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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 the date on one set of bottles was for yesterday. Needs the correct date. 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 package of chips in nonresealable bag in Threes room. Needs to be in resealable bag or container.

General Comment: 15A NCAC 18A .2819 (b) Nothing shall be placed on the diapering surface except for those items required for diapering and the child whose diaper will be changed. Observed toys and water bottle on diaper table in Toddler room. CDI - items were moved off the table.

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 cream in unlocked cabinet less than 5ft up. Needs to be 5ft up or locked.

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 cracked floor tiles in Toddler bathroom. 15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair Observed cracked floor tiles in Fours 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 large cup of milk that Director is sent daily for one student in refrigerator with no name or date label. Needs name and date.

General Comment: 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed pointer in bathroom handsink in toddler room. Lavatories shall not be used for storage.

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 dial thermometer not metal stem type.

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. Center has completed required lead water testing and are awaiting results. EHS will follow up with center before end of fiscal year.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed no liquid soap at handsink in toddler restroom.

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 minor touch up paint needed to blue walling leading to PreK classroom. -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. Center has started process and are waiting sample bottles. EHS advises director to reach out to Clean Water for Carolina Kids to receive and update on when sampling bottles will be received. https://www.cleanwaterforuskids.org/en/carolina/contact/

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 touch up paint needed to walling in NC Pre K classroom. 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 cracking in kitchen.

15A NCAC 18A .2806 (d) Bulk food stored in a refrigerator shall be stored in the child care center's kitchen or in an approved food preparation area equipped with a full-size refrigerator. Observed 1/2 gallon of bulk milk stored in dorm refrigeration unit in infant classroom. EHS advises center to adhere to notated rule.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed handle to hot water faucet turned off in school age classroom. Hot water was at 70F.

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 faucet turn off in 4’s classroom. Center is aware of issue and are actively working to have issue repaired.

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 some cribs mats fraying. EHS advises center to replace cribs mats as needed.

15A NCAC 18A .2826 (b).Windows and window treatments shall be kept clean and in good repair. All ventilation equipment, including air supply diffusers, return grilles, and fans shall be kept clean and in good repair. Observed floor vents sporadically throughout center rusting and in need of replacement.

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. EHS emailed emailed center new required template procedure.

Microwaves shall not be used to thaw or warm breast milk, baby food, formula or other bottled beverages. 15A NCAC 18A .2804 (d). Asked procedure for warming bottles in infant room. Staff said they heat water in microwave then put bottle in hot water. Asked for demonstration, hot water > 140F. Hot water cannot get >120F. Recommend bottle warmer, and removing microwave.

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 sticky tape reside on furniture and cribs. 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).

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed wood backing behind hand sink needs repainting. Paint edges of particle board shelving.

Keep all ventilation related equipment clean and in good repair. 15A NCAC 18A .2826 (b). Observed rusted vent covers. Light covers with dead insects.

Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). *Critical Violation* Observed no lock on gate to can wash. Keep gate locked.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). *Critical Violation* Observed one air freshener dispenser not secured. Observed white out not locked in one classroom. Emailing hazardous items handout.

Coat hooks must be 12 inches apart. 15A NCAC 18A .2820 (e). Observed coat hooks not 12 inches apart. Observed 2 coats stored within 12 inches of each other

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 some shelving made of particle board have unfinished ends. Paint or add adhesive edging.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed flooring in one bathroom cracked. Grout has disintegrated and tiles lifting as well as small tiles used for threshold.

At child care centers, the premises, including the outdoor learning environment, shall be kept clean. 15A NCAC 18A .2832 (a). Observed chipping paint on reader board on playground. Touch up any chipped paint.