TUTOR TIME LEARNING CENTER

General Comment: 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed one toilet out of order in Twos 2. Needs repair.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed toys in diaper change sink in Toddler 2.

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 soapy water stored less than 5ft up in Twos 1.

General Comment: 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 crackers in cabinet in Early Preschool in non-resealable bag/container. Observed crackers in emergency bag in Preschool classroom in non-resealable bag/container. 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 lunches brought from home in Early Preschool with no date label.

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 in the Kitchen reach only 110F. Staff stated a new water heater had been put in earlier this year. Kitchen water temperature needs to be a minimum of 120F. When adjusting ensure water temperature at sinks accessible to children is 80-110F. PROVISIONAL ITEM.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed storage of play items in Toddler 2 bathroom.

General Comment: 15A NCAC 18A .2819 (d) Use approved diapering methods as follows: 1) gather supplies, 2) wear disposable gloves (if needed), 3) use a disposable moist towelette to clean child, wiping front to back, 4) dispose of gloves if used and soiled towelettes, 5) wiping the employee's hands and the child's hands with a separate disposable towelette, 6) slide clean diaper under child and apply diapering products if needed using approved methods, 7) fasten diaper and place clothing on child, 8) wash child's hands, 9) and 10) clean and disinfect diapering surface using approved methods, 11) employee washes their hands. Observed staff member miss step 4 and 5 in diaper change procedure. Needs to follow procedure correctly.

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 bags containing epi pen stored hanging from hook less than 5ft up in Infant room. Needs to be stored 5ft above the floor.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed 4 aerosol shaving creams and 2 small air fresheners stored unlocked in classroom. Observed chemical ice packs stored unlocked in emergency bags in Twos 2 and Infant classroom. Observed white out pen stored in unlocked cabinet in Twos 2. 15A NCAC 18A .2820 (b).Keys used to access hazardous item storage must be out of reach of children (5 ft above the floor) and stored separately from lock. Observed Key stored in lock to storage closet in Twos 1 and Twos 2 classrooms. Needs to be stored out of the lock and 5ft above the floor. PROVISIONAL ITEM.

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 (Tods) classroom not having disinfectant available during inspection. Director provided and supplied classrooms with disinfectant.

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 cots in use spaced within 18inches (touching, 1-5 inches).

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. Walls throughout classrooms observed scuffed and in need of touch-up painting. (Cot storage areas).

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed cups used for bottle warming in Infant room with pink build up. Needs cleaning.

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 antibiotic ointment in infant room outside bag and anti itch ointment in preschool outside bag. Needs to be stored locked.

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 facility has a box of specialty milk sent from home for one child with no date received. Needs to be labeled with name and date received and sent home at the end of each week. 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day. Observed snacks and specialty milk brought from home with not date label in Toddler 2. Needs date. 15A NCAC 18A .2807 (i) Potentially hazardous foods that are frozen shall be thawed using one of the following methods: (1) in refrigerated units at a temperature not to exceed 45 degrees Fahrenheit; (2) submerged under potable water of a temperature of 70 degrees Fahrenheit or below, with sufficient water velocity to agitate and float off loose food particles into the overflow; (3) in a microwave oven only when the food will be immediately transferred to conventional cooking equipment as part of a continuous cooking process or when the entire, uninterrupted cooking process takes place in the microwave oven; or (4) as part of the uninterrupted cooking process. Observed meat thawing floating in sink water. Needs to be thawed using one of the above processes.

General Comment: 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. Staff stated high chair trays in infant room are cleaned by wash/rinse/sanitizing with spray bottles in the classroom. Needs to be taken to the kitchen after each use.

General comment: 15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean. Observed build up on some outside drinking fountains. Needs to be cleaned or disabled.

15A NCAC 18A .2820 (b).Keys used to access hazardous item storage must be out of reach of children (5 ft above the floor) and stored separately from lock. Observed magnet keys for locked cabinets containing hazardous items or diaper creams stored less than 5ft up. Needs to be stored 5ft up. 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed air fresheners in multiple rooms stored unlocked. Observed chemical ice packs stored in emergency bag in school age rooms. Needs to be stored behind lock and key. PROVISIONAL ITEM.

