GODDARD SCHOOL OF HUNTERSVILLE, THE

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 bottle with date 10/19 and two bottles with date 10/21. Ensure bottles are labeled with correct date. 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 speciality milk dated 9/28. Ensure speciality milks are discarded or sent home at the end of each week.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed a child enter an infant 2 with a parent, no hand washing happening before engage with friends and class activities. Ensure staff, children, parents who are planing to help or engage in any activities wash their hands upon entering a classroom.

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 children bottles in infant classrooms refrigerator, several of them without date. Ensure to label both name and current date that items received at the center. 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 baby foods in infant refrigerators without date received. Put label with both name and date received on the items for that day. 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 leftover snack folded and taped with blue painting tape in kitchen cabinet. Ensure to stored dry goods leftover snacks in a ziplock bag or resealable container to protect from pests.

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 measured between 67F -79F throughout the building. Provide tempered water between 80F- 110F.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at hand sink in room 9 need repair. Observed several hand sinks in some classrooms need better cleaning and keep clean.

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 spray bottles throughout the school measured at about 250 ppm. Ensure to provide correct chlorine disinfectant concentration between 500- 800 ppm at anytime.

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 under diaper table less than 5ft, unlocked in infant1. Keep diaper cream at least 5ft or higher at anytime or lock up if less than 5ft. 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 lotion in drawer less than 5ft in infant 2. Ensure to keep all approved non hazardous items at 5ft or higher at all times.

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 is washing her hands in between changing diaper, turning a faucet knob with bare hands. Ensure to follow proper hand washing procedures at all time.

15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed sanitizer solution in spray bottles measure between 250 ppm and 500 ppm. Ensure to provide correct concentration of sanitizer solution between 50 ppm and 200 ppm at all time.

REPEAT 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 staff in Toddler 3 miss step 5 of procedure. Observed teacher is changing diaper in toddler 2, missing proper steps #5, 8, 9, and 10. Proper diaper changing procedures discussed in detail with teacher, director, and owner at the time of inspection.

General comment REPEAT 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 minor tearing on corner of mats throughout the center. Repair/replacement needed.

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. Observed one specialty bulk milk in kitchen refrigerator with a date label of 7/21 and one behind it for June. Needs to be sent in unopened at the beginning of the week and labeled with name and date received and sent home at the end of the week.

General Comment: 15A NCAC 18A .2819 (d). (9), Diapering surfaces shall be cleaned, prior to disinfection, by spraying the entire diapering surface with detergent solution and wiping clean, using disposable paper towels. 15A NCAC 18A .2819 (c) and 15A NCAC 18A .2819 (d) (10). Diapering surfaces shall be disinfected using an approved disinfectant by spraying the entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry. Observed staff in Toddler 3 perform a diaper change and then spray disinfectant and wipe disinfectant off immediately after spraying. Needs to spray soapy water, then wipe clean and spray disinfectant. Allow disinfectant to remain on the surface for two minutes or air dry.

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 staff in Toddler 3 miss step 5 of procedure. Observed parent change diaper in Infant 2 and not wash child’s hands at the end. Needs to follow correct procedure. REPEAT.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosol Lysol and aerosol air freshener in cabinet over food prep area, and spray cleaning solution in cabinet under diaper sink stored unlocked in Infant 1 classroom. Needs to be stored locked. Observed 5 hour energy stored unlocked in front office. REPEAT. PROVISIONAL ITEM.

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 disinfectant wipes stored unlocked under sink in infant 1. Observed bulk lotion stored under sink in Toddler 1. Observed lotions stored in unlocked front office on counters less than 5ft up. Needs to be stored 5ft up or locked. Lock offices when no one is in the office. REPEAT.

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 minor tearing on corner of mats throughout.

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 baby bottles without date in infant 1. Observed bottles in infant 2 with date on but very hard to read. Ensure to label name and date received. Make it clear and legible. 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 a child snack in ziplock bag without name and date on in Bridge. Ensure to label name and date on items sent from home.

