BRIGHT HORIZONS AT MALLARD CREEK

15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use 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 sun screen placed at the front desk upon arrival waiting for parent to complete the paper work. Ensure to keep the items at least 5ft while waiting or anytime. 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 stored at the diaper sink counter in infant 2. Put all hand sanitizer at 5ft or higher at anytime.

General Comment: 15A NCAC 18A .2820 (f). Coat hooks not in individual cubbies or lockers must be 12 horizontal inches apart.- Observed hooks in room 127 was placed too closed less than 12” apart. Items are touching each other. Ensure to keep items apart and not allow contact at anytime while storing.

PROVISIONAL ITEM: 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 measured at 126F- 133F at hand sink in back hallway restrooms, 122, 123, 115. Provide tempered water where children have access to between 80F- 110F at anytime.

REPEAT 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow drain at diaper hand sink in room 112, observed loose faucet at hand sink in room 125, observed gaps between sinks in room 125 need repair. Keep all hand sinks in good repair.

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 stored in unlocked cabinet less than 5ft in infant and young toddler. Ensure to keep/store all personal belongings/purses that do not contain hazardous items at 5ft or higher at all times.

REPEAT 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 teacher washing her hands and turn off faucet knob with bare hands. Hand washing procedures posted. CDI- Correct hand washing again at the time of inspection. Ensure to follow correct hand washing procedures at anytime.

General Comment: 15A NCAC 18A .2809 (2) Food-contact surfaces shall be kept clean and in good repair.- Observed broken lid of water cooler in room 127. Replacement needed.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at diaper hand sink in room 112. Repair needed.

15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use 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 diaper creams stored in unlock cabinet under diaper table in room 127. Ensure to keep cabinet lock or store items at 5ft or higher at all time.

General Comment: 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 children washing their hands in 128 and turn off faucet knob with bare hands. Hand washing procedures posted. Ensure to educate children proper handwashing.

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 a container of specialty milk in kitchen refrigerator dated 6/16. Ensure to receive the unopened container of specialty milks at the beginning of the week, put name and date that was received, send home or discard at the end of the end either opened or unopened containers.

15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed soiled water fountain all around spout and base at the front hallway. Cleaning needed. Keep clean even not in used.

General Comment: 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use 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 diaper creams in basket in unlocked cabinet under changing diaper in room 115 less than 5ft. Ensure to items at 5ft or higher at all times or always lock the cabinet.

15A NCAC 18A .2821 (f).Linens shall be kept clean, in good repair, and stored with the mat or cot that the linens are assigned to or stored apart from the mattress or cot in a manner that keeps the linens used for each child separate from the linens belonging to other children.- Observed soiled sheet on a cot in infant and room 115. Ensure to change sheet when visibly soiled. Keep clean.

REPEAT 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmers in infant rooms. Need better cleaning all around front and back crevices. Keep clean.

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 next to hand soap at diaper sink in infant room less than 5ft. Store all non hazardous 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 purses stored in unlocked cabinets less than 5ft in infant room. Ensure to store items at 5ft or higher or keep lock. NOTE: **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. And keep keys at 5ft or higher at all time**

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.- According to teacher in infant room, the children pacifiers get sanitize in the bottle warmers which has a sanitizer function. EHS suggests proper wash, rinse and then sanitizer at the end for proper cleaning process. 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmers in infant rooms, need detail better cleaning and keep clean.

REPEAT 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 sink measured above 111F up to 119F (room 125, 126, 127, 112, 124). Provide tempered water where is accessible to children.

PROVISIONAL ITEM: 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 measured at 120F- 122F in classroom (infants food prep sink, infant diaper 2,125, 127 middle sink, 128 both restrooms). Ensure to check throughout the building and provide tempered water between 80F -110F where is accessible to children.

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 changed a child diaper, missing step 5 and almost step 8. After changing, teacher reviewed process of diaper changing with EHS. Ensure to follow proper changing procedures.

General Comment REPEAT: 15A NCAC 18A .2820 (b) (e). All hazardous items must be stored behind lock and key. A locked kitchen is not considered to be a locked storage room or cabinet for the purpose of this rule - Observed container of dishwasher cleanser and degreaser on the counter and other chemical container in the kitchen not being lock away in the storage room. Hazardous items and how to store them discussed with chef and director at the time of inspection. Items put away in the locked storage room inside the kitchen at the time of inspection. NOTE: Kitchen shall kept Locked and key store at 5ft or higher at all time. 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed bug sprays stored mix with sunscreen and diaper cream in room 128, and infant 1. Ensure to stored all hazardous products that is labeled “keep out of reach of children “ and any other warning/caution on the label in the locked cabinet or storage. NOTE: **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keep key at 5ft or higher**

General Comment: 15A NCAC 18A .2821 (f).Linens shall be kept clean, in good repair, and stored with the mat or cot that the linens are assigned to or stored apart from the mattress or cot in a manner that keeps the linens used for each child separate from the linens belonging to other children.- Observed soiled sheets on the cots in room 112, and at the hall way. Clean the sheets as it is visible soiled, keep clean.

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 sink (restrooms at the front entrance, food prep sink and diaper sink in infant 2) measured 111F-114F. Observed one sink in EP2 measured at 62F. Ensure to provide tempered water where is accessible to children.