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 red cushions for couch tearing in Twos 2 and Navy stools tearing in School age rooms. Needs repair/replacement.

15A NCAC 18A .2822 (b) and .2810 (f).Hard plastic toys may be washed, rinsed, and sanitized in a dishwasher, food preparation handwashing sink, or in the kitchen sink. Observed bin of paint covered toys next to diaper sink in toddler 2 classroom. Staff stated the toys were going to be cleaned in the diaper sink. Diaper handsinks cannot be used for wash/rinse/sanitizing toys. Needs to bo to kitchen sink.

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 stained ceiling tile in school age classroom. Needs to be checked for leaks and repaired/replaced.

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 package of cereal sealed with tape in cabinet in kitchen. 15A NCAC 18A .2806 (g) Food shall be stored above the floor and in a manner to protect it from dust, pests, drip, splash, and other contamination. Observed boxes of shelf stable milk stored on the floor in kitchen.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed minor cleaning needed to outside corners of toilets throughout center. General comment.

15A NCAC 18A .2832 (a). Child care center premises, including the outdoor learning environment, shall be kept clean, drained to minimize standing water, free of litter and hazards, and maintained in a manner which does not create conditions that attract or harbor pests. Observed boxes, litter, and debris stored outside of shared dumpster area.

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 snacks not properly resealed in two’s 1 and 4’s classrooms.

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. Director showed EHS proof that she attended the required webinar. Center is now waiting on testing bottles. During time of inspection, Director contacted Clean Water for US Kids for update and showed EHS documentation that bottles have been ordered.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed detailed cleaning needed to the following toilets: toddler 2 and school age (boys and girls).

15A NCAC 18A .2818 (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803. Observed handwashing sign missing at boys and girls restroom handsinks in school age classroom.

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 a few crib mats fraying around the edges in infant classroom.

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 stained ceiling tiles in toddler 2 and early preschool classrooms. EHS advises center to ensure no active leak is occurring and to have stained ceiling tiles replaced.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed dumpster sliding doors opened and debris/dilapidated structures within dumpster enclosure area.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed child arrive to attend childcare for the day in infant classroom and child’s hands were not washed. (Child was walking and able to hold head steady). EHS advises center to ensure children hands are washed according to below rule. (1) upon arrival at the child care center (2) after each diaper change or visit to the toilet (3) before eating meals or snacks (4) before and after water play (5) after being outdoors (6) after handling animals or animal cages

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. EHS advises center to complete updated lead water testing. Director was made aware and is actively working to complete updated sampling.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed detailed cleaning needed to after school girls toilet and toddler 2 toilet. Observed 1 toilet out of order in PreK1 classroom, work order has been submitted to have toilet repaired.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed sippy cups stored in food prep handwashing sink basin in infant classroom. 15A NCAC 18A .2818 (e) Handwash signs shall be posted at every handwash lavatory area. The signs shall instruct children and child care center employees to wash their hands in accordance with Rule .2803 Observed handwashing signs missing at several handsinks throughout center.

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 chlorine disinfectant measuring at 200ppm chlorine throughout center. Disinfectant was properly remade during time of inspection.

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 stained ceiling tile near door in toddler 2 classroom. EHS advises to ensure no active leak is occurring and to have stained ceiling tile repaired/replaced.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed 1 sliding door missing from dumpster. Observed debris surrounding/behind dumpster area.

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 3 baby bottles and 2 individual containers of baby food not properly labeled in refrigeration unit located in infant classroom. Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed package of cereal in school age classroom not properly resealed.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Observed minor food debris build up under high chair feeding trays in infant classroom. EHS educated center on notated rule.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed black staining on outside corners of toilets in school age classroom.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed no paper towels at handsink in girls 4’s restroom class. Teacher supplied paper towels to sink during time of inspection.

To clean and disinfect diapering surface: 1) Spray soapy water onto surface 2) Wipe off soapy water 3) Spray disinfectant onto surface until surface is glistening wet 4) Let disinfectant sit for at least 2 minutes or until air dry. 15A NCAC 18A .2819 (d). Observed teacher in toddler 2 classroom spray disinfectant onto diapering surface and immediately wipe up after completing diaper change. EHS educated teacher on misstep. If critical violation is observed during next inspection, demerits will be taken.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed teacher leave on soiled gloves throughout entire diaper changing process in toddler 2 classroom. EHS educated teacher on missed steps of procedure.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed Lysol toilet bowl cleaner and Fabuloso cleaner stored unlocked in toddler 2 classroom restroom. Hazardous items were properly locked during time of inspection by Director. If critical violation is observed during next inspection, demerits will be taken.

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 approved spray bottles (soapy water, sanitizer, disinfectant) stored below 5 feet throughout center. Center is in the process of being renovated and wall hooks that originally were placed 5 feet up to hang spray bottles have been removed. Per director, these hooks will be replaced.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed some sleeping cots not individually labeled in toddler 2 and 1-2’s classroom.

Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f).Observed crib sheets with holes and 1 crib sheet with staining in in infant classroom.

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Observed dumpster sliding doors opened during time of inspection. Observed minor debris/litter surrounding dumpster area.

Completely air-dry all equipment and utensils before stacking or storing the items. 15A NCAC 18A .2812 (h) Observed sippy cups and lids not properly air-dried stored in Ziploc bags in cabinet area within the kitchen. Thoroughly air-dry utensil/equipment before stacking or storing.

Provide sanitizer test kit. 15A NCAC 18A .2812 (g) Observed sanitizer test strips and disinfectant test strips water damaged. Provide sanitizer and disinfectant test strips at all times. Points deducted under this violation and also could be deducted under item #26. But will general comment under #26.

Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3). Wipe/clean underside of shelving in up-right refrigeration unit in kitchen. General cleaning of shelving in cabinet area and exterior of cabinet doors in kitchen. General detail cleaning of oven (exterior/control). Replace broken/split gasket on refrigeration unit in classroom area.

Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b). Observed cases of single service articles on the floor in storage room on back hallway. Store items off the floor

Provide test strips for the chlorine disinfectant. 15A NCAC 18A .2819 (c ) Observed sanitizer test strips and disinfectant test strips water damaged. Provide sanitizer and disinfectant test strips at all times. Points deducted under this violation and also could be deducted under item #26. But will general comment under #26.

Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b). Properly repair all diaper changing/hand washing sink duo. Observed laminate on diaper changing station/handwashing sink station in bad repair and tape is being used to hold laminate. Caulk/seal back and side splash on diaper changing/ handwashing sink area throughout in all rooms.

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). Thoroughly clean toys in the village play rooms/stations. Observed toys in village room/stations soiled. Wipe/clean underside edge of tables. Wipe/clean shelving under cabinet areas. Tighten loose screws and tighten loose bolts on furniture/fixture (tables, sensory tables, etc.). Clean/dust window blinds throughout in all classrooms.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls, doors and door framing needing painting/repainting throughout in all classrooms/hallways, storage areas, etc. Repair water damaged door framing. Clean/dust window ledge (high ledge).

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d).Keep dumpster lids and doors closed to prevent insect and vermin nuisances. 15A NCAC 18A .2830 (d). Clean grounds around dumpster within the dumpster corral. Keep dumpster lid and door closed at all times.

Keep the premises clean and free of dilapidated structures and broken play equipment. 15A NCAC 18A .2832 (a). Remove broken/damaged tables on the playground area. Cut back thorny holly bush on the playground. Cut root that is a trip hazard on the playground area.

Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed opened can of marinara in refrigerator. Once can is opened put contents in a container with a lid.

Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12).Repeat- Observed missing digital thermometer. 2 dial top thermometers present, but no ice to check proper calibration.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e).Repeat- Observed 2 children in infant room eating directly off tray. Tray must go to kitchen for w/r/s after each meal. If plate/bowl is used, tray can be cleaned in place and sent to kitchen once per day for w/r/s

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 in disrepair in kitchen. Ovens need old food/grease removed.

Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b). Observed opened carton of plastic-ware under paper towel dispenser in kitchen. Keep clean items out of splash-zone.

Hot water used to warm bottles shall be maintained between 80°F and 110°F, unless the hot water is located in an approved bottle warming device. Hot water exceeding 120°F is considered to be a burn hazard. 15A NCAC 18A .2815 (e). Observed hot water in dispensers used to heat bottles >150F. Kitchen was 121F, asked how they got the water so hot. Heating water with electric tea pots in staff lounge. Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). Observed kitchen door unlocked. Kitchen must be locked if no staff are present.

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed toys stored below hand sinks in many classrooms. Toys/crafts etc must be stored in containers with lids if stored below hand sinks. Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed crafts stored in one bathroom.

Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b). Observed several diaper changing tables with broken areas taped. Keep the diaper changing table free of non-diaper changing related storage. 15A NCAC 18A .2819 (b). Observed diaper changing table with phone charger and wireless speaker. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed wrong diaper changing procedure. Follow posted procedures. Remove dirty gloves before touching diaper. Wipe hands with wipe after removing gloves and before putting on new ones. Remove wipes from container before diaper change.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed white out unlocked in one classroom. Antiseptic wipes and cold packs in emergency bags throughout. These items must be locked.

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 < 5 feet above floor in many areas including front desk. Lotions less than 5 feet above floor in many 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- Observed many shelf units with tape residue that needs to be cleaned off. Washing machine needs wiping down.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Repeat- Observed damaged walls throughout facility. Blinds dusty throughout.

Keep the premises clean and free of dilapidated structures and broken play equipment. 15A NCAC 18A .2832 (a). Observed box of trash on playground. Observed broken climber stairs on playground.

Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12). Observed thermometer in kitchen 13 degrees off. Calibrate or discard and replace thermometer with a calibrated accurate thermometer to ensure proper food temperatures during meal preparation.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Observed dried food remaining underneath highchair feeding trays and crumbs in highchair seat. Wash, rinse and sanitize highchairs feeding trays and seats after each use. and when visibly dirty.

Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d) Sanitizer in infants classroom concentration level was 500ppm. Sanitizer must be between 50 to 200ppm. Discard and remake sanitizer to meet the 50 to 200ppm compliance.

Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3). Observed encrusted food debris in kitchen cabinet drawer. Observed loose handle on refrigerator door in the kitchen. Repair handle on the refrigeration door. Increase cleaning frequency in kitchen, clean cabinets and drawers when visibly soiled.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet in pre-K classroom when flushed not filling tank and continuous running. No points taken because PIC checked toilet, REHS rechecked toilet to verify that the toilet is functioning properly. CDI

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 grit and dirt in crevices of toys in several classroom. Observed ripped child's bench and seat cushion in Two's classroom allowing cushion to absorb dirt, or bacteria. Toys, equipment and furniture provided by a child care center shall be kept clean and in good repair. In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces shall be cleaned and then sanitized at least daily when used and more frequently if visibly dirty ***THIS IS A REPEAT VIOLATION***

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed peeling drywall in several classrooms. Repair or spot paint walls to prevent further damage to the drywall in each classroom. ***THIS IS A REPEAT VIOLATION***

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed a little more detailed cleaning needed to back of toilet lids and outside of toilet basins. Overall cleanliness of toilets has improved significantly from previous inspection.

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

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed teacher in infant room not wipe her hands with a wipe after removing soiled gloves before placing clean diaper on child.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed wall paint peeling throughout center. Touch up paint.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed all toilets throughout center soiled with pink and brown build up. Clean. REPEAT VIOLATION.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed storage in toddler 1 restroom that was not toileting and diapering items. REPEAT VIOLATION.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed mats stored in cribs located in infant room fraying around the edges. REPEAT VIOLATION.

