KINDERCARE STATESVILLE

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 spray bottles in several classrooms with zero concentration, and one classroom has chlorine concentration over 1000 ppm. Director stated that the center uses QAC sanitizer solution and it get refill every at the kitchen. Ensure to provide correct concentration with whichever solution you use (QAC= 200-400 ppm, OR Chlorine= 50-200 ppm) at anytime.

REPEAT 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 soap/ or broken dispenser in room 107, 110, 111. Observed no paper towel available in the dispenser in restroom sink room 111. Ensure to provide soap and paper towel at all hand sinks at all times.

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 stored in front desk drawer less than 5ft. Ensure to keep all diaper cream at 5ft or higher at 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 lotion stored in front desk drawer. Keep all hand lotion 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 bulk soap bag for refill stored in unlock cabinet in room 115. Keep all bulk soap at 5ft or higher anytime while storing.

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 book bag/ jackets hanging on the hook in the cubbies in few classrooms. Items are touching each other. Ensure to keep items separate and not allow contact while storing at anytime.

REPEAT 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 in room 113 and 115, cots need labeling/ relabeling. Ensure to use only one number for each cot/ no duplication same number on different cot. Put name or number, assign a cot to each individual in classroom. Provide chart assignments if number labeled (visible and legible).

15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed some HVAC gate are not locking, broken lock fence, or locking incorrectly and still allow access to HVAC units. Keep the area locked. 5A NCAC 18A .2831 (c). For outdoor toys and play equipment, including all structures accessible to children, the following shall apply: (1) Equipment and toys shall be kept clean, in good repair, and free of peeling, flaking, or chalking paint, rust, and corrosion; and (2) A sandbox used in outdoor play shall be constructed to allow for drainage of water and shall be covered when not in use and kept clean. - Observed some playground with uneven ground, broken concrete around the play equipment need repair. Keep all equipment and ground in good repair and safe to play in.

General Comment: 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 dispenser machine that has ability to dispense hot water in staff lounge. The staff lounge room shall be locked at all times if hot water there. Install lock at both front at back door. Or remove hot water access.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilets in resource restrooms. Detail cleaning needed and keep clean. Observed slow draining in Toddler 1 diaper sink, dysfunctional faucet in art studio, very low water pressure at restroom sink 113. Repair needed, keep all in good repair.

REPEAT 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 paper towels available in the dispenser at hand sinks in restrooms (112, 113). Ensure to provide all hand washing supplies at all hand sinks at all time.

General Comment: 15A NCAC 18A .2820 (d).Designated emergency medications shall be kept inaccessible to children, 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 emergency medication in a bag stored on top of cubby less than 5ft in room 116. Ensure to always put/store any emergency medication at 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 a squeeze container of hand sanitizer attached to key chain hanging down from a hook in infant 1, less than 5ft. Ensure to put all non-hazardous items at 5ft or higher at all time.

REPEAT 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 several classrooms with cots labeling same numbers on different cots. Ensure to put name or number, one number per cot in each individual classroom. Provide chart assignments if number labeled (visible 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 water stained/damaged on ceiling tiles in back and front hallway, restroom 113. Repair/replace ceiling tiles. Check for no active leaks, repair leaks if needed.

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 after changing diaper wash hand less than 10 seconds (step 2) before proceed to finish the rest of process correctly. Observed director wash hands and turn off the faucet knobs with bare hands (step 6). Observed a child after got diaper changed, washed hands with only running water. A child needs help, and teacher came to help. Ensure everyone is washing hands properly and follow correct hand washing procedures posted in the classrooms.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilets (inside the blow, back/bottom surfaces) in several classrooms and guest restrooms. Detail cleaning needed and keep clean. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed several soiled hand washing sinks in several classrooms, Better cleaning needed around surfaces, base of faucets, and basin. keep clean. Observed open gaps between hand sinks and the wall in restrooms/ food prep sink along edges in several classrooms. New caulking maybe needed and keep surfaces in good repair for easily clean. Keep clean.

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 paper towels available at hand sinks in restrooms/classrooms (front room to the left upon entry, and PreK2). Therapists use the classroom for their sessions. Ensure to provide all hand washing supplies at all hand sinks at all time.

