CRE8TIVE CHILD CARE

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 less than 18 inches apart during naptime. Ensure cots are at least 18 inches apart.

15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key. Observed disinfectant wipes stored on counter in kitchen below 5ft. Ensure disinfecting wipes are stored 5ft up.

General Comment: 15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens. Observed one child with no sheet during naptime. Ensure each child has individual linens.

15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed sanitizer solution measured more than 1000 ppm chlorine. Sanitizer solution needs to be between 50-200 ppm.

REPEAT 15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed front door of the oven is broken/missing. Repair needed.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilet tank lid missing, it was covered with a trash bag at the time inspection. Repair needed and keep all fixture in good repair. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed hand washing sink in bathroom need detail cleaning. Keep clean.

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

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed bug spray on top of the shelf unlock. Keep all hazardous items that has labeled “Keep out of reach of children” and any other “warning” or “caution” in lock cabinet/storage. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time**

15A NCAC 18A .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 on a shelf in unlock pantry closet less than 5ft. Keep all non hazardous items at 5ft or higher at all times.

General Comment: 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 personal purse hanging down on the hook less than 5ft. Keep all personal belongings that has no hazardous items at 5ft or higher at all time.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer at 500 ppm chlorine. Needs to be 50-200 ppm.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed build up in refrigerator. Needs cleaning. Observed front door of oven is broken. Needs repair. REPEAT.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed build up on toilet seat. Observed toilet tank lid missing. Observed build up in potty chair and tear on toilet adapter seat. Needs cleaning/ repair. REPEAT. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed build up on bathroom sink. Needs cleaning.

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 neosporin stored on high shelf unlocked. Needs to be stored locked. CDI- moved to lock box in kitchen.

15A NCAC 18A .2827 (d). The child care center shall have written procedures that employees shall follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the center. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, children, food, and surfaces to vomitus or fecal matter. Observed facility did not have plan. EHS provided operator with a copy.

5A NCAC 18A .2831 (c). For outdoor toys and play equipment, including all structures accessible to children, the following shall apply: (1) Equipment and toys shall be kept clean, in good repair, and free of peeling, flaking, or chalking paint, rust, and corrosion; and (2) A sandbox used in outdoor play shall be constructed to allow for drainage of water and shall be covered when not in use and kept clean. Observed sandbox uncovered and not in use. Needs to be covered when not in use.

15A NCAC 18A .2812 (f) Kitchen surfaces that are not food-contact surfaces shall be kept clean. Observed refrigerator drawer with old food debris, better but not clean.

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 water tested for lead > 3 years ago. Contact https://www.cleanwaterforcarolinakids.org/enroll to enroll to get water tested. Only testing at 2-comp sink required.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilet seat loose and surface marred and uncleanable. Replace toilet seat, recommend child adaptable toilet seat. (Note-potty chairs have been removed)

15A NCAC 18A .2819 (b). Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair. Observed diaper changing table pad does not appear to be cleanable, can see it had tried to be cleaned. Replace pad or can change diapers on surface without pad.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed dishwasher pods under kitchen sink. Install magnetic locks on those cabinet doors or another way that is lockable with key. I will check back in to see if installed sometime in January.

15A NCAC 18A .2825 (b).Walls and ceilings in rooms in which food is stored, handled, or prepared, utensil-washing rooms, and toilet rooms shall be nonabsorbent. Acoustic and other absorbent ceiling material may be used where ventilation in the room precludes the possibility of grease and moisture absorption by the acoustic or other material. Observed stained ceiling in main room from plumbing leak upstairs. Repair/paint ceiling.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Repeat-Observed one rolling garbage bin without a lid.

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 eggs sitting on counter, no longer sweating. Staff said she just cooked an egg for a child and she keeps the eggs at room temperature. Cold foods must stay cold. Dispose of any PHF that have been out of temp > 4 hours.

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 no digital food thermometer, provider said it just broke. Provide a digital thermometer

15A NCAC 18A .2812 (e) Multi-service articles, including highchair feeding trays, shall be washed, rinsed and sanitized in the child care center kitchen after each use. Observed used water bottles still in tray for in use water bottles. Some of the water bottles are from children on vacation or no longer attend center. Provider said she washes all the bottles they don’t go home to the parents. All water bottles to be washed everyday and put away. Only children that are currently at the center that day should have filled water bottles in the holder.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed entire kitchen needs a thorough cleaning. Inside and outside of cabinets, drawers, refrigerator, counters, fronts of counters, latch on baby gate, etc.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Repeat-Hot water at hand sink in bathroom 115F

15A NCAC 18A .2817 (c) If potty chairs are used, they shall be located and stored in a toilet room equipped with a spray-rinse toilet or utility sink. Potty chairs shall be emptied, rinsed, cleaned, and disinfected after each use. Observed 2 potty chairs with dried urine in bottom. Potty chairs are not allowed without a spray rinse toilet or equivalent, remove potty chairs from premises. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed what looked like urine on the bathroom counter top. Do not empty potty chairs in sink. Sink bowl with residue build-up. 15A NCAC 18A .2817 (b) Toilet fixtures shall be cleaned and disinfected daily and when visibly soiled. Observed smudge/grime on toilet seat.

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 at kitchen hand sink, food particles in hand sink. Hand sink is only for washing hands.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed diapers stored under hand sink in bathroom.

15A NCAC 18A .2819 (d). (9), Diapering surfaces shall be cleaned, prior to disinfection, by spraying the entire diapering surface with detergent solution and wiping clean, using disposable paper towels. Observed sticky substance and grime on diaper changing pad. Keep clean.

15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm). Observed unlabeled bottles of disinfectant. One reading > 1000 ppm chlorine. Test strips expired in 10/2016. Replace test strips.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed outside rolling bin without lid. Have bin replaced.

Observed no test strips during the inspection. Ensure that sanitizer is used to clean tables in which the kids eat on. **Provide sanitizer test kit. 15A NCAC 18A .2812 (g)

Observed hot water in the restroom reach 114F before falling back down to 112F. **Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e).

Observed potty chair with urine still in it. Restroom would need to be properly equipped to use potty chair. A potty chair adapted to be used on top of toilet seat would be needed if the restroom is not equipped to clean potty chairs properly. **Potty chairs may only be used if restroom is equipped with spray-rinse toilet or utility sink. 15A NCAC 18A .2817 (c ).

Observed dog in the kitchen area during the inspection. Ensure that dog feeding bowl is outside the kitchen during operating hours to ensure the dog is not in the kitchen area. **Animals are not permitted in food preparation areas or at the entrances to food preparation areas. 15A NCAC 18A .2831 (a).

Observed sanitizer above 200ppm during the inspection. **Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d) Observed test strips expired. Please provide test strips that are not expired. **Provide sanitizer test kit. 15A NCAC 18A .2812 (g)

Observed disinfectant wipes stored below 5 ft. Wipes were removed and placed on shelving above 5 ft. **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 stained carpet. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed diaper pad stained. Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b).

Provide a probe thermometer that reads 0-220F to ensure proper temperatures for hot hand cold foods. Provide a numerically scaled metal stem-type thermometer accurate to 2°F. 15A NCAC 18A .2807 (h)

Observed food debris or spills on stove and around kitchen sink faucet (big). Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3).