COVENANT PRESBYTERIAN CHILD CARE DEVELOPMENT CTR

Observed cereal not properly sealed in the 2 year old room. Removed **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 bulk milk dated for 7/20 in the kitchen refrigerator. **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 hot water reach 114F in the older toddler room. Only sink in the building out of range. 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 staff leave out of storage room without locking door. Paint and aerosol cans were located in the closet. Have staff lock the door immediately after leave out of rooms without locking hazardous items. GENERAL COMMENT **15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.

Observed touch paint needed in rooms near the disinfectant/sanitizer solutions. **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.

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. EHS observed some milks that were dated as sent in today and were mostly empty in kitchen refrigerator. Milks arrived opened. Specialty bulk milk needs to be sent in at the beginning of each week unopened.

General Comment: 15A NCAC 18A .2810 (f) A classroom food preparation area countertop shall be kept clean and in good repair. All equipment shall be kept clean. Observed build up in door of refrigerator in Angelfish classroom. Needs cleaning.

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 reach only 116F. PROVISIONAL ITEM.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed toys stored in Toddler bathroom. Storage shall be limited to toileting and diapering supplies. 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed food bins holding breakfast stored in food prep lavatories during breakfast. Lavatories shall not be used for storage.

15A NCAC 18A .2819 (b) Nothing shall be placed on the diapering surface except for those items required for diapering and the child whose diaper will be changed. Observed linens and basket stored on diaper table in Stingrays classroom. Nothing shall be placed on diapering surface except items required for diapering and child in need of changing.

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 small packs of hydrocortisone cream unlocked in Dolphins classroom. Observed small packs of ointment in first aid kits in other classrooms. Medicine was removed and locked away.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosol febreeze in cabinet with only plastic child lock on it in Seahorses. (Lock and key mechanism was not working correctly on both cabinet doors. ) Observed essential oil unlocked in Stingrays classroom. Needs to be stored behind lock and key.

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 brown couch tearing in Jellyfish. Staff stated new couch has been ordered.

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 specialty bulk milks sent from home in WC108 fridge missing date received labels and one dated from last week. Needs to be labeled with date received and sent in unopened each week and sent home at the end of the week. 15A NCAC 18A .2806 (d) Bulk food stored in a refrigerator shall be stored in the child care center's kitchen or in an approved food preparation area equipped with a full-size refrigerator. Observed bulk milks in mini fridge in room WC108. Bulk food shall be stored in a full-sized refrigerator.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed bottle warmer with heavy build up in WC104. Needs cleaning.

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 at prep sink in WC114 at 114F and in WC115 at 111F. Needs to be 80-110F. REPEAT.

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. Facility is due for water testing. Facility has enrolled in at Clean Classrooms for Carolina Kids and is going through procedures for testing.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed storage in cabinets under sinks in several classrooms. Do not store items under lavatory exposed sewer lines or store in waterproof containers.

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 medicine cabinet key stored in lock with pain medicine inside in WC106. Observed key stored less than 5ft up for cabinets containing hazardous items in room WC104.

15A NCAC 18A .2806 (f) Food and containers of food shall not be stored under exposed sewer lines. Food shall not be stored in toilet or laundry rooms, except that child care centers licensed for fewer than 13 children and located in a residence may store food in laundry rooms if the food is stored and protected as required in rule 2806 (g). Observed box of chips stored under sink in room WC115. Food shall not be stored under sewer lines.

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 internal thermometer in kitchen fridge was inoperable due to a dead battery. Needs new thermometer or replace battery. REPEAT.

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. EHS discussed washing of highchair feeding trays in infant 1 classroom. Teachers stated the trays are cleaned in the classroom with soapy water and spray sanitizer. EHS informed staff that highchair feeding trays must be washed, rinsed, and sanitized in kitchen.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed handsink at food prep area in room WC114 reach 116F. Needs to be 80 -110. All other handsinks were in temperature.

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 facility does not have vomit and diarrhea cleaning procedures. EHS provided a copy of the procedures with updated rule information.

Observed no thermometer in the kitchen. Food is prepared in licensed kitchen in the church building but ensure that a thermometer is on hand to check temperatures of food both cold and hot in the main care building. **Provide a numerically scaled metal stem-type thermometer accurate to 2°F. 15A NCAC 18A .2807 (h)

Observed floor in need of sweeping underneath handwashing sink in Starfish and Jellyfish rooms. Observed touch up paint needed near the spray bottles in Starfish room and wall damage near the trash can in the Seals room. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed cereal stored in boxes not properly sealed in closet. Spoke with staff about proper storage. **Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)

Observed disinfectant around 250ppm during the inspection. Disinfectant was made and the concentration was 500ppm after correction. **Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed hot water reach 118F in the staff lounge which was unlocked. Ensure that door remains locked or have water temperature decreased. **Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e).

Observed toys stored directly under pipes unprotected in Angelfish classroom. **Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a).

Observed handwashing sink between the Stingrays and Dolphins class room with a short run time (8 seconds). Timer needs to be longer to allow for handwash that lasts at least 15 seconds. **Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

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

Provide test strips for the chlorine disinfectant. 15A NCAC 18A .2819 (c ). Observed no test strips to check for chlorine disinfectant. Per conversation with Director an order has been placed for strips.

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 lotion stored in pull-out drawer unlocked, below 5 feet in 4's classroom.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed markings on wall in older 2's classroom and paint chipping.

Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a). Observed several bags of cereal opened in kitchen cabinet sealed with tape.

Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e). Observed high chair tables housed in infant room with minor food debris build up under tray. Per conversation with teacher high chair trays are sprayed with soapy water, wiped, and then sprayed with sanitizer after each use. EHS educated center on rule 15A NCAC 18A .2812 (e).

Completely air-dry all equipment and utensils before stacking or storing the items. 15A NCAC 18A .2812 (h) Observed multi-use sippie cups, water bottles air drying on bath towel and being wiped dry with another bath towel. Air dry on non-absorbent surfaces and do not wipe dry.

Liquid soap and disposable towels shall be provided and accessible at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed some hand sinks without paper towels present and accessible.

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed large bin of dirty dishes in hand sink, infant 1. Keep all storage out of hand sink.

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 in 1 classroom stored <5 feet and diaper cream in infant 1 store <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).