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 incorrectly/missing step 3, 4, 5, 11. EHS, teacher and director goes over correct diaper changing procedures on the poster posted in the classroom at the time of inspection. Ensure to follow the correct diaper changing procedures at all time.

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 unlocked cabinet, inside unlock black box in infant 2. Observed a diaper creams a lock box with a long hook key lock, it allowed EHS to take the creams out of the box during inspection. CDI- Director changed to a new short key lock at the time of inspection. The box is now lock and no access to the cream.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed 2 disinfectant Lysol spray aerosol cans in unlocked cabinet underneath diaper changing table in Toddler 3. Childproof lock devices do not count as a lock. Observed a basket of disinfectant aerosol cans in a lock closet with a key in the lock hanging down in PreK2 while therapy is session. All hazardous items must be lock at all times. CDI- Director took items out and store properly at the time of inspection. EHS and directors discussed in detail how to store hazardous items properly and the facility has the hazardous items poster. 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. Store/keep keys at 5ft or higher at all time.**

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 several classrooms with cots labeling incorrectly, 2 cots with same number in several classes. 2 different numbers in same cot. Ensure to put name or number, provide chart assignments if number labeled (visible and legible).

15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed one gate of HVAC units not having a lock installed. Install/put a lock on the gate, make it inaccessible to children. Keep all gates that lead to HVAC units lock when not in use. 15A NCAC 18A .2831 (b). Sand toys, water tables, and other unfiltered items that can collect standing water in the outdoor learning environment shall be emptied and stored to prevent the collection of standing water.- Observed several buckets/containers in the playground collecting and holding old water from the rains. Ensure to empty the containers face down, keep away from standing water.

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 speciality milk in the full size refrigerator in Toddler, dated 7/15. EHS and director discussed proper way to handle specialty milks at the time of inspection. 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. 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 bottle/cup of milk/beverage in the fridge in Toddler 1, dated 7/22, 7/24 and one other child without the date. Ensure to have both name and date received at the child care center each day.

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 a container of hand sanitizer on table less than 5ft in room 110, lotion in drawer less than 5ft in office restroom. 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 pink soap in drawer less than 5ft in office restroom. NOTE: Ensure to put all non-hazardous items at 5ft or higher at all time.

General Comment: 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 Lunchables (ham and cheese) package in lunch box stored at room temperature in a cubby room 112. Ensure to store all potential hazardous food items as required in the childcare center.

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 the back of high chair trays need better cleaning. Ensure to throughly clean (wash, rinse, sanitize) all multi-service articles (high chair trays, spoons, plates/bowls, rubber bibs) in the kitchen after each use.

REPEAT 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 Quaternary Ammonium Compounds (QAC) sanitizer solution with weak concentration of 50-100 ppm. Ensure to provide correct concentration according to manufacturer. QAC sanitize solution required to be between 200-400 ppm. Observed the other class 108 is using chlorine sanitizer solution which measure over 1000 ppm. Correct chlorine sanitizer concentration is between 50-200 ppm. NOTE: The center can use either QAC or Chlorine sanitizer, and ensure the correct sanitizer solution for each one. The solution shall be prepared for use within 24 hours.

General Comment: 15A NCAC 18A .2809 (2) Food-contact surfaces shall be kept clean and in good repair.-Observed disrepair/missing surface inside the warmer basin in infant 2. Replacement needed for proper clean and sanitizer the equipment. Keep in good repair. Observed soiled refrigerator infant 2, need 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 no disinfectant solution for diaper changing table in Toddler 1. Ensure to provide disinfectant at all changing stations. Note: The center is using the disinfectant solution from manufacturers and its instructions, according to teacher the contact time for the solution they use was 2 minutes. Actual contact time on the label is 3 minutes. Ensure to educate and train all staff the proper cleaning and contact time for chemical use in the center.

