THE LEARNING TREE

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand sink in 116, 115 need caulking. Keep all hand sinks in good repair. 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed very loose toilet seat need repair in restroom 104/106. Keep all toilets 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 sanitizer bottle inside pocket of outside bag hanging down from the bottom hook less than 5ft in room 115. Ensure to put the bag up on the higher hook that keeps the bag at 5ft or higher at all time. Observed hand lotion and squeeze sanitizer bottle in unlock cabinet less than 5ft in 114 and 116. Keep/store items at 5ft or higher at anytime.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand sink in 117, 115 need new caulking. Keep all hand sinks in good repair.

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 inside pocket of outside bag hanging down from the hook less than 5ft in room 115. Ensure to put the bag up on the higher hook that keep the bag 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 store in unlocked cabinet less than 5ft in infant room. Ensure to keep purses/personal belongings that contain no hazardous items at 5ft or higher at all time. 15A NCAC 18A .2820 (f) A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children.- Observed children bags hanging on the hooks in infant and few classrooms, touching each other. Ensure to keep individual items separate and not allow contact while storing at anytime.

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 cot without/missing label with either name or number in 105. Label each individual assigned cot. If number use, please provide a cot chart telling which number belongs to whom.

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 holes on wall, mix match paining/patching spot in several classroom near hand sink, play area, around room may not include (115, 117, 105, 107, 104). Repair needed. Keep all wall in good repair.

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 several lunch boxes without date received. Ensure to label name and date on all items send from home.

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 no thermometer inside pink refrigerator infant room. Obtain a thermometer and put at the warmest part of the refrigerator.

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

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed aerosol can of cleaning product in unlocked cabinet in room 119. Observed glycerin liquid bottle stored in unlocked cabinet in room 105. Ensure to keep all hazardous items in lock cabinet/storage at all time. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time**

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 store in locked cabinet with a key hanging less than 5ft to access. Ensure to keep purses/personal belongings at 5ft or higher at all time. NOTE: Store locking key right at 5ft or higher at all times.

General Comment: 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children.- Observed hot water in infant 2 (room 109) both sinks measure at 115F. Ensure to provide tempered water between 80F to 110F.

15A NCAC 18A .2820 (f). Coat hooks not in individual cubbies or lockers must be 12 horizontal inches apart.- Observed children coats/book-bags are hanging on the hooks touching each other. Ensure to keep all individual items separate and not touching while storing.

General Comment: 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users.- Observed several mattresses in infants room start to crack open at the corners. Keep all mattresses in good repair.

15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed at the playground the HVAC units fencing with gate left unlock where they are accessible to children. Lock the gate/install locking key to prevent children from having access to the units.

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 inside the outside bag hanging on the hook down less than 5ft. Ensure to move the hook higher and bag shall be stored right at 5ft or higher.

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 body cream/hand sanitizer stored in cabinet with child prof lock and the long string of lock less than 5ft in 117, 116. Ensure to store items at 5ft or higher at all time.

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 hanging down from the hook in 114 and in the hall way cabinet with child prof device on it, stored less than 5ft. Store purses without hazardous items at 5ft or higher at all time.

15A NCAC 18A .2821 (c). Beds, cots, and mats shall be assigned and labeled for use by an individual child and equipped with individual linens.- Observed two classrooms without cot chart/name or number labeling. Ensure to identify and label all the cot for individual child, and update as needed.

General Comment: 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 children lunches in thermos containers without parents or guardians permission form. Obtain the written permission for records.

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 items stored less than 5ft, hand sanitizer bottle on a roller cart at the side entrance where children are waiting to do home. Hand sanitizer bottle on the counter and sanitizer dispenser on the hallway. Hand lotion in cabinet in young 2’. Ensure to store/put all non hazardous items at 5ft or above at all time.

General Comment: 15A NCAC 18A .2827 (d). The child care center shall have written procedures that employees shall follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the center. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, children, food, and surfaces to vomitus or fecal matter.- Observed the facility without the vomiting and diarrhea written procedures in place. EHS emailed the director assistant the written plan and poster at the time of inspection.

15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed at the playground the AC outside units fencing with gate left unlock where they are accessible to children. Ensure to lock the gate to prevent children from having access to the units.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed water damaged ceiling tiles in classrooms in need of repair / replacing.

Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e). Observed Hand washing sink inside (toddler) room measuring 113F in need of adjusting.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed scuffed walls throughout classrooms behind cots and trash cans in need of touch-up painting. Observed water damaged ceiling tiles inside (toddler) classroom in need of replacing.

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 disinfectant wipes stored below 5ft inside (summercamp classroom); Observed bulk shampoo with (warning label) stored below 5ft inside (3's) classroom. CDI all items properly stored above 5ft or behind lock and key.

Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e). Observed hot water measuring 114F inside (INFANT) classroom.

REPEAT Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed scuffed walls inside classrooms throughout from trash cans, cots and misc storage.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seat very loose in pre-school room 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 tiles inside 3's classroom in need of repair.

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 bottle warmer, children's water bottles stored in splash zone of hand sinks.

Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f) Observed old dried food on high chair. Observed paper towel dispenser over 2-comp sink in kitchen. Move paper towel dispenser to where clean surfaces will not be contaminated during hand washing (kitchen).

Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f). Observed a purse stored unlocked and less than 5 feet above floor, TK room.

Opened baby food jars, intended to be finished on another day, must be labeled with the date opened, and discarded after 2 days. 15A NCAC 18A .2804 (d). Observed opened baby food in infant room fridge unlabeled.

Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b). Observed plastic spoons stored loose in a container with other items. Store in clean container or baggie. Protect food service equipment from contamination. 15A NCAC 18A .2814 (a) and (b). Observed teacher rinsing spoons from child's home in hand sink. Parent must send a spoon for each meal/feeding or use disposable spoons that are discarded after each meal/feeding.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed unlocked laundry room, unlocked (several rooms) after bite sting relief, antiseptic pads, disinfecting wipes, toothpaste, and chemicals (touch-up paint bottle, aerosol sunscreen, windex, bleach) in kitchen. Shared spaces used by church must also have their items properly stored/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 bath pellets stored in teachers bag sitting on chair in classroom. Teacher's purse sitting in classroom less than 5 feet above floor.

Medications stored in a room with food or chemicals, shall be stored in a separate and locked container or cabinet. 15A NCAC 18A .2820 (d). Observed first aid box in kitchen with 10+ different types of medications. Coat hooks must be 12 inches apart. 15A NCAC 18A .2820 (e). Observed coat hooks not minimum of 12 inches apart.