PRIMROSE SCHOOL AT EASTFIELD VILLAGE

REPEAT 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 bottle in infant refrigerator without date. Ensure to put both name and date on items sent from home. 15A NCAC 18A .2806 (d) Specialty bulk milk that is sent from home for consumption by a child while at the child care center may be stored as set forth in the 2800 rules when the child's parent or guardian provides written permission and the specialty bulk milk is sent to the child care center at the beginning of each week unopened, labeled with the date received by the child care center, and labeled with the name of the child to whom the bulk specialty milk belongs. Any remaining bulk specialty milk shall be sent home at the end of the week with the child to whom the bulk specialty milk belongs.- Observed specialty milk in kitchen refrigerator without date. Ensure to label name and date received at the center. NOTE: 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 week either opened or unopened containers.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed low water pressure at hot side diaper sink in room 4. Water pressure needs adjustment to allow good flow for proper hand washing.

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/soapy water bottles in the unlock cabinet less than 5ft in room 3. Ensure to keep the cabinet lock at all time when not in use, or keep items at least 5ft at anytime.

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 dis-repaired at corners or frayed of climbing furniture in room 1 and 2. Repair/ replace.

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 bottle in infant refrigerator without date, baby food labeled date 10/2 and 10/6. Observed baby foods and snacks on the counter without date. Ensure to put both name and correct date on items sent from home for that day.

General Comment: 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed damaged/stained toilet seat in restroom 9. Repair/replace needed. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand sinks in classroom 6, 8, 9, all around edge need new caulking. Keep clean and good repair.

15A NCAC 18A .2821 (d). Mats be stored so that the side of the mats that makes contact with the floor does not touch the side of a mat that any child sleeps on. The sleeping surface of one child's mat shall not come in contact with the sleeping surface of another child's mat during storage.- Observed in classroom 1, toy and laundry basket stored right on top of sleeping cot with sheet on. CDI- Items removed at the time of inspection. Keep sleep cot/sheet protected from any possible cross contamination at anytime.

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 damaged/dis-repaired wall/baseboard next to hand sinks in front of restroom 6. Waiting on a contractor, in process of repairing.

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 student in room 9, washing her hands and turn off faucet knobs with bare hands. Ensure to have everyone wash hands properly according to the hand washing signs poster in the classroom at all times.

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 bottle in infant refrigerator labeled date 6/18, and one without date. Ensure to put name and correct date on items send from home.

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 student diaper in room 1, incorrectly and missing step 3- 11. EHS and teacher discussed through a proper procedure process at the time of inspection. The poster posted in the classroom. Ensure to follow correct procedures at all time.

General Comment: 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 book bags in room 3, 5, 6, 8, 9- hanging on the hooks touching each other in several classrooms. Ensure to store individual bags/items separate and not allow touching while storing.

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.- Observed water testing for lead was expired. Last testing was 2/27/2021. The center had completed the online training, received the test kit from RTI, water was collected and mailed out same day 12/14/24. Now waiting for the results to come in. The center is working to complete the remaining requirement/procedures and update the department.

15A NCAC 18A .2822 (d).Water play centers shall be filled with potable water immediately before children begin a water play session. Water shall be emptied after each play session and at a minimum each morning and afternoon, or more often if no longer clean.- Observed water table was filled and played this morning during arrival time. According to teacher, water table gets empty and clean at the end of the day or twice daily depending on the day. EHS, teacher, director discussed proper detail procedures of water play station at the time of inspection. Ensure to stay compliance with this notation rule above.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed teacher enter the classroom, putting stuff away and went on to engage with kids and activities. Ensure that employees, children, whoever will be engaged in classroom activities for a bit or awhile, wash their hands upon arrival.

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 washing hands after changing diapers and turn off the faucet knob with bare hands. Ensure to have everyone wash hands properly according to the hand washing signs poster in the classroom at all times.

PROVISIONAL ITEM: 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.- Observed water testing for lead was expired. Last testing was 2/27/2021. The center had completed the online training on 5/30. According to RTI website is showing status “lead in water”-In progress, enrollment started 5/30/24. “Lead-based paint and Asbestos”- Enrollment started. The center shall be working to complete the remaining requirement/procedures as required.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand sinks in infant room need better cleaning and keep clean. Observed some hand sinks in several classrooms where applicable (room #6, 8, 10), new caulking maybe needed for clean looking and easily cleanable.

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 change diaper for a child and letting a child go without hand washing first. Ensure a child wash their hands right after changing every time. Observed teacher clean the diaper surface with soapy water and wipe. Then spray sanitizer solution and wipe. At the time of inspection, EHS discussed proper diaper changing procedure, hand washing, cleaning steps with teacher and director assistant.

General Comment: 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 tube stored next to hand sink on the counter in room 5. Keep/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/belongings stored in unlocked cabinets under diaper sink room 4. There is magnetic lock, the cabinet door was not push all the way back to latch and lock. Ensure to check after yourself that all lock cabinet/storage stay lock when it supposed to at all time.

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 snacks that was send from home in cabinet in infant room without date received. Observed lunch boxes inside kitchen refrigerator with “incorrect” date on it 5/24, and one lunch box without name and date received. Ensure all items that were sent from home have name and date received at the center.