PROVISIONAL ITEM: 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 unlock diaper table cabinet (Toddler 1, 2 and 3, 108, 109). Ensure to store items as required by notated rule, if choose to keep items under 5ft (they shall be in locking key box/storage. And key shall be stored at 5ft or higher 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 all keys at 5ft or higher at all time.**

General Comment REPEAT: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed Clorox wipes in unlock drawer in woman restroom upon entrance, Observed containers of cleaner and Clorox stored in unlock/unused classroom 105 and 106. Proper storage and way to resolve issues discussed in detail with lead teacher during 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 disinfectant solution spray bottle stored on sink counter less than 5ft in room 108. Keep 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 soap pink bag in unlock diaper cabinet less than 5ft in Toddler 1. Store item properly as required. 15A NCAC 18A .2820 (c ) Sanitizing, disinfecting, and detergent solutions shall be labeled with the product name (ex. "Sanitizer")- Observed soapy water in infant room without labels. Ensure to label all sprays bottles.

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 several classrooms with cots with no label (name/number chart). Ensure to put name or number, provide chart assignments if number labeled (visible and legible).

REPEAT 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 Quaternary Ammonium Compounds (QAC) sanitizer solution with weak concentration of 50ppm. Ensure to provide correct concentration according to manufacturer. QAC sanitize solution required to be between 200-400 ppm. Director is calling Ecolab and will ensure correct concentration provided for sanitation. NOTE: Corrected During Inspection (CDI), the center is using bleach to prepare chlorine sanitizer solution with the concentration between 50-200ppm, while waiting for Ecolab to correct the issue. Sanitizer solution shall be prepared for use within 24 hours.

REPEAT 15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed soiled, black buildup on unused water fountains in need of cleaning and keep clean either in-used or un-used.

REPEAT 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilets need cleaning in restroom 111. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed soiled hand washing sink in restroom 109, need cleaning and keep clean.

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 containers of Clorox in the kitchen not being locked away in the storage room. Hazardous items and how to store them discussed with chef and director at the time of inspection. Clorox container put away in the locked storage room at the time of inspection.

REPEAT 15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed HVAC units inside the gate fenced. Some keep lock with key, made it inaccessible to children and some are not. Keep all gates lock and make it inaccessible to children. One of the gate was broken, it looks like maintenance is working on repairing and will put lock on it. **Clean/remove unused pipes inside the gate where tricycles were in***

General comment: 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 .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 kitchen has two disrepair thin probe thermometers. Obtain thin probe thermometers to measure food.

General Comment: 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 highchairs trays in the infant room get clean stationary in the classroom. All multi-service articles (high chair trays, spoons, plates/bowls, rubber bibs) shall be wash, rinse and sanitize properly in the kitchen after each use.

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 Quaternary Ammonium Compounds (QAC) sanitizer solution with weak concentration of 50ppm. Ensure to provide correct concentration according to manufacturer. QAC sanitize solution required to be between 200-400 ppm. Observed the facility within the QAC test strip to measure the correct concentration as well. Obtain the test kit. NOTE: Some classroom use chlorine sanitizer and some classroom use QAC. Not consistent.

General Comment: 15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed soiled unused water fountains in need of cleaning and keep clean either in-used or un-used.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed several toilets in the center need cleaning and keep clean. Observed several toilets were covered with black plastic bag and disrepair. Need repair. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. -Observed several hand washing in several classrooms need cleaning and keep clean. Observed disrepair hand sink with very strong odor in 114. Need repair and correct issues.

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 center uses ECOlab (TB Disinfectant Cleaner Ready to Use) as their disinfectant solution spray. When asking teacher while spray the solution on diaper surface and several teachers about the contact time, incorrect contact time was given according to the manufacturer instructions. Ensure staff know and have cleat knowledge of how to use the solution effectively.

PROVISIONAL ITEMS: 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 eye wash bottle and burn creams inside the first aid kit in 116 empty classroom. Keep all medications lock at all time. 15A NCAC 18A .2820 (d).Designated emergency medications shall be kept inaccessible to children, 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 emergency medication, inhaler, inside the outdoor bag in 116, on the table less than 5ft. Ensure to proper store the emergency medication at all time. 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 key to open the lockbox that stored diapering creams in Infant 2 drawer less than 5ft. Ensure to store all keys to access hazardous/non hazardous items out of reach of children, keep inaccessible at 5ft or higher at all time. 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.**

PROVISIONAL ITEMS: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. **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.**- Observed room 105, 106, staff lounge, restroom behind front desk, left unlock and containing many chemicals/cleaners/paint container/sun screens lotions. Keep all hazardous items lock at all time. And keep keys at 5ft or higher.