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 tape/sticker residue.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls throughout center with tape residue and chipping paint. Observed a piece of baseboard missing in 2's restroom. Minor stained ceiling tile in 2's classroom. Director unsure when carpet was cleaned last as this in only her 3rd week in the role as Director, EHS reminds center of rule carpet shall be extraction cleaned at least once each 6 months. 15A NCAC 18A .2824 (c ).

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed stain in after school boys restroom. Observed staining on toilet in preschool and 4's room. Clean.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed teacher in infant room miss the following steps of 15A NCAC 18A .2819 (d) (4) disposing of gloves if used and (5) wiping hands with disposable towel or moistened paper towel. REPEAT VIOLATION.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed fraying of several crib mat's in infant room. Repair/Replace.

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 sticker residue build up on furniture throughout several classrooms used to store toys, supplies, etc. Observed red cushions with slits and tears in early pre school room. Observed dolls in need of cleaning in 2's classroom.

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 summer camp child washing hands, turn off water with hand and tap excess water off hands on side of sink. Monitor handwashing procedures.

Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f) Repeat- Observed dried food and debris on undersides of high chair trays and high chair seats. Microwave in kitchen with food splatters.

Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7). Observed one weak (>250, <500) disinfectant bottle, Infant B. CDI Provide test strips for the chlorine disinfectant. 15A NCAC 18A .2819 (c ) Make sure test strips have the color chart. The color chart is part of the test strip kit.

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 toys and other supplies/paperwork stored below sink plumbing in several classrooms. Remove any tape or sticky residue from shelving, doors, ets. Replace cardboard blocks that are in disrepair. Clean washing machine of dirt/soap build-up.

Observed highchair feeding trays with dried food debris on the under side in Infant room.. Needs to be cleaned. Spoke with staff about taking them to the kitchen to be cleaned at the end of the day. **Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e).

Observed disinfectant at 200ppm in Infant room. Disinfectant was replaced at proper concentration. **Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed toy bin with white flaky debris in Toddler 1 room. Bin was removed to be cleaned. Ensure bins are being cleaned when toys are. Observed peeling blocks in Two year old room. Blocks were removed. Observed large green pillow torn in Early Pre-K room. Pillow was removed. **Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed dust debris on some hard toys (buses, cars) in Two's 2, red cushion has rips in Two's 2, and tape residue on toys cabinets in Prek 2. 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 wall paint peeling in (various) classrooms. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed hand sinks needing to recaulked to wall in infants, toddlers, toddler 2, and Pre K 2 classes. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed damage to paper blocks in 2s and 3s classes. 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 wall damage at centers in infants, toddler, and toddler 2 classes. Observed wall damage and pencil markings in village. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

REPEAT - Observed the kitchen sanitizer was 500ppm. **Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Repeat - Observed the sinks need re-caulking in the 5 yr old care room and preK. **Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed shelving and furniture throughout the faclility with sticky resudue, some book shelfes with dust and debris, a plush toy was not clean in the toddler room, paper books were worn and damaged, some window blinds were dusty, and some music toys were rusty. **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 damaged wall paint and door paint in most room, water damaged ceiling tiles in the "town shop" and the Two's room, and the wall-to-wall carpet had several stains in the infant room. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed: Scoop handles touching food products in the kitchen. All food shall be stored and handled in a manner that protects it from contamination. 15A NCAC 18A .2806 (d),(f), .2807 (b), and .2808 (e).

Observed: Sanitizer in the 3 comp sink at 0ppm and the sanitizer in the bulk jug and in spray bottles in excess of 1000ppm. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed: Most wall hung sinks in need of caulking/silicone. The counter top sink faucets dirty in Pre K and Preschool. Keep hand washing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed: Staff purse in reach of students in Pre K 2. Lotions within 5' of the floor ( in a low cabinet with a broken mag lock) and soapy water bottle within 5' of the floor in Pre School. Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f). Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d).

Observed.: Several cots with damaged corners. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a).

Observed: The glider dirty and a plush toy stained in Infants. A damaged water play/sand play table leg in Pre School. Cardboard boxes damaged in Pre K 2. Water in the play table and the center time over. 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). Water center shall only have water in them during center time. 15A NCAC .2822 c.