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 warmer in infant 1 in need of detail cleaning. Keep clean.

REPEAT 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 is changing diaper and missing/incorrect steps throughout. Ensure to follow correct procedures, hand washing is needed for students and staff at the end of procedure every time.

REPEAT 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 sunscreen at a front desk in unlock office less than 5ft. Observed diaper cream stored underneath changing table unlock less than 5ft in Toddler 3. Ensure all diaper creams, non aerosol sun screen store at 5ft or higher, or keep them lock up 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**

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed air freshener spray bottle stored on top of a cubby in Toddler 1, disinfectant wipes container on top of cubby in Toddler 3, aerosol spray can of disinfectant and air freshener in unlocked closet in Toddler 3, fish related solution that has labeled “Keep out of reach of children” and extra “Caution/Warning” in PreK, air freshener spray bottle in unlocked closet in Two’s. All hazardous items must be stored in lock cabinets/storages/closets 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 (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 lotion and sanitizer bottle on top of cubby in Infant 1. Observed hand cream tube on top of cubby and disinfectant spray bottle on a diaper sink counter less than 5ft in Infant 2. Ensure to keep all non hazardous items at 5ft or higher at all times. 15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed a refill bag of bulk soap in unlock cabinet less than 5ft in Infant 2. Keep it at 5ft or higher at anytime.

REPEAT 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 in Toddler 1, sheets of children mats stored in cubby sticking out and touching each other while storing. Ensure to keep all individual items separate and not allow contact at any time while storing. 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 closets, some closet was not push all the way to properly lock it, some left unlocked (Toddler 1, Two’s)

General Comment: 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 in Infant 1, there were four cribs placed back to back and side to side. Ensure to keep the side to side at least 18 inches apart. 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 couple rooms without cot list that number assigned to a name. On room the number start to fade away. Provide cot list clear and legible.

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 dust covered ceiling vents in preschool, toddler 2, PreK. Cleaning needed and keep clean.

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 specialty milk container in kitchen refrigerator with date received. According to conversation, that container may be left from last week. Because the same student just came back today and the new container today has both name and date received. 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 .2804 (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration.- Observed water cups inside infant refrigerator, according to conversation with teacher the water cups offer to children several times a day. EHS, teacher and director discussed detail proper procedures at the time of inspection.

REPEAT 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottles warmers in infant 1. Detail cleaning needed and keep clean.

REPEAT 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 is changing diaper and missing/incorrect step #3, 5, 8, 11. Observed parent and a child entering a class and start changing diaper for her own child, after changing and before a child engaged in classroom activity, hand washing must occurred. Detail proper procedure discussed during inspection. Hard copies of diapering poster provided.

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 sunscreen and hand cream in a container stored on cabinet shelf less than 5ft in PreK. Ensure all indicated items mentioned above store at 5ft or higher, or keep them lock up at all time. 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 throughout in red bag (outside bag) the antiseptic towels and alcohol 70% wipes, which has “drug fact” and “Keep out of reach of children” and extra “warning or caution” on label. Keep all medication related items lock 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 (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 in several classrooms, children bags hanging on a hook in their cubby touching each other while storing. Ensure to keep all individual items separate and not allow contact at any time while storing.

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 teacher in toddler after changing diaper, washing hands and turned faucet knob off with bare hands. CDI- Teacher was correct, proper hand washing procedures goes over with teacher and director. Hand washing poster provided at the time of inspection.

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’s lunches brought from home in thermos containers without parent permission. Obtain parents permission and keep for records. NOTE: 15A NCAC 18A .2806 (h) The temperature of potentially hazardous food provided by the child care center for consumption by children shall be 45 degrees Fahrenheit or below, or at 135 degrees Fahrenheit or above at all times, including field trips, catering events, and outdoor service, except during periods of preparation and service immediately prior to consumption.- Observed food brought from home for lunches in regular plastic lunch containers, hazardous food items (chicken, cut melons, pasta) holding temperature at 65F in the classroom counter. Ensure to keep all hazardous food within the temperature required for food safety. Detail procedures and ways to handle it discussed with director and owner at the time of inspection.

