PROSPERITY GUIDEPOST MONTESSORI

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 in spray bottles measured at 0.00 ppm. The center shall ensure to provide correct chlorine sanitizer concentration between 50-200 ppm at anytime for proper cleaning.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children.- Observed in classrooms hot water temperature measured between 112F- 115F. The center shall ensure to provide tempered water between 80F- 110F where children have access to at anytime.

REPEAT: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at Hans sink in restroom 5 still need repair.

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 infant room, children are sleeping, their mattresses are close to each other less than 5 inches apart. Their legs are touching each other while sleeping. Ensure to place their mattresses apart at least 18 inches apart during nap time.

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 children foods in infant refrigerator without date and a lunch in a bag on the counter in room 5 without date. Ensure to label both name and date on items send from home.

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 in spray bottles measured at 0.00 ppm. Ensure to provide correct chlorine sanitizer concentration between 50-200 ppm at anytime.

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 in kitchen three compartment sink at 106F. Provide hot water at 3 compartment sinks in the kitchen with a temperature of at least 120F in kitchen at all times.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at Hans sink in restroom 5 need repair.

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 and paper towels in the dispensers in restroom 5. Ensure to provide all hand washing supplies at all hand sinks at all times.

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 antihistamine medication stored in same ziplock bag along side with Epi pen in red bag in room 1. Ensure to keep all medications, except emergency medications in a lock bag/cabinet/storage at all time.

15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand sanitizer bottle stored at front desk and hand lotion bottle in unlock cabinet and less than 5ft in room 5. Ensure to keep all non hazardous items at 5ft or higher at anytime.

General Comment: 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals 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 child’s lunch containing potentially hazardous foods stored in classroom cubby with a temperature of 81F. 15A NCAC 18A .2804 (k) Hot foods that a child brings from home to the child care center in double-walled, insulated thermos containers may be stored outside of refrigeration at the child care center with the written permission of the child's parent or guardian. Observed incomplete permission slips for food being stored in insulated thermoses without refrigeration. Permission form does not contain parent’s name or signature. Ensure permission slips contain all required information.

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 of milk in Room 4 without date mark. Ensure bottles of milk is labeled with name and date it was received. 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 pre-packaged bag of pretzels closed with piece of tape. Store in resealable bag or container. 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 lunches brought from home without date marking in Room 5 and in kitchen refrigerator.

GENERAL COMMENT 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 kitchen three compartment sink at 119F. Ensure to provide water with a temperature of at least 120F in kitchen at all times.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Handwashing sink in Room 5 restroom is slow draining. Both sinks in classroom 7 are soiled.

REPEAT 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.-Observed dry erase board stored restroom in Room 4. Only toileting related items can be stored in restrooms.

GENERAL COMMENT 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed alcohol prep wipes, lens wipes, antiseptic wipes, and insect relief wipes stored in first aid kit, stored inside outdoor bag, without being behind lock and key in Room 2. Observed aerosol can of bug spray and container of Clorox wipes stored in unlocked cabinet in Room 1. Container of Clorox wipes in unlocked cabinet in Room 7. All items had keep out of reach of children with extra warnings and caution. Keep all hazardous items in locked storage cabinets at all times.

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 child’s book bags and blankets stored in cubbies overlapping and touching other child’s belongings in room 5 and room 7. 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 purse stored at front desk stored less than 5 ft above the floor.

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 mats in Room 4 with tears and not in good repair. Repair or replace mats.

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 barrel with standing water located on playground. Keep equipment free of standing water to prevent mosquito breeding.

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 entering classroom to help out and washing hands incorrectly, turning faucet knob with bare hands. Observed student in infant was dropping off by a parent and did not get his hands wash upon entering classroom. According to teacher, student is 3 months old and can not hold up his neck. As a result, hands can be wiped with baby wipes in place of hand washing for young infant who can not hold their neck up yet. Proper hand washing procedures discussed in detail with teachers, director at the time of inspection. Center has hand washing signs posted at hand sinks.

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 children snacks sent from home in several classrooms without date received. Ensure all food items sent from home have both name and date that received on items. 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 an opened big bag of snack in the kitchen folded and taped with painting tape. Observed student big snack bag opened and taped with painting tape in classroom cabinet. Ensure to keep all left over snacks in resealable bag or container for proper food protection/storage.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed a stroller and classroom chairs stored inside restrooms infant. proper storage of classroom items discussed with teacher and director at the time of inspection. Only toileting related items can be stored in restrooms.