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 in staff lounge, art studio and office, doors left unlock. Observed hand sanitizer squeeze bottles and hand lotion in drawer lees than 5ft in Toddler 2. Keep all approved non-hazardous items at 5ft or higher.

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 several classrooms with cots with no label (name/number chart). Ensure to put name or number, provide chart assignments if number labeled.

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.

General Comment: 15A NCAC 18A .2832 (a).In the child care center premises and outdoor learning environment. Debris, glass, dilapidated structures, and broken play equipment shall be removed from areas accessible to children. Wells, grease traps, cisterns, and utility equipment shall be made inaccessible to children.- Observed HVAC units inside the gate fenced. Some keep lock with key, made it inaccessible to children and some are not. Keep all gates lock and make it inaccessible to children.

15A NCAC 18A .2806 (j) (1) Each refrigerator shall be provided with a numerically scaled indicating thermometer that is accurate to ± 3 degrees Fahrenheit and located to measure the air temperature in the warmest part of the refrigerator. Recording thermometers that are accurate to ± 3 degrees Fahrenheit may be used in lieu of indicating thermometers. Observed no thermometer in kitchen refrigerator. Needs thermometer.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed bottle warmer for single bottle in infant room 1 food prep area in need of cleaning.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilets in bathroom of Room 109 in need of cleaning. Needs to be cleaned.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed employee in Toddler 2 changing a diaper did not wash child’s hands after diaper changing was completed. Need to wash child’s hands after diaper changing before returning the child to other areas.

No points taken. General comment. All hazardous items must be stored in a locked storage room or cabinet. 15A NCAC 18A .2820 (b). Observed jug of tide stored in unlocked bottom shelf in infant food prep area. Observed chemicals stored in locked kitchen but not in a locked storage room or cabinet. EHS informed employees that the chemicals in the kitchen need to be stored in a locked storage room or cabinet when not in use.

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 bottle of disinfectant in unlocked cabinet under diaper changing area in infant room 1. Observed soapy water stored in unlocked cabinet under sink in infant food prep area. REPEAT.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed no labels on cots in Toddler 2. Observed Room 109 teacher stated they go to DPS 3 for nap time and there are no cots labeled for the children in her class. Observed cot list was missing in Toddler room 3. Need assigned cots labeled with children’s name.

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 cabinet under diaper changing area broken in Toddler room 2. Observed torn upholstery on small couches in multiple classrooms. Observed tape residue on furniture. Needs repair. Repeat.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed floors in bathroom of Room 109 needs cleaning. Floors appeared wet and tiles were stained in bathroom.

Lighting shall be capable of illumination to at least 10 foot-candles of light, 30 inches above the floor in areas describe in 15A NCAC 18A .2826 (a). Lighting in school age varsity boys bathroom was 2.18 FC. Needs to be at least 10 FC.

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.

Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3). Observed microwave in staff lounge in disrepair and needs replacing.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed hand sinks corroded in some classrooms. Some hand sinks need better cleaning in classrooms. Repair any leaking sinks.

Cleaning and disinfecting solutions shall be provided at each diaper changing station. 15A NCAC 18A .2819 ( c ). Observed no disinfectant at changing table in Toddler 1.

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). Repeat- Observed diaper creams stored unlocked under diaper changing table. Store locked or above 5 ft above floor.

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 shelving, cribs and other surfaces with sticky tape throughout. Bookshelves with debris.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls with dirt, grime, moisture damage. Holes that need repair, etc

Solid waste must be covered, and dumpster area must be kept clean. 15A NCAC 18A .2830 (c ) and (d). Observed trash on ground behind dumpster. Keep trash picked up.

All kitchens shall have a refrigerator. 15A NCAC 18A .2810 (a). Observed broken refrigerator not yet replaced. Staff says will be installed tonight.

Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). CRITICAL VIOLATION- Observed can wash on playground not turned off with key. Water >120F. Director found key and turned water off.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed leaking hand sink. Faucet fixtures need cleaning around bases and corroded faucets need replacing.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Critical Violation-Observed unlocked glass cleaner in closet, Pre-K 1.

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). Repeat- Observed diaper creams stored below 5 feet and unlocked in Toddler 1 and Discovery preschool 2. Lotion stored below 5 feet Pre-K 1.

Individual linen shall be provided for all beds, cots, or mats. 15A NCAC 18A .2821 (c ). Observed children sleeping directly on cots, Pre K 1. All crib and play pens, used for sleeping, shall have an easily cleanable, waterproof, washable, firm, and tight fitting mattress that is at least 2 inches thick. 15A NCAC 18A .2821 (b). Observed several crib mattresses with torn edges.

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 shelf with gouged finish in Toddler 1. Remove sticky tape residue from all surfaces.

Wash hands when required. 15A NCAC 18A .2803 (a). Observed child’s hands not washed after diaper change, infant 1.

All potentially hazardous food products shall be maintained at 45°F, or below, or 140°F or above. 15A NCAC 18A .2806 (f). Observed case of cream cheese room temperature in refrigerator in kitchen. Refrigerator is kitchen broken for close to 2 weeks. Cream cheese disposed of.

Keep all food service equipment clean and in good repair. 15A NCAC 18A .2812 (f). Observed refrigerator in kitchen broken for close to 2 weeks. New refrigerator to be installed next week. Prep sink in kitchen needs detail cleaning.

Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b). Observed uncovered plastic cups in outside bag. Lips exposed and top cup with lint/debris in it.

Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). Observed can wash not turned off and hot water in excess of 120F. Use key to turn off water when not in use.

Toilets shall be cleaned and disinfected at least daily and when visibly soiled. 15A NCAC 18A .2817 (b). Observed toilets in unused classrooms needing cleaning. Sinks shall be cleaned and disinfected at least daily, when visibly soiled, and when the designated use of the handwashing sink has been changed. 15A NCAC 18A .2818 (c). Observed hand sinks in unused classrooms needing cleaning. Several faucet fixtures corroded and need replacing. Sink handle is ambled to be removed, 2 year class.

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 throughout with faded labeling on soapy water. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed incorrect diaper change procedure in toddler 1 class. Staff left soiled gloves on until after the child was diapered/dressed. Follow posted procedures.

All medications must be stored behind lock and key. 15A NCAC 18A .2820 (d). Repeat- Observed unlocked first aid kits containing alcohol swabs in several outside bags in classrooms. First aid kits must be locked up or remove any medications, burn treatment, alcohol swabs, ice packs, etc. Observed emergency medication stored below 5 feet above floor in infant 1 and school age classrooms.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed aerosol air freshener in unlocked bathroom.

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). Repeat- Observed hand sanitizer and sunscreen stored in outside bag less than 5 feet above floor.

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). Repeat-Observed furniture with sticky tape residue. Some vinyl blocks, mats and furniture with frayed edges.

In areas where children are not toilet trained, small mouth contact toys shall be washed, rinsed, sanitized (submerged for 2 minutes), and allowed to air dry, after use and more frequently when visibly dirty. 15A NCAC 18A .2822 (a). Through discussion with staff toys are being cleaned and air dried at diaper changing sinks in classrooms. Clean in kitchen or after a change of use at food prep hand sinks.

Keep the property free of standing water. 15A NCAC 18A .2831 (b). Observed clogged gutter causing ponding against building. Unclog and repair gutters to drain water away from building.

Handwashing procedure 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 well 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. 15A NCAC 18A .2803 (c). Observed child improperly washing hands. Teachers need to do more coaching.

All food shall be stored and handled in a manner that protects it from contamination. 15A NCAC 18A .2806 (d),(f), .2807 (b), and .2808 (e). Observed shell eggs stored above ready to eat foods. Specialty milk container sent to classroom without ice for meal and then to be sent back to kitchen. This procedure is not allowed. Food must be kept 45F or below while in classroom. Recommend sending a cup of the specialty milk to the classroom, or get the ice machine repaired so containers of ice can keep the milk cold. Store all foods in approved re-sealable bags or containers once opened. 15A NCAC 18A .2806 (a) Observed opened container of potatoes not in sealable container.

Keep all non-food contact surfaces and equipment clean and in good repair. 15A NCAC 18A .2812 (f) and .2809 (1) and (3). Observed 3 comp sink compartment need deep cleaning of scum lines.

