BIG BLUE MARBLE ACADEMY

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 multiple bottles of milk in Infant 1 classroom with no date label. Ensure bottles are labeled with date.

General Comment: 15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizing solution at 800-1000ppm. Ensure sanitizer is between 50-200ppm.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilets in Tod 2 bathroom in need of cleaning. Keep clean.

General Comment: 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 hand wash sink in Tod2 room. Ensure soap is available at every hand sink at all times.

General Comment: 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed bottle warmers in infant rooms in need of cleaning.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilets in Tod 2 bathroom in need of cleaning. Keep clean.

General Comment: 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 pad in Tod rooms with small tear. Repair/replace.

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 bench cushion in 3’s room with tear. Repair/replace.

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 chipped/peeling paint on window sills in Tod 2 room. Repair.

General Comment: 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilets in Twos bathroom in need of cleaning. Observed loose toilet seats in Preschool classrooms. Tighten.

15A NCAC 18A .2826 (b).Windows and window treatments shall be kept clean and in good repair. All ventilation equipment, including air supply diffusers, return grilles, and fans shall be kept clean and in good repair. Observed ventilation equipment in various bathrooms with buildup in need of cleaning. REPEAT

General Comment: 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 two bottles of milk in Infant 1 classroom with no date label. Ensure bottles are labeled with date. No points deducted.

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 hand sinks in 3’s and 4’s classrooms at 118F. Ensure hot water at hand sinks accessible to children is between 80F-110F.

15A NCAC 18A .2815 (e) Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children. Observed hot water at hand sinks in Infant 1, Infant 2, Toddler 1 and 2, and 2’s rooms range from 126F-135F. Water exceeding 120F is a burn hazard and should not be in areas accessible to children.

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 disinfectant solution in all classrooms at 100-250ppm. Ensure disinfectant solution is between 500-800ppm.

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 teacher in 2’s classroom perform step 11 before step 10 and perform step 6 before step 5. Ensure steps are completed in correct order.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlabeled pine sol solution stored on shelf in Infant 1 classroom. Needs to be behind lock and key. No points deducted.

General Comment: 15A NCAC 18A .2820 (f). Coat hooks not in individual cubbies or lockers must be 12 horizontal inches apart. Observed coat hooks in Tod’s room less than 12 inches apart. Ensure hooks are at least 12 inches apart. 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’s coats coming into contact with each other in Tod’s room. Personal items belonging to children should not come into contact with each other.

General Comment: 15A NCAC 18A .2826 (b).Windows and window treatments shall be kept clean and in good repair. All ventilation equipment, including air supply diffusers, return grilles, and fans shall be kept clean and in good repair. Observed dust buildup around ceiling vents and dust clinging to ceiling in 4’s classroom and Infant rooms. Director stated they are working with electricians to get ventilation repaired to prevent the dust buildup. No points deducted.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed children enter infant 2 classroom did not have hands washed upon entrance. Needs to have hands washed upon entrance to classroom.

No points deducted. 15A NCAC 18A .2804 (d) Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Observed refrigerator in infant room holding at 50F. Temperature was checked this morning by Director and thermometers were reading in the 35F range. All bottles were moved to the kitchen refrigerator while adjustments and repairs are being made to the small refrigerator. Infant fridge is out of use.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed art supplies under sink in threes room.

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 build up in cabinets under sinks in prek classrooms. Needs cleaning.

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 three bottles in infant 1 room missing date labels with one missing the name label. Needs to be labeled with name and date received. 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 one carton of specialty bulk milk missing date received and one missing name label. 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 brown sugar in taped closed container. Needs to be in resealable bag or container.

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

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilet seat worn in 2s classroom. Observed toilets in need of cleaning in Toddler 2 room. Observed loose toilet seat in Prek 2 classroom. Needs cleaning/repair.

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 prescription medicine and other medicine in personal bag in unlocked cabinet with key in lock in Toddler 2 classroom. Observed migraine medicine in personal bag in unlocked closet in Prek 2. Needs to be stored in a locked cabinet or container. PROVISIONAL ITEM.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosol and cleaner in unlocked closet in Prek 1. Observed matches, wood glue, and super glue stored unlocked in 3s classroom. Observed pinesol/water mix unlabeled and in unlocked cabinet in 2s classroom. PROVISIONAL ITEM. REPEAT. 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 magnets used to unlock cabinets containing hazardous items in infant room stored on small refrigerator less than 5ft up. Observed several mounted magnets in classrooms stored slightly less than 5ft up. Ensure all magnet keys for cabinets are stored 5ft above the floor.

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 some cots less than 18 inches apart in 2s classroom. Needs to be 18 inches apart or separated by partitions.

15A NCAC 18A .2831 (b). Sand toys, water tables, and other unfiltered items that can collect standing water in the outdoor learning environment shall be emptied and stored to prevent the collection of standing water. Observed one water table outside not emptied. Director stated it was used this morning. Observed a water table insert in a/c area full of water. Director emptied water.

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 staff turned off water with hand instead of paper towel, toddler room.

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 < 80F in 3’s room. Hot water was initially hot but ran out in less than 1 minute. This is a bank of 4 sinks with one point of use water heater, staff says it is the one water heater that was not replaced. Strongly recommend tying these sinks in with the main water heater.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed storage, toys, diapers, paper towels stored below hand sinks.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed window cleaner on shelf in hall bathroom. Hazardous items are required to be locked in all areas of the building, not just the classrooms.

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. Through discussion teachers in infants rooms said they fill bottle warmers with tap water. Use bottled water, water fountain or kitchen sink.

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 high chair trays not being sent to kitchen for cleaning. Undersides with considerable amounts of dried food. 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed bottle warmers with old stickers and visibly soiled.

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 105F.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Repeat-Observed hot water not working in Pre-K 1 and 2, men’s bathroom

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed storage in bathroom, toddler 2. Storage under hand sinks in several classrooms.

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 broken diaper table 2’s #1. 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 iPad on diaper change pad during a diaper change. 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 wrong procedure for diapering in infant and toddler rooms. Follow posted procedures.

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 contact cleaner Pre-K 2 in room and Acetamenophen and cough drops unlocked in 3’s #1.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlocked hazardous items as follows: Fabuloso unlabeled and unlocked 2’s #1, aerosol air freshener infants, goo-gone 3’s #1, febreeze toddler #2

15A NCAC 18A .2820 (c ) Sanitizing, disinfecting, and detergent solutions shall be labeled with the product name (ex. "Sanitizer"). Observed unlabeled spray bottles. 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 spray bottles stored below 5 feet in several classrooms. Diaper creams stored < 5 feet in infants. Hand sanitizer < 5 feet 3’s #1.

15A NCAC 18A .2820 (f). Coat hooks not in individual cubbies or lockers must be 12 horizontal inches apart. Observed coats all hanging together without any spacing, toddler 1.

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 not spaced min of 18 inches apart Pre-K 2

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 shelves, bookshelves with dust/debris infants room.

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 ceilings around vents very dusty throughout. Recommend removing popcorn from ceiling, once it has become this dirty it is very hard to clean.

15A NCAC 18A .2826 (b).Windows and window treatments shall be kept clean and in good repair. All ventilation equipment, including air supply diffusers, return grilles, and fans shall be kept clean and in good repair. Observed vents in many classrooms and bathrooms, and kitchen dusty.

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. New Rule will email poster

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed dumpster with no drain plug.

Observed teacher cleaning child’s nose and not wash her hands or child’s hands. Must was hands of teacher and child after cleaning nose. (Toddler 1) Wash hands when required. 15A NCAC 18A .2803 (a)

Observed hot water faucet not operating in Pre k 1 and 2 classrooms. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed food prep hand sink needing to be resealed to the wall in 2s class. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).

Observed dust build up on HVAC filters in Pre K2 and 3s class. Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b).

Observed toilets in classroom Three's 1&2 and classroom Four's in need of cleaning around the base and behind. Toilets shall be cleaned and disinfected at least daily and when visibly soiled. 15A NCAC 18A .2817 (b).

Observed cob-webs on cots in Three's classroom. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a).

Observed glitter on rug in classroom Three's three (not used due to staffing and low enrollment) and stains on carpet/rug in classroom two's. Sweep laundry detergent and accumulated dust debris off floor in laundry room. All floors and floor coverings shall be kept clean and maintained in good repair. 15A NCAC 18A .2824 (e ).

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed no paper towels in men's hall bathroom.

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 cabinets and some locks in disrepair. Keep baskets that hold clean laundry clean. Clean wahing machine of soap/lint build-up. Clean undersides of diaper changing pad and table.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed dusty vents in 3's bathroom and toddler bathroom.

Water pressure at drinking fountains must be high enough so that water clears mouth nozzle, and so that water does not splash on the floor. 15A NCAC 18A .2815 (f). Observed one water fountain with pressure too high and spattering onto ground.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed no paper towels in 3's classroom.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed unlocked insect repellant in 2's, 3's, and 4-5's classrooms. CRITICAL VIOLATION

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 unlocked purses stored below 5 feet in 2's, 3's classrooms. 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 unlocked and less than 5 feet in 4's classroom. Observed unlocked and stored less than 5 feet diaper creams and sunscreen in 2's and toddlers.

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 torn vinyl couches in 2's and school age classrooms. Sticky tape residue needs removing. Several cabinets in disrepair in classrooms and kitchen. Keep cabinets and drawers wiped out of debris.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed a very dusty vent in 2's classroom. Keep vents clean.

Keep the property free of high vegetation. 15A NCAC 18A .2831 (i). Observed vegetation growing through the fence onto playground. Keep bushes trimmed

Wash hands when required. 15A NCAC 18A .2803 (a) Observed child's hands not washed at drop off by parent to classroom.

Protect food service equipment from contamination. 15A NCAC 18A .2814 (a) and (b). Observed bottle lids and other items in splash zone on hand sink, infant room. Area needs rearranging so food prep area is back to the shelf above the food prep hand sinks. Do not use towel (absorbent surface) for clean items.

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 took an excessively long time to reach a minimum of 80F in infant food prep, heated up faster closer to water heater. May need a recirculation pump on water heater.

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed a diaper changing hand sink full of toys. Keep hand sinks clear of items. Toys shall not be cleaned in the diaper changing hand sink. Teacher needs to wash hands in the appropriate sink.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed incorrect diaper changing procedures in several classrooms. One room did not wash child's hands after diaper change. One was pulling wipes from container as she was changing a diaper with a BM. Follow posted procedures.