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 lotion bottle inside unlock cabinet room 1, less than 5ft. Teacher assistant forget to lock the cabinet. Ensure to store all non hazardous items at 5ft or higher 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 unlock cabinet in room 2. Ensure to put up all personal beginnings/purses that do not contain hazardous items at 5ft or higher vertical distance from the finished floor at all time.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed children dropped off by parents in several classrooms, not washing their hands before engaging in class activities. Observed staff entering a classroom to assist and stay a while, not washing hands before engaging in activities as well. EHS, teacher, director discussed hand washing requirement, when to wash and where to wash at the time of inspection. Ensure staff wash their hands and direct children/ or assist them with hands washing upon arrival.

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 children and teacher washing hands incorrectly, less than 10 seconds and turning faucet knob with bare hands. Proper hand washing procedures discussed in detail with teachers, director at the time of inspection. Center has hand washing signs posted at hand sinks.

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 children lunch boxes sent from home without date and name, without date, wrong date. Ensure all food items sent from home have both name and date received on items for that day. 15A NCAC 18A .2804 (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center.- Observed baby bottles without date in infant refrigerator. Ensure to put both name and date on items sent from home.

General Comment: 15A NCAC 18A .2810 (f). Water from a handwash lavatory shall not be used for bottle warming or to prepare formula, mix dry cereals, or other foods.- Observed teacher is warming a bottle and ask where the water inside the warmer comes from. According to teacher, water comes from hand sink. EHS, teacher, director discussed in detail proper procedures. Water needs to come from the kitchen or bottle water, not from the hand sink.

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 solutions concentration measured more than 500 ppm. Ensure to provide correct chlorine solution of sanitizer between 50-200 ppm at all time. Prepare every 24 hours.

General Comment: 15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination.- Observed play/class items stored underneath hand washing sinks. Do not store any items under sinks/sewer piping.

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 in kitchen 3 compartment sinks measured at 113F. Hot water at 3 compartment sinks in the kitchen shall be and maintained at least 120F at all time.

General Comment: 15A NCAC 18A .2812 (i) Provide a testing method for chlorine disinfectant to ensure compliance with prescribed chlorine concentration.- Observed center without testing strips for disinfectant solution. Obtain testing strips for all solutions use in the center and have available.

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 toward the end of process, staff is changing diaper to a child upon entering infant class. Staff is putting a child down without hand washing, and no hand washing for staff as well. EHS, staff, director discussed in detail procedures of diaper changing. The classroom has a procedures posted on the wall for reference. Ensure to follow correct diaper changing procedures at all time.

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 in red bag at front office stored less than 5ft. Observed red bags that contained emergency medications hanging on a hook high enough, however the black strings of the bags dropped down towards the floor, making the red bags from ground up less than 5ft while storing. Ensure to keep all strings and whole bag up at 5ft or higher at anytime.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed air freshener spray bottle in restroom shelf in infant room, Observed ice pack that has labeled “Keep out of reach of children “ and extra “warning” in first aid bag in unlocked cabinet in infant. Observed cleaner spray bottles on a shelf in room 9. All hazardous items shall be kept in lock cabinet 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**

REPEAT 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand sanitizer bottle on a desk in front office, door unlock. Ensure to store 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 a bulk refill soap bag sit on counter hand sink in infant. Teacher was going to refill the soap dispenser, and have not get a chance to complete a task. Ensure to store/place item at 5ft or higher 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 purses stored in unlock cabinet in room 6, Observed a purse on a desk in front office upon entering for inspection. Ensure to put up all personal beginnings, items and purses at 5ft or higher vertical distance from the finished floor. 15A NCAC 18A .2820 (f) A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children.- Observed children personal items (coats, book bags, lunch boxes) hanging on hooks/cubbies/counters throughout the center, items are touching each other while storing. Ensure to provide enough storage for individual items, and not allow contact while storing at anytime.

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 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 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.

15A NCAC 18A .2804 (d) 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 room, water bottles in the refrigerator didn’t get to send home at the end of the day since last Friday. Ensure to send all bottle of beverages home at the end of each day or discard. REPEAT 15A NCAC 18A .2804 (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration.- Observed in infant room, bottled of water was offered this morning and returned back and kept in the refrigerator to continue offering throughout the day. EHS, director assistant, teacher discussed proper detail how to handle the situation at the time of inspection. Previously used bottles shall not be returned to refrigerator for later use again and again. Only clean items allowed. 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 sent from home without date that was received. Ensure to put both name and date on items send from home.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes.- Observed no sanitizer solution spray bottle for general cleaning in room 2. Ensure to provide sanitizer solution spray bottle for cleaning in every classroom.