Single-service articles must be kept clean and protected from contamination. 15A NCAC 18A .2809 (8), .2814 (a) and (b). Observed paper towels stored under hand sink at diaper changing table, infant 2.

Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Repeat-Observed several handsinks need better cleaning in bowl and around fixtures.

All medications must be stored behind lock and key. 15A NCAC 18A .2820 (d). Observed unopened first aid kit unlocked in classroom, kit must be locked up or remove any medications, burn treatment, alcohol swabs, ice packs, etc.

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 on counter in infant 2 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). Repeat- Observed furniture throughout center with sticky tape residue. Some shelving and bins need cleaning. Some books torn and in disrepair.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls and switch plated grimy in bathrooms throughout. *No points to the extensive wall repairs completed since last inspection

Install dumpster drain plug to prevent insect and vermin nuisances. 15A NCAC 18A .2830 (d). Observed missing drain plug in dumpster. Doors open and some trash on ground. Note-waste company called, new dumpster getting delivered.

Keep the property free of standing water. 15A NCAC 18A .2831 (b). Observed containers of water on playground, school age Keep the property free of high vegetation. 15A NCAC 18A .2831 (i). Observed grass needs mowing, more than ankle high in places. All play ground equipment must be kept clean and in good repair. 15A NCAC 18A .2832 (c ). Observed climber on school age playground with plastic coating in disrepair.

All food shall be stored and handled in a manner that protects it from contamination. 15A NCAC 18A .2806 (d),(f), .2807 (b), and .2808 (e). Observed opened dry cereal not covered in container. Classroom serving snack had bowls surrounding hand sink and folder and Ipad on food prep surface. Keep food away from hand sink. Parent supplied specialty milk not labeled/dated.

Protect food service equipment from contamination. 15A NCAC 18A .2814 (a) and (b). Observed 1 classroom had their single service plates, cups exposed. Keep protected.

Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e). Observed hot water 70F around Pre-K classrooms. Check all sinks in that area.

Hot water at areas accessible to children shall not exceed 120°F. 15A NCAC 18A .2815 (e). CRITICAL VIOLATION- Observed both laundry room and kitchen doors unlocked. Hot water at 3-comp and utility sink in laundry >130F. Laundry room and kitchen must be locked when no staff present.

Keep water fountains clean at all times. 15A NCAC 18A .2815 (f). Observed water fountains need cleaning.

In child care centers, areas accessible to children shall be free of identified lead poisoning hazards as defined in G.S. 130A-131.7(7). CRITICAL VIOLATION- Observed water fountains operable and accessible. Drinking fountains not tested for lead. Either turn off fountains or have tested for lead by an accredited lab.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed staff toilets out of order. Director said that they flood frequently enough where they put them out of order. She said plumbers cannot find clogs or reason why flooding. Loose toilet seat in YPS 3. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a). Observed sinks incl. around fixtures and toilets need more frequent cleaning. Some sinks need recaulking to wall.

Handwashing sinks must be free of storage. 15A NCAC 18A .2818 (a). Observed toys stored unprotected below hand sink in 1 classroom.

Diapers shall be changed at diaper changing station approved by the Department. 15A NCAC 18A .2819 (a) and (b). Observed diaper changing table over near bathrooms. Diaper changing table must be located near diaper changing hand sink. Sinks in bathroom cannot be used after diaper changing.

Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d). Observed incorrect diaper changing procedure in infant room. Observed incorrect signage for diaper changing procedure. Gave diaper changing procedure signs. Observed diaper changing procedure signs are not located where they can be viewed during diaper change.

All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). CRITICAL VIOLATION-Observed hazardous items unlocked in kitchen, laundry, storage room at end of hall and infant room. Alcohol prep pads on table at front door Keep doors locked that contain hazardous items.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed classrooms without cots labeled or system was confusing. Observed children without sheets sleeping directly on cot.

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 furniture throughout center with sticky tape residue.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls in disrepair in areas where the staff bathroom flood water has wicked up the drywall. Reattach loose FRP in hallway outside school age classroom. Repair damaged drywall in mop closet where mop heads have touched drywall.