A HOME JUST LIKE HOME

Observed loose toilet in the hall restroom. Needs to be tightened. GENERAL COMMENT **15A NCAC 18A .2817 (a.) All toilet fixtures shall be kept clean and in good repair.

Observed mattress in crib torn. Replaced during the inspection. **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 floor tile cracked in near the toilet in the hallway restroom. GENERAL COMMENT **15A NCAC 18A .2824 (a). Floors and floor coverings in food preparation, food storage, utensil washing, toilet rooms, and laundry areas shall be constructed of nonabsorbent material and shall be kept clean and in good repair.

Observed no soap and paper towels at some handwashing sinks during the inspection. Soap and paper towels were provided during the inspection. **15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer spray bottle at less than 10 ppm chlorine. Needs to be 50-200 ppm. REPEAT.

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 ppm. Needs to be 500-800 ppm. REPEAT.

General Comment: 15A NCAC 18A .2819 (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. Observed diaper changing procedure posted is missing steps. EHS gave staff a copy of the correct procedure.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed spray bleach cleaner stored unlocked in staff bathroom. Needs to be stored locked.

General Comment: 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 2 mats stored on top of cots with floor and sleeping side in contact in 2s classroom. Needs to be stored where floor and sleeping side are not in contact.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer spray bottle at 10 ppm chlorine. Needs to be 50-200 ppm. REPEAT.

General Comment: 15A NCAC 18A .2810 (f) A classroom food preparation area countertop shall be kept clean and in good repair. All equipment shall be kept clean. Observed refrigerator in infant room with build up. (Refrigerator is not considered as part of a food preparation area. )

15A NCAC 18A .2815 (e) Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children. Observed hot water at infant handsink and middle classroom handsink at 128F. Needs to be 80-110F. PROVISIONAL ITEM.

General Comment: 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 100 ppm. Needs to be 500-800 ppm.

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 children sleeping on cots less than 18 inches apart. Needs to be 18 inches apart or separated by partitions. 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 one bottle in mini refrigerator dated 7/26. Staff stated the label was written down wrong and was corrected.

15A NCAC 18A .2807 (h) Metal stem-type, thin probe, numerically scaled indicating product thermometers, accurate to ± 3 degrees Fahrenheit shall be used to ensure the maintenance of the internal cooking temperatures of all potentially hazardous foods required under this Rule. Observed facility does not have thin probe thermometer. Needs thermometer.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer spray bottle over 1000 ppm chlorine. Needs to be 50-200 ppm.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed sheets/laundry and toys stored in staff bathroom.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed white out stored unlocked in office. Observed cleaner and cleaner/disinfectant stored on shelves over 5ft high but unlocked. Needs to be stored behind lock and key.

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 aquaphor ointment stored less than 5ft up in diaper change area. Needs to be stored 5ft up.

15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observed cots less than 18 inches apart when in use. Needs to be 18 inches apart.

No points deducted. 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 in Bathroom 1 at 124F. Water temperature was adjusted under the sink using the mixing valve to 106F.

15A NCAC 18A .2820 (c ) Sanitizing, disinfecting, and detergent solutions shall be labeled with the product name (ex. "Sanitizer") Observed bottle of soapy water in Bathroom 2 labeled incorrectly.

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 ripped red chair in middle room. Director removed chair.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed space rug in front room in need of cleaning. 15A NCAC 18A .2824 (a). Floors and floor coverings in food preparation, food storage, utensil washing, toilet rooms, and laundry areas shall be constructed of nonabsorbent material and shall be kept clean and in good repair. Observed floor tiles in Bathrooms 1 and 2 loose. Needs to be secured.

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 open box of waffle mix not in a resealable bag or container.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer at 1000 ppm sanitizer on shelf in room outside kitchen entrance. Need to be between 50-200 ppm.

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 high chairs in need of cleaning.

General Comment: The childcare center shall have a written procedure 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. 15A NCAC 18A .2827 (d). Observed facility does not have a written procedure. Requirement has recently been adopted in rule changes on July 1, 2023. EHS emailed PIC link to page with procedures and rule update information.

Observed dramatic play equipment with build up. Needs to be cleaned. **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 tape residue on floor tile. Needs to be removed. **Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825.

Child care centers, licensed for 13 or more children, are not approved to use domestic refrigerators to cool food. 15A NCAC 18A .2810 (d). CRITICAL VIOLATION- Observed small portions cooked meals in refrigerator. Dispose of any leftovers or get commercial refrigerator. All food must be prepared in an approved kitchen (no cooking at home) or a permitted caterer.

Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). CRITICAL VIOLATION- Observed kitchen doors not locked Must be locked when no staff is present (both doors). Observed can wash at 123F. CDI-hot water knob removed. Keep handle or pliers on site.

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 lotion stored less than 5 feet above the floor in staff bathroom.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed cots not clearly labeled and no cot chart present.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed new adhesive floor tiles throughout. Tiles have gaps, lifting or areas where missing. Floor is not easily cleanable.

Keep dumpster lids and doors closed to prevent insect and vermin nuisances. 15A NCAC 18A .2830 (d). Observed both garbage can lids open and trash on outside of binns.