REPEAT 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 some baby food/ snack brought from home in infant room, without a date that was received at the center. Observed children lunch boxes, some with name no date and some without name and date in several classrooms. Ensure to have both name and date received on items brought from home. 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 some baby bottles in refrigerator infant room without date received. Ensure to have both name and date received on items. 15A NCAC 18A .2804 (e) Frozen human milk may be stored frozen for three months. Any frozen human milk stored beyond seven days shall be stored in the freezer compartment of a full-size refrigerator that has a separate door to the freezer, in a chest freezer, or in an upright deep freezer.- Observed frozen human milk in the freezer in infant room dated 3/18/24.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottles warmers in infant rooms need detail cleaning and keep clean.

General Comment REPEAT: 15A NCAC 18A .2815 (f).. The water pressure of a drinking fountain shall be regulated so that an individual's mouth does not come in contact with the nozzle and so that water does not splash on the floor. -Observed very low water pressure at the outdoor water fountains. Adjust water pressure to not allow mouth contact.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair.- Observed hand sinks in several classrooms throughout need better cleaning and keep clean.

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 soiled surfaces at the back of diaper pad in room 1 and 4. Detail cleaning needed and keep clean. 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 is changing diaper and missing/incorrect step #3, 5, 6, 10. Detail proper procedure discussed with teacher, director, and owner at the time of inspection. Hard copies of diapering poster provided.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed air freshener not being lock away in restroom hallway, room 6, 10. Observed absorbing power/eliminator container on the counter, and wood cleaner in unlock cabinet in infant room. All hazardous items shall be locked 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 and keep keys at 5ft or higher at all time**

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 sanitizer/disinfectant spray bottles stored on the sink counter in infant room less than 5ft. Ensure to put all non hazardous items at 5ft or higher at all time. 15A NCAC 18A .2808 (g). Purses, that do not contain hazardous items, must be stored 5ft above the floor, behind lock and key. Observed teacher purses inside the unlock storage/ closet in several rooms less than 5ft. 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 soap container in cabinet less than 5ft in room 7.

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 baby food brought from home in infant room, without a date that was received at the center. Observed food containers in the cubs refrigerator without date. 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 children water bottles from home some are missing date and some are missing both name and date. Ensure to have both name and date on the water bottles. 15A NCAC 18A .2810 (f) Water from hand wash lavatory shall not be used for bottle warming or to prepare formula, mix dry cereals, or other foods. According to teacher in infant room, teacher used water from food prep handwashing sink to warm the bottles in the warmer. Water needs to come from the kitchen or bottle water, not from the hand sink.

General Comment: 15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed the facility without the test kit to measure the concentration of their sanitizer solution. Obtain the test kits.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children.- Observed throughout the facility water temperature at most hand sinks measured between 63F -78F. Ensure to provide tempered water where accessible to children.

General Comment: 15A NCAC 18A .2815 (f).. The water pressure of a drinking fountain shall be regulated so that an individual's mouth does not come in contact with the nozzle and so that water does not splash on the floor. -Observed very low water pressure at the outdoor water fountains. Adjust water pressure to not allow mouth contact.

General Comment: 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.- The facility last water testing for lead was 10/16/2020. The owner of the facility had registered with RTI website at the time of inspection. The seminar scheduled for January 9, 2024 at 10 AM. The facility will follow all the requirements and get water tested and will provide results to EHS at the next inspection.

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 the facility is using the solution that has contact time of 10 minutes and without the test kit to measure the concentration of their disinfectant solution. Obtain the test kits. The facility will be moving to bleach solution so it allow shorter contact time at least 2 minutes when changing diapers.