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 center water testing for lead was 07/01/2021. The center had started the process and enrolled with RTI on 09/02/2024. The center will update the new testing results once it’s available.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand sink at the back in infant and room 1, need cleaning and maybe new caulking for easily cleanable. Keep clean.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed items (trays, apron/bibs, toys) belong to classroom stored in the restroom in infant. Remove items and find appropriate place for it to be. Only toileting related items can be stored in restrooms.

15A NCAC 18A .2812 (i) Provide a testing method for chlorine disinfectant to ensure compliance with prescribed chlorine concentration.- Observed no disinfectant spray solution bottle available for cleaning in room 5. Ensure to provide disinfectant solution spray bottle for cleaning in every classroom.

15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand sanitizer bottle store in unlock cabinet, and sanitizer solution in bin for toys cleaning store on a counter less than 5ft in infant room. Ensure to store items at least 5ft or higher at all time. 15A NCAC 18A .2820 (c ) Sanitizing, disinfecting, and detergent solutions shall be labeled with the product name (ex. "Sanitizer")- Observed soapy water bottle without a label. Ensure to put label on all bottles even just a water.

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 purses stored in classroom less than 5ft (room 9, 10). Ensure to put up item at least 5ft high vertical distance from the finished floor.

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 the back of diaper changing pad/table in infant room need cleaning and keep clean. Observed dust/residue in cabinet under sinks, and most bottom cabinets in general throughout the center need detail cleaning and 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 some stain ceiling tiles in classroom and hallway. Check for no active leaks, repair if needed and replace the ceiling tiles.

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 big bag of snacks closed with tape in the kitchen and room 10. Ensure to store all left over in resealable bag/container. 15A NCAC 18A .2804 (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration.- Observed sippy cup of water in infant room inside the refrigerator. According to teacher one cup is going in and out refrigerator after serving and send home at the end of the day. EHS, teacher, and director discussed proper way to handle the situation at the time of inspection. Ensure to not put previously used bottles/cups back in the refrigerator to prevent any possible contamination.

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. Provide correct concentration between 50-200 ppm. Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes.- Observed room 3 without sanitizer solution bottle, the one they had was emptied and missing the spray nozzle.

REPEAT 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 ranged between 111F -113F in infant room, room #2, #3, #9. Hot water temperature at one of the hand sink in room #1 measured 62F. Provide tempered water where is accessible to children.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed clogging hand sink in restroom 5, need repair. Observed disrepair faucet, provides no hot water in room 1, need repair. 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed disrepair toilet in restroom 1, need repair.

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 inside the outside bag in room 7. EHS discussed proper way to store non-emergency medication with teacher and director at the time of inspection. Teacher locked up the item at the time of inspection. **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 lotion store in cabinet less than 5ft in room 9. Store all non hazardous items at 5ft or higher at all time.

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 classroom 10, washing her hands less than 20 seconds and turn of the faucet knob with bare hands. Hand washing sign was posted at the sink. Proper hand washing discussed with director and teacher. Teacher washed hands again at the time of inspection. EHS emailed hand washing sign to director.

REPEAT 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. - Observed some classroom water temperature measured between 111F -115F. Director had put in work order and the technician will be coming to adjust to tempered water ASAP.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair - Observed loose hand washing faucet and hot water side is not working in one of the sink in classroom 1. Observed mildew around food prep hand sink in infant room, caulking may be needed. Need to keep clean and in good repair.

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 lotion stored below 5ft in classroom 1 and 10. Teacher and director moved items up 5ft at the time of inspection. 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 personal bag stored in unlock cubby and less than 5ft in classroom 10.

General Comment: 15A NCAC 18A .2820 (f). Coat hooks not in individual cubbies or lockers must be 12 horizontal inches apart. - Observed children coats hanging up using hangers on the cubby line outside each classroom. Coats are touching each other. Ensure to provide hook/space at least 12 inches apart and not allow individual item to touch each other.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed children dropped off by parents and entered to the infant classroom, not washed their hands before engaging in the activity or be part of the group. Ensure to direct children or assist them with hands washing upon arrival.

General Comment: 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 the specialty milks with name but no date that was received at the center. Observed another specialty milk dated 10/24 with a name of a child. Ensure to follow the notated rule above. Have both name and date that was received at the center and send home or discard at the end of each week. Proper procedure about the specialty milk discussed with director at the time of inspection. 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 a bag of graham crackers not closed and stored properly in 1’s classroom. Teacher discarded item at the time of inspection. 15A NCAC 18A .2810 (f) Water from hand wash lavatory shall not be used for bottle warming or to prepare formula, mix dry cereals, or other foods. - According to teacher in infant room, teacher used water from food prep handwashing sink to warm the bottles in the warmer. As well as in the pitcher for drinking water for the class. Water needs to come from the kitchen or bottle water, not from the hand sink.