REPEAT 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.- Observed water testing for lead was expired. Last testing was 2/27/2021. The center had completed the online training on 5/30, and is working to complete the remaining requirement/procedures. The center will provide the update results at the next routine 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 classroom where mouthing/dirty toys present. The 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 let them air dry. Proper toys cleaning discussed with teacher and director at the time of inspection. All dirty toys shall be washed/rinsed/sanitized properly in the kitchen at the three compartment sinks. Or 3 step bins suggested, label (wash/rinse/sanitize). Some toys that cannot not be submerged in water after washed and rinsed, the sanitizer spray can be used. All toys that can be in the water shall be submerged in sanitizer solution for at least 2 minutes and let air dry after. Ensure to use/provide the correct strength of sanitizer solution in the bin for cleaning toys each day and ensure to store the sanitizer bin at 5ft or higher.

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 a baby bottle sat outside the refrigerator on the counter. When asked, teacher stated they are waiting about an hour to complete feeding a child. The child was playing and teacher was attending a new task at the time of inspection. Proper way to handle the situation according to the rule discussed in detailed with teacher and director. Teacher plan to ask parent and send less milk as needed for feeding. 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 big bag of cereal and vanilla wafers cookies in the kitchen cabinet wrapped around with plastic wraps. Ensure to store leftover items in resealable bag/container. REPEAT 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. Staff brought a pitcher of water from the kitchen for classroom at the time of inspection.

REPEAT 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 need better cleaning and keep clean. No point escalation due to one out of two dirty.

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 chlorine sanitizer solution bottle measured at 500 ppm.The center redo the solution. Ensure to provide correct concentration for chlorine solution between 50-200 ppm for sanitizer.

REPEAT 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 measured at 111F -119F, in room 12, 1, 2, kindergarten. The temperature started hot at 120F and went down to about 114F-115F. Ensure to 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 water temperature in restrooms hallway, room 1at the hand sinks, measured at 120F- 128F. Restrooms doors have no lock.

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.- Observed water testing for lead was expired. Last testing was 2/27/2021. The center is working with the owner and finding out if they have already started the process. Lead letter and instructions texted to director to follow at the time of inspection. The center enrolled for webinar on 5/30 at 10 am. The center shall complete the required process and have the new results and update the department.

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 hand lotion/sanitizer solution bottle/ teacher purses in the lock cabinet/drawer in room 12. All items were accessible due to magnetic key to unlock the cabinet/drawer stored less than 5ft on the refrigerator door. NOTE: 15A NCAC 18A .2820 (b).Keys used to access hazardous/non hazardous item storage must be out of reach of children (5 ft above the floor) and stored separately from lock.

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 foods that brought from home without parent/guardian permission form. EHS and director discussed to obtain a permission from parent at the time of inspection.

General Comment: 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 lunch boxes that contained snack sent from home without the date that was received. Ensure to put both name and date each day when they come into the center. 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.

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 tray need better cleaning at the back crevices. According to teacher highchair trays get clean in the classroom with soapy water and sanitizer spray. EHS discussed proper cleaning multi-service articles with teachers, director, and at the time of inspection. All multi-service articles (high chair trays, spoons, plates/bowls and rubber bibs) shall to be wash, rinse and sanitize properly in the kitchen after each use. 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 room need detail cleaning.

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 throughout the building except few classrooms measure about 73F -74F. The temperature started cold and went up to about 80F -90F then dropped down gradually and stayed at 73F. Ensure to provide tempered water where is accessible to children.

General Comment: 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 containers of Clorox in the unlock kitchen cabinet. Hazardous items and how to store them discussed with chef and director at the time of inspection.

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 bottle stored less than 5ft in preK2. Observed diapering creams stored in the (unlock/not latched properly) cabinet in early preschool 2. 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 less than 5ft in kindergarten. 15A NCAC 18A .2820 (b). Keys and electronic or magnetic unlocking devices shall be kept out of reach of a child and shall not be store in the lock. Keep keys inaccessible to children when stored on shelf or in unlock cabinet that is mounted a minimum vertical distance of five feet above the finished floor. -Observed Keys and or magnetic device to unlock the cabinet stored less than 5ft in infant room, kindergarten, early preschool 2. Keep all key devices at 5ft or higher at all time.

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 the facility without the vomiting and diarrhea written procedures in place. EHS emailed the director the written plan and poster 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 1 infant bottles labeled with initials and no date stored in dorm refrigeration unit in infant classroom. Observed several specialty milk’s in domestic refrigeration unit in kitchen with names and no dates. EHS advises center to follow notated rule.

Vacuum cleaners used with the children present shall have a HEPA filter rated at the level described in 15A NCAC 18A .2824 (c ). (HEPA vacuum cleaner shall include a HEPA filter individually tested and rated as 99.97% efficient at 0.3 microns dust particle size and sealed to prevent leakage around connecting points). Observed housekeep vacuuming rug during time of inspection. EHS advises center to ensure the vacuum cleaner has the required HEPA filter as detailed above, if vacuuming occurs while children are present at center.

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 having build-up inside classrooms starting from (toddlers on up) in need of general cleaning.

NO POINTS DEDUCTED Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed ceiling area around outlet vents inside classrooms (several) collecting dust in need of general cleaning.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seat very loose in need of tightening / repair located in bathroom between two (early pre-school) classrooms.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed numerous vents (outlets) having rusty surfaces in need of repair.

Observed bin in hand sink in older toddlers room. Do not store items in hand sink

Observed hand sanitizer below 5 feet in lobby, out front and one classroom.

Observed diaper change using wrong procedure, young toddlers. Follow posted procedure

Observed a child in 2 different classrooms turn off water with hand. Supervision required to teach turning off with paper towel

Observed infants being fed directly off high chair tray. High chair trays will need to return to kitchen for W/R/S after every use.