General Comment: 15A NCAC 18A .2820 (b) (e). All hazardous items must be stored behind lock and key. A locked kitchen is not considered to be a locked storage room or cabinet for the purpose of this rule - Observed container of dishwasher cleanser and degreaser beside the dishwasher in the kitchen not being lock away in the storage room. Hazardous items and how to store them discussed with chef and director at the time of inspection. Items put away in the locked storage room inside the kitchen at the time of inspection. 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed bug sprays stored higher than 5ft in unlocked cabinet in KP1. Ensure to stored all hazardous products that is labeled “keep out of reach of children “ and any other warning/caution on the label in the locked cabinet or storage. **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device.**

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 lipgloss stored in little drawer in toddler 2 less than 5ft. Store all non hazardous items at 5ft or higher at all time. 15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed bulk container of liquid soap in unlock cabinet stored less than 5ft in EP2. 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 purses stored in unlocked cabinets (cabinets kept closed with childproof lock) less than 5ft in EP2, EP3. Ensure to store items at 5ft or higher. **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device.**

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 a bulk opened bag of crackers in EP3 classroom was closed with tape. Ensure to store foods in resealable bag/container. 15A NCAC 18A .2806 (b) Food that is stored in child care center classrooms or other rooms intended for child care use, shall be limited to foods that are individually packaged unless the classroom is equipped with a food preparation area.- Observed a bulk opened bag of crackers in EP3 classroom. EHS and director discussed the proper way to prepare the individual packages at the kitchen and the individual prepared snack bags can be stored in the classroom that has no food preparation area.

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 water temperature at hand sink in toddlers and EP 3 room measured between 67F-77F. CDI- Director corrected to the correct temperature at the time of inspection.

General comment: 15A NCAC 18A .2822 (a). In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. - According to teacher in infant room dirty toys were collected and put in dirty bin and get clean at the end of the day. Teacher spray sanitizer solution on toys, and wash them in the sink in the classroom and then spray the sanitize solution again and let them air dry. EHS discussed with teacher and director, all toys shall be cleaned and sanitized properly (Wash, rinse, sanitize). Toys that can be in the water should be submerged in sanitizer solution for at least 2 minutes and let air dry after. Toys that cannot not be submerged in water after washed/rinsed can be spray with sanitizer solution and let dry. Ensure to use correct strength of sanitizer solution when cleaning toys.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed cribs mats fraying around edges of crib mats sporadically throughout infant classrooms.

Individual linen must be kept clean and in good repair. 15A NCAC 18A .2821 (f). Observed minor staining on linen covering mats in play spaces in toddler classroom.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed minor touch up paint needed to some door frames throughout center. Observed minor stained ceiling tile in rear restroom in 5’s classroom.

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Observed 1 lid opened to dumpster during time of inspection. *NOTE: Safety Specialist, Michele, was present during time of inspection. Report emailed to Director and center at the following: annalee.noreika@brighthorizons.com Mallardcreek@brighthorizons.com Andrea.barnat@brighthorizons.com

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 baby food in squeeze-able pouch brought from child’s home labeled with child’s name only and no date in domestic refrigerator stored in infant classroom.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed diapering handsink in infant classroom draining slow. Per conversation with staff, a work order has been submitted to have sink repaired.

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed plastic container stored in hand sink when EHS went to wash hands in infant classroom (hand sink in between domestic refrigerators).

All cleaning and disinfectant solutions shall be properly labeled (i.e. soapy water, disinfectant). 15A NCAC 18A .2819 (c ) and .2820 (c ). Observed spray bottle containing green solution not labeled in Early Preschool 2 classroom. Per conversation with teacher in class, the liquid in the bottle was soapy water. EHS advised teacher to label spray bottle.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed aerosol sunscreen stored on high shelving in cabinet in K-Pre1 classroom unlocked. Per conversation with employee center has been trying to return aerosol sunscreen home to parent, EHS educated employee on notated rule and aerosol sunscreen was properly secured during time of inspection.

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 approved soapy water, disinfectant, and sanitizer stored below 5 feet on shelving in Early Preschool 3 classroom. Observed spray water stored below 5 feet in Preschool 2 classroom. Observed bulk hand sanitizer stored below 5 feet on rolling cart in main hallway upon EHS arrival to complete sanitation inspection.

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Observed dumpster lid opened during time of inspection. *NOTE: Safety Specialist, Michele, was present during time of inspection. Report emailed to Director at: annalee.noreika@brighthorizons.com Andrea.barnat@brighthorizons.com Mallardcreek@brighthorizons.com

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 diaper cream stored below 5 feet in classroom 124. Observed soapy water spray bottles stored below 5 feet in toddler classroom. *NOTE: Director Annalee and Safety Specialist Michele were present during time of inspection. Report emailed to center at: annalee.noreika@brighthorizons.com

Keep all light fixtures clean and in good repair. 15A NCAC 18A .2826 (a). Observed light fixture in Pre K classroom hanging out of ceiling, center is already aware of issue and a service request has been submitted to have light repaired.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed water table stored inside bathroom inside (Toddler) classroom in need of removal.

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 spray sanitizer stored below 5ft inside classrooms (Early Pre #2, older aged classroom). CDI spray sanitizer stored above 5ft during inspection.

Protect food service equipment from contamination. 15A NCAC 18A .2814 (a) and (b). Observed bottle warmers in infant room and clean racks of utensils in splash zones. Keep clean items away from areas of contamination

Keep water fountains clean at all times. 15A NCAC 18A .2815 (f). 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 water fountains need cleaning around nozzles and water pressure too low.

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Observed dumpster overflowing. You may need more frequent pick-ups if this continues.

Animals cages shall be kept clean. 15A NCAC 18A .2831 ( c ). Observed rabbit cage in need of cleaning. Too much rabbit feces.