15A NCAC 18A .2820 (b) (c). 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 cleaners in the unlocked kitchen cabinet. Hazardous items and how to store them discussed with chef and director at the time of inspection. Observed ice packs in the outside bags which has labeled “Keep out of reach of children “ and extra warning and caution at the back of the package. All hazardous items shall keep lock. **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 sanitizer bottles stored in unlock storage in cubs room less than 5ft. Ensure to put all non hazardous items at 5ft or higher. 15A NCAC 18A .2808 (g). Purses, that do not contain hazardous items, must be stored 5ft above the floor, behind lock and key. Observed teacher purse inside the unlock storage in cubs room less than 5ft. Teacher locked the storage with key at the time of inspection.

Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d). Observed several bottles stored in domestic refrigeration unit in infant classroom labeled with child’s name and no dates. Teacher labeled bottles with dates during time of inspection. 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 2 baby food pouches brought from child’s home stored in domestic refrigeration unit with child’s name only and no date in older infant classroom.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed 1 loose toilet seat in classroom 10.

Liquid soap shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed no liquid soap at handwashing sink located in kitchen. Toilet tissue shall be provided in each toilet room. 15A NCAC 18A .2817 (a). Observed no toilet paper in foxes classroom. Toilet paper was supplied to toilet during time of inspection.

Limit storage in restrooms to toileting and diapering items only. 15A NCAC 18A .2817 (a). Observed toys stored in restroom located in squirrels classroom. Children in this class are not toilet trained and restroom and not used, however notated rule must still be followed.

All cleaning and disinfectant solutions shall be properly labeled (i.e. soapy water, disinfectant). 15A NCAC 18A .2819 (c ) and .2820 (c ). Observed several spray bottles with name of solution fading throughout center.

All medications must be stored behind lock and key. 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. Designated emergency medication shall be stored out of reach of children, but are not required to be in a locked storage. Non-prescription diaper cream and sunscreen shall be kept out of reach of children when not in use, but are not require to be in locked storage. 15A NCAC 18A .2820 (d). Observed liquid medication stored in cabinet on high shelving with emergency medications. EHS educated center on notated rule and liquid medication was relocated behind lock and key 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 hand sanitizer stored below 5 feet on counter located in waiting lobby area.

Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed some sleeping mats throughout center fraying around the edges of mat. All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed mats not labeled/no sleeping chart in older infants classroom and classroom #4.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed minor touch up paint needed sporadically throughout center.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed missing towels at hand washing sink at diaper changing station inside (toddler) classroom.

Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Observed childrens sleeping mats stored within 18 inches inside (red wolves) classroom.

Disposable towels shall be provided at all hand washing sinks. 15A NCAC 18A .2818 (d). Observed toddler room missing paper towels or hand drying device at hand washing sink at changing station.

Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Observed sleeping mats inside (red wolves) classroom spaced too close within (18inches).

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed numerous classrooms (Infant, Cubs, 1’s, Honey bees, Red wolves) all having aerosols and white out stored not behind lock and key. CDI all hazardous items properly stored behind lock and key during inspection. (Provisional Status issued)

NO POINTS DEDUCTED Children must be spaced at least 18 inches apart or separated by a partition while napping. 15A NCAC 18A .2821 (e). Observed children s mats stored within 18 inches inside (Foxes) classroom.

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 table edges (first two inches) accumulating debris in need of cleaning.

REPEAT Purses, that do not contain hazardous items, must be stored 5ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f). Observed staff purse stored below 5ft inside (infant) room. Approved non-hazardous products must be stored 5ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed diaper cream stored below 5ft and not behind lock and key inside (toddler) classroom.

Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b). Observed damaged diaper changing mats inside (Infant, 1yr old) classroom in need of replacing.

Approved non-hazardous products must be stored 5ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed disinfectant wipes stored on floor inside unlocked closet inside (1yr old) classroom. CDI wipes placed at 5ft or above.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls scuffed / damaged behind trash cans in majority of the classrooms. Recommendation to use a wall covering similar to (FRP) fiber reinforced plastic to prevent further damaged from occuring.