresses. Observed damaged sleeping cots in pre school room. Replace sleeping cots with damaged legs. Observed covering to cover sleeping cots soiled with mulch. Clean cover to cover sleeping cots and keep clean at all times. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). 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).

Clean handle on chairs and underside edge of table children eat at throughout in different classrooms. Clean area around door on washer machine and keep clean at all times. Repair or replace damaged vinyl furniture in toddler 2, pre kindergarten and pre school 3B. Thoroughly clean and repair green chair covering in school age room or just discard chairs. Wipe/clean exterior of cabinet doors in rooms. Thoroughly clean hard plastic dolls throughout in rooms. I recommend cleaning plastic dolls with rubbing alcohol. After cleaning with rubbing alcohol; clean with soapy water solution and sanitizer. Do not clean toys with rubbing alcohol when children are present in center. Paint top of manipulative center in pre school 3B where particle/ press wood is exposed. 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).

Touch-up paint wall in infant 1&2. Clean walls and touch up paint in toddler 1, toddler 2 and school age room. Thoroughly clean walls in school age girls and boys bathroom above door. Monitor and repair ceiling and wall in kitchen, pre school 4 and bathroom between pre school 2 and 3A. Tightly secure bulletin board to wall near school age room.

Observed loose/leaning fence on pre school playground area(back fencing). Observed loose boards on playground fencing in infant/toddler playground area. Replace missing pedals on tricycle throughout on playground area. Keep the premises clean and free of dilapidated structures and broken play equipment. 15A NCAC 18A .2832 (a).

Observed storage in restrooms in classroom restrooms throughout.Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a).

Repeat non-compliance: Observed toy sinks in play centers damaged in several classrooms.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 wall damage in classrooms throughout facility. Observed baseboard coming away from wall in Pre K restroom.Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Repeat non-compliance: Observed vents collecting dust throughout facility.Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed no functioning thermometer in kitchen.Provide a numerically scaled metal stem-type thermometer accurate to 2°F. 15A NCAC 18A .2807 (h)

Observed can opener blade collecting residue in kitchen.Food contact surfaces and utensils shall be cleaned and sanitized after preparing raw foods, prior to preparing ready to eat foods, and after any interruption of operations in which contamination may have occurred. 15A NCAC 18A .2807 (c ) and .2812 (b).

Observed sanitizer in kitchen between 500 and 800 ppm.Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed vent throughout facility collecting dust.

Observed: No soap in 104 restroom. No paper towel in 104 restroom No soap at the staff sink in 106. No paper towel in 107 restroom.Liquid soap and disposable towels shall be provided and accessible at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed: Excessive storage on the closet floor in 107 and floor wax on the floor.Adequate space shall be provided for the storage of equipment, furniture, toys, clothes, linens, backpacks, book bags, diaper bags, beds, cots, mats, and supplies and shall be kept clean. 15A NCAC 18A .2820 (a).

Observed: Damaged blue vinyl sofas in 107 and 111. All diaper changing surrounds damaged/chipping paint.Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed: Most ceiling vents, HVAC returns, and restroom exhaust vents collecting dust.Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed no functioning thermometer in facility.Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12).

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

Observed diaper changing tables with damage to finish.Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b).

Observed trash collecting on school age playground and behind fence near HVAC units.At child care centers, the premises, including the outdoor learning environment, shall be kept clean. 15A NCAC 18A .2832 (a).

Observed can opener blade dirty, can opener stored as clean. **Multi-service utensils must be washed, rinsed, and sanitized after each use. See rule .2812 (e)

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

Observed wall damage in classrooms throughout facility. Observed urine on floor in boys 3b restroom. Observed dust collecting on window sill in toddler 2 and table in pre 4. **Keep all floors, walls, and ceilings, clean and in good repair. See rule sections .2824 and .2825.

Observed trash on playground. **Solid waste must be covered, and dumpster area must be kept clean. See rule .2830 (c ) and (d).

Observed no accessible paper towels in Pre 3 restroom.**Disposable towels shall be provided at all hand washing sinks. See rule .2818 (d).

Observed disinfectant in infant 1 and toddler 1 classrooms below 250 ppm.**The diaper changing surface shall be properly disinfected between each child. See rule .2819 (c ).

Observed hand lotion and hand sanitizer in pre 2 classroom unlocked.**Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. See rule .2820 (b), (c ) and (d).

Observed dust collecting on several window sills in care room.Observed wall damage throghout facility.**Keep all floors walls and ceilings clean and in good repair.

Observed dust collecting on vents in classrooms throughout facility. **Keep all ventilation related equipment clean and in good repair. See rule .2826 (b).Observed light not functioning in kitchen freezer. **Keep all light fixtures clean and in good repair. See rule .2826 (a).