General Comment: 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 refrigerator inside the kitchen without internal thermometer. Obtain the thermometer and put inside at the warmest part of the refrigerator. 15A NCAC 18A .2807 (h) Metal stem-type, thin probe, numerically scaled indicating product thermometers, accurate to ± 3 degrees Fahrenheit shall be used to ensure the maintenance of the internal cooking temperatures of all potentially hazardous foods required under this Rule. - Observed the facility without a thin probe thermometer to measure the potential hazardous food/water temperature. Obtain a thin probe thermometer.

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 baskets inside the refrigerator in infant room. The baskets use to store individual bottles/snack for each child in class. All baskets need to be cleaned and keep clean.

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 in some classrooms throughout the building measured between 111F to 115F. Ensure to provide tempered water in the range that was required.

15A NCAC 18A .2817 (a) Storage in toilet rooms shall be limited to toileting and diapering supplies. - Observed a clean bag of blankets stored on diapering table. Staff jackets, aprons, outside bag for water bottle hanging on the hooks inside the toilet room in room 6. Observed laundry baskets full of laundry and cardboard toy car stored in the infant toilet room. Removed all items and make an appropriate space where items shall be stored where it’s belongs.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Purses that contain hazardous items shall be stored behind lock and key. 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. -Observed buckets of paint stored in unlock stroller closet at the front entrance. Observed teacher computer bag that contains medication cream stored on the floor, the bug spray aerosol can, and an ice pack in an emergency bag in 1’s classroom. The powder cleanser container in unlock cabinet in room 8. Little tubes of super glue in unlock cabinet in room 10. Sunscreen/bugs spray in aerosol can in broken locked container on the bathroom shelf in 5’s classroom. Ensure to store all hazardous items in locked storage/cabinets. PROVISIONAL ITEM.

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 a bottle of water conditioner which has label “keep out of reach of children” store in cabinet under the counter in room 10. 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’s purses stored below 5ft in room 9, 10, 3’-6’ classroom, and 5’ classroom.

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 written procedures of vomiting and diarrhea. EHS emailed the written plan to director at the time of inspection.

All potentially hazardous food products shall be maintained at 45°F, or below, or 140°F or above. 15A NCAC 18A .2806 (f). Observed children lunches throughout center being held outside of refrigeration in cubbies. Per conversation with Director parents have been told to pack children lunches with ice packs. EHS educated director on notated rule, cold food being housed inside of lunches must be maintained at 45F or below. EHS advises center to go back to places lunches in refrigeration units stored in kitchen immediately. If violation is observed during next inspection and potentially hazardous products are not maintained at 45F or below, demerits will be taken for critical violation.

Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed snacks opened in kitchen and in classrooms (8 and 10) sealed with tape. EHS advises center to reseal opened food according to notated rule. Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d). Observed speciality milk brought from children’s home in refrigerator located in kitchen with names and no dates. Observed 1 child’s cups not labeled with name nor date in refrigerator located in classroom 3. 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 several children lunches with no names nor dates throughout center.

Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d). Observed sanitizer at 1000ppm in classroom 4. EHS corrected sanitizing solution during time of inspection to required range.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed spring loaded faucet in restroom in classroom 7 with approximately an eight second run time. EHS advises center to have run time adjusted to at least 15 seconds to allot proper handwashing.

All cleaning and disinfectant solutions shall be properly labeled (i.e. soapy water, disinfectant). 15A NCAC 18A .2819 (c ) and .2820 (c ). Observed spray bottles in classroom 7 restroom not labeled. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed teacher leave on same gloves throughout entire diaper changing procedure in classroom 3. EHS educated teacher on the correct diaper changing procedure process. Teacher also washed hands in food prep handwashing sink. EHS educated teacher on the proper sink to use and EHS properly cleaned and disinfected food prep handwashing sink.

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 in cabinets in classroom 9.

Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f). Observed staining on fitted sheets on mats in classroom 3. *NOTE: Director, Kayla Brito, was present during time of inspection. Report emailed to:

Wash hands when required. 15A NCAC 18A .2803 (a). Observed teacher enter into infant classroom #3 and use hand sanitizer on hands. Teacher proceeded to pick up a child. Per conversation with teacher she had just returned from her break. Teacher stated that she sometimes uses hand sanitizer as it is easier. EHS educated teacher on notated rule.

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 child's bottles not dated in domestic refrigerator located in classroom 4. Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed opened package of food sealed with a clip in classroom #4. Observed bag of chips stored on shelving in kitchen sealed with tape. EHS advises center to reseal opened packages of food according to notated rule.

Hand washing signs shall be posted at all hand washing areas. 15A NCAC 18A .2818 (e). Observed no handwashing sign posted at handsink in classroom #7 and #10.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed cleaner stored in Windex bottle on high shelving in room #9. EHS locked cleaner behind lock and key inside of cabinet located in kitchen. 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 hand sanitizer stored in cabinet below 5 feet in classroom #9. EHS advises center to store approved non-hazardous products above 5 feet or behind lock and key.

Clean and sanitize water play centers and associated toys daily (if used) and when visibly soiled. 15A NCAC 18A .2822 (c ). Observed teacher in classroom #7 washing toys in handsink in soapy water solution. EHS was unable to receive clarity as to if toys are being sanitized after being washed. EHS advises center to ensure that toys are washed, rinsed, and sanitized. *NOTE: Report emailed to Head of School, Dr. Mazie Parkmond at MPARKMOND@GUIDEPOSTMONTESSORI.COM

Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d). Observed several specialty milks brought from children's home with name and no date. EHS educated center on rule 15A NCAC 18A .2804 (d).

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seat in classroom 1 and 10. Tighten loosen toilet seats. Observed toilet lid missing off 1 toilet in classroom 2 restroom, replace missing lid.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed teacher in classroom 4 not wipes hands after removing soiled gloves when completing diaper change. EHS educated teacher on rule 15A NCAC 18A .2819 (d). All cleaning and disinfectant solutions shall be properly labeled (i.e. soapy water, disinfectant). 15A NCAC 18A .2819 (c ) and .2820 (c ). Observed spray bottle not labeled in classroom 2 that housed only water per conversation with teacher.

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed very loose toilet seat inside classroom #8 bathroom in need of repair / re-tightening.

REPEAT Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed misc storage underneath hand sink drain lines inside classroom (#8).

REPEAT Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seat inside restroom of classroom (#10).

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed misc storage inside restrooms of both (Infant) rooms.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed large section of wall with missing / peeling paint in need of painting inside classroom (#6).

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed very loose toilet seats in need of repair inside (Infant, 3's) lavatories.

Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b). Observed changing pad damaged in need of replacing inside classrooms (Infant, Toddler, 2's).

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

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seat loose in need of repair in classroom #9.

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 off counter top area in classroom #9 in need of repair.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed water damaged ceiling tile in mens restroom (currently wet) with mold growth; in need of removal. Observed all Toddler rooms having scuffed walls in need of touch-up painting; Observed wall surfaces around light switches in restrooms of Toddler rooms in need of cleaning.

Observed bottle of formula sitting on the counter in the younger infant room with a time label on it. Caregiver stated they keep they save the bottle for up to one hour before discarding in case the child is hungry again. EHS explained that formula cannot be re-served after being served and the activity has changed. **Once served, portions of leftover food shall not be served again unless the package is intact and the food is not potentially hazardous. 15A NCAC 18A .2808 (d)

REPEAT Observed hand sink faucets with build-up around the base in toddlers room and rooms 8,9, and 10. Observed cleaning needed around the base of toilets in the bathroom of room #9. **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).

Observed disinfectant below 500 ppm chlorine in classrooms. Director had employee increase bleach concentrations. Observed no disinfectant strips onsite today. EHS emailed new bleach dilution chart and test strip vendor list. **Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7). **Provide test strips for the chlorine disinfectant. 15A NCAC 18A .2819 (c )

Observed hand sink faucets in classrooms throughout facility with build-up. Ensure that the base of faucets and all around faucet handles are properly cleaned. **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).

Observed dust and debris collecting in the sliding door cabinets and tracks of sliding door cabinets throughout classrooms. Observed items such and wash clothes, paper towels, tissues, and other items being stored under sinks throughout classrooms. Ensure that no items to be used by children are stored under sinks. **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 refrigerator shelving rusted. Microwave needed cleaning in teacher's lounge (room 8) **Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).

Observed no toilet paper in room 6. No soap (overly diluted) in room 2. **Toilet tissue shall be provided in each toilet room. 15A NCAC 18A .2817 (a). **Liquid soap shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d).

Observed damaged flooring in bathrooms of rooms 3 and 10. Wall damage in bathroom of room 8. Window sill damage in room 8. Wall damage at can wash. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

CCA wood needs sealing on picnic tables and play equipment. **All exterior non-painted wood installed before 1/1/05 must be sealed or stained at least every 2 years. Seal wood with either an oil-based, semi-transparent sealant, oil-based clear stain, or water-based clear stain. 15A NCAC 18A .2831 (e), (f), and (g). Giving CCA wood form to fill out.