COMMUNITY PRESCHOOL OF HUNTERSVILLE

General Comment: 15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed parent is dropping off a child and helping putting bottles in the refrigerator in infant room without washing hands. Ensure to educate parents and staff to practice clean and safe hands when required.

REPEAT 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed baby food jar in refrigerator and cabinet in infant rooms without date. Ensure to label both name and date received on items sent from home.

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 in the dispenser in Toddler 1 and 3. Ensure to provide all hand washing supplies and have available/accessible at all hand sinks at all time.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed Clorox wipes stored in unlocked cabinet in Pre toddler 1, 2, 3, and pre K. Ensure to keep all hazardous items that has label “Keep Out of Reach of Children” and or extra “Caution/Warning” in lock cabinet/storage at anytime. 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**

REPEAT 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed diaper creams stored below 5ft on shelving/cabinets in Pre toddler3 and Toddler 1. Put all diaper creams at 5ft or higher or in lock cabinet at anytime.

REPEAT 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/bag stored inside unlock closet in pre toddler 3, Preschool1, and Toddler 3. Ensure to store all personal belongings/bags/purses that contain no hazardous items at 5ft or higher at anytime.

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 toy buckets stored on top of sheet on the cot in closet in Toodler 2. Do not store anything on top of the cot and sheet unless you have the cover to prevent contamination.

15A NCAC 18A .2822 (d) The water play centers, including toys, shall be cleaned and sanitized at least daily or more often if no longer clean. Water play is prohibited during the outbreak and investigation of a communicable disease or condition at the child care center.- Observed soiled old water in the water table need cleaning and keep clean in Preschool 1.

REPEAT 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 - Observed old wooden round table, some with nails and splitting wood at the back learning playground. Remove the items. Keep all equipment in good repair. NOTE: Observed one loose gate needs repair at the back learning playground.

REPEAT 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed snack in several classrooms without date received at the center. Ensure to label both name and date that was received at the center as they come in. 15A NCAC 18A .2806 (a) Once pre-packaged food has been opened, the food shall be stored in clean, resealable bags or containers made of plastic or glass that are tightly covered and manufactured for the purpose of food storage.- Observed leftover open bag of graham cracker in cabinet Pre-school 2. Ensure to keep all leftover snacks in ziplock bag or containers.

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 between two hand sinks counter in Toddler 1. Provide all hand washing supplies at all hand sinks at all time.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed a box of toys, balls stored in the restroom Pre-Toddler 3. Only restroom related items are allowed in the restroom at anytime.

REPEAT 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor.- Observed items stored less than 5ft, diaper cream on the counter in infant 1 and diaper cream in cabinet Pre-Toddler 1. Ensure to keep all diaper creams at 5ft or higher at anytime. 15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed a bulk container of soap stored in cabinet in women restroom hallway less than 5ft. Keep/store bulk soap at least 5ft at anytime.

REPEAT 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 inside unlock closet in preschool 1. Ensure to store all personal belongings/bags/purses that contain no hazardous items at 5ft or higher at all time.

General Comment: 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 - Observed old wooden round table, some with nails sticking out at the back learning playground. Repair or remove the items. Keep all equipment in good repair.

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 and students washing their hands and turn off a faucet knob with bare hands. There is hand washing procedure posted at all hand sinks. Ensure to follow correct hand washing procedures at all time.

REPEAT 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed baby snack/food without date received at the center in infant 2. Ensure to put name and date that was received at the center as they come in.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes.- Observed no sanitizer solution spray in preschool 3 and sensory room. Observed no soapy water in preschool 1. Ensure to provide soapy water, sanitizer, disinfectant solution where appropriate at all time for proper cleaning.

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 and paper towels in the dispenser at hand sink between restrooms TK, no paper towel in PreK2, no soap and paper towels in Toddler 3. Ensure to refill and replenish hand washing supplies at all hand sinks as they run out at all time.

General Comment: 15A NCAC 18A .2819 (d) Use approved diapering methods as follows: 1) gather supplies, 2) wear disposable gloves (if needed), 3) use a disposable moist towelette to clean child, wiping front to back, 4) dispose of gloves if used and soiled towelettes, 5) wiping the employee's hands and the child's hands with a separate disposable towelette, 6) slide clean diaper under child and apply diapering products if needed using approved methods, 7) fasten diaper and place clothing on child, 8) wash child's hands, 9) and 10) clean and disinfect diapering surface using approved methods, 11) employee washes their hands.- Observed teacher is changing diaper and missing steps in the middle part (wiping teacher hands and a child hands after dirty part). The poster was posted at the changing station. Ensure to follow correct diaper changing procedures 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 several classrooms with green outside book bag attached with long black strings hanging down. The hook is higher and way above 5ft, the bag is hanging way above 5ft on a hook, however the black strings that drop and hang down from the bag way down, make the whole bag reachable by grabbing and pulling the strings. Ensure to keep the whole bag and all attachments at 5ft or higher at all times.

15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand lotion and lip gross in unlock drawer less than 5ft in infant 1. Ensure to put all non hazardous items at 5ft or higher at all time.

REPEAT 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 on top of cots inside unlock closet in preschool, on the counter in infant 1, unlock preschool 2/3 closet. Ensure to store all personal belongings that contain no hazardous items at 5ft or higher at all time.

General Comment: 15A NCAC 18A .2821 (g). Wash cloths, bibs, and burping cloths shall be laundered after each use. Each time a wash cloth, bib, or burping cloth is used, it shall be used for only one child.- Observed a center is using wash cloth to wipe down the tables after meal or a mess. In several classrooms the cloth was placed inside hand sink or on top on the faucet after used. After each use/clean, ensure to place item in a designated dirty container for cleaning. Cloth shall not be used more than once after each cleaning.

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 peeling on white seating sofa in atrium room, broken cabinets in toddler 3, pre toddler 1 where diaper cream stored, tