TENDER LOVE & CARE CHILD DEVELOPMENT CENTER

Observed diaper changing pad torn in the infant room. **15A NCAC 18A .2819 (b). Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair.

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 testing just under 500 ppm. Facility uses test strips that require 1 minute wait before comparing to indicating scale. Color at first appears within appropriate range but as the minute goes on the color changes to slightly more blue which indicates less than 500 ppm. Needs to be 500-800 ppm. Wait one minute to compare test strips.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosol air freshener and poo-pourri spray stored in unlocked cabinets in bathroom. Observed mop stored just outside bathroom next to sink with cleaning chemical in mop. Needs to be stored locked. CDI - items were moved to locked cabinet.

General Comment: 15A NCAC 18A .2821 (d). Mats shall be of a waterproof, washable material at least two inches thick. Observed many mats in facility less than 2 inches thick. Needs to be 2 inches thick. REPEAT. No points deducted because operator had ordered new mats and they recently arrived at the facility.

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 one cup of milk in infant room refrigerator with no date or name label. Cup is employees child at center still needs name and date label. General Comment: 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. EHS observed bulk milk in infant room refrigerator. Needs to be stored in a full size refrigerator. 15A NCAC 18A .2806 (g) Food shall be stored above the floor and in a manner to protect it from dust, pests, drip, splash, and other contamination. Observed box of cheez-its stored on the floor in kitchen. Needs to be stored off the floor.

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 soapy water stored less than 5ft above the floor in room 3. Needs to be stored 5ft above the floor. REPEAT.

General Comment: 15A NCAC 18A .2821 (d). Mats shall be of a waterproof, washable material at least two inches thick. Observed many mats in facility less than 2 inches thick. Needs to be 2 inches thick.

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 at less than 100 ppm. Needs to be 500-800 ppm.

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 sanitizer wipes store in outside bag hanging less than 5ft up. Bag was moved to hook in wall that would allow bag to be 5ft above the floor.

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 vomit and diarrhea cleaning procedure. EHS provided a paper copy.

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 infant room handsinks at 117F. Needs to be 80-110F. REPEAT. Note: classroom to the far left of entrance was closed and inaccessible to children. Classroom handsinks are 116F. Needs to be 80-110 if made accessible to children.

15A NCAC 18A .2821 (f) Linens shall be large enough to cover the bed, cot, or mat's sleeping surface. Observed several children sleeping on mats with linens that did not cover the entire sleeping surface. Needs to cover the entire sleeping surface.

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 almond milk in kitchen dated November 4th. Specialty bulk milk needs to be sent from home unopened each week and sent back home at the end of the week.

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 all handsinks except ones at bathroom (which were 135F) at 116-117F. Needs to be 80-110F. REPEAT.

Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). Observed handsinks near bathroom temped at 135F. Observed the 3-compartment sink temped at 135F. Door to the kitchen is a latch and hot water is accessible to the children. Door to kitchen needs to be lock and key. Handsinks next to bathroom needs new mixing valve installed to temper water to 80-110F. REPEAT. PROVISIONAL ITEM. El agua caliente utilizada para la limpieza y desinfección de utensilios y ropa debe proporcionarse a una temperatura mínima de 120 grados Fahrenheit en el punto de uso. El agua en áreas accesibles a los niños deberá estar templada entre 80 grados Fahrenheit y 110 grados Fahrenheit. El agua caliente que exceda los 120 grados Fahrenheit presenta riesgo de quemaduras y no debe ser proporcionados en áreas accesibles a los niños.

Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7). Observed disinfectant in the infant diaper changing and in the hallway diaper changing at a concentration at 250ppm of chlorine. REPEAT.

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 tear on diaper changing pad in infant room. Needs repair/replacement.

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 sanitizer in classroom to the far left upon entering stored on counter less than 5ft above the floor. Needs to be stored 5ft above the floor.

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 or diarrhea cleaning procedures. CDI - EHS emailed facility a copy with rule updates.

GENERAL COMMENT: All potentially hazardous food products shall be maintained at 45°F, or below, or 140°F or above. 15A NCAC 18A .2806 (f) Observed green beans on the stove temped at 85F. Owner of facility stated this is going to be prepped now for lunch.

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 two bulk milks in the infant refrigerator without dates. CDI - Caregiver discarded. REPEAT: Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a) Observed open crackers in the infant cabinet over the food prep sink. Observed open bread and cereal in the kitchen food shelving. Food preparation shall occur in the approved kitchen or at an approved food preparation area. 15A NCAC 18A .2807 (a). Observed during breakfast, food and bottles stored at the diaper changing handsink counter.

Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12). Observed no food thermometer. Provide All thermometers in refrigerators shall be stored in the warmest part of the refrigerator and located to be easily readable. 15A NCAC 18A .2806 (h) (1). Observed refrigerator thermometer in kitchen was stored in the back of the refrigerator. Relocate

GENERAL COMMENT: Cleaned and sanitized utensils and equipment, including single service service articles, shall be handled in a way that protects the food contact surfaces from contamination. 15A NCAC 18A .2814 (a) and (b). Observed food trays stored on the floor under the dry food shelving.

REPEAT: Water accessible to children shall be tempered between 80F and 100F. 15A NCAC 18A .2815 (e). Observed the hot water at the outside mop sink temped at 117F which is accessible to the children.

GENERAL COMMENT: Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). Observed the 3-compartment sink temped at 133F. Door to the kitchen is a latch and hot water is accessible to the children.

GENERAL COMMENT: Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed the infant food prep handsink slow to drain. Repair

Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7). Observed disinfectant in the infant diaper changing and in the hallway diaper changing at a concentration at 250ppm of chlorine. CDI - Disinfectants were remade.

Store all sleeping mats so that the floor side of the mats are only touching. 15A NCAC 18A .2821 (d). Observed sleep mats stored with the sleep side touching the floor side in the 3’s, Toddler 2 and infant rooms. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed some sleeping mats in the 3’s, Toddler 2 and infant rooms frayed or torn. Replace.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed vinyl floor damaged in the back area of the infant room. Repair. Observed baseboards in the 3’s, toddler 2 and infant room, and hallway to restroom peeling paint. Repaint.

GENERAL COMMENT: Lighting shall be capable of illumination to at least 50 foot-candles at work surfaces describe in 15A NCAC 18A .2826 (a). Observed the light bulb burnt in the hallway to restroom/diaper changing area. Replace.

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). Playground wood border was last painted on 9/1/2019. Repaint.

Observed water in the room near the kitchen where water temperature reached 58F. Needs to be increased. **Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e).

Observed diaper changing pad in the infant room torn. Needs to be replaced. **Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b).

Observed sanitizer above 200pm during the inspection. Water was added to dilute the solution. **Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed hot water reach 115F before dropping to 107F. Ensure that water temperage range stays within allowable limits. **Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e).

Observed cereal in infant room and snacks in the kitchen not properly sealed. Ensure that food items are placed in sealable bags/containers once opened. **Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a)

Observed sanitizer above 200ppm during the inspection. Water was added to dilute the solution. **Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed hot water reach 117F and the handwashing sink near the kitchen. Ensure that water remains within allowable range. **Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e).

Observed sanitizer 1000ppm in infants class. Remake.

Observed mats fraying in green room.

Observed Abc soft toys peeling in infants class. Observed stains on small activity rugs.

Observed package of raw and shrimp stored on container of brocccoli an above milk. Educated on food storage. Raw meats, poultry, fish, shellfish, and eggs shall be stored on shelving beneath and separate from other foods. 15A NCAC 18A .2806 (f)

Observed disinfectant 100ppm. No diaper changing at time. Remade. 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 baseboard damage beside toilet in restroom. Foam/sponge material. Repeat. Repair to smooth and cleanable. Touch up baseboards throughout. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Observed staining in bottle warmer. Bottle warming equipment shall be cleaned and sanitized at least daily and when visibly soiled. 15A NCAC 18A .2810 (f) (1) and .2804 (d).

Observed baseboard damage beside toilet in restroom. Foam/sponge material. Make smooth and easily cleanable. Touch up baseboards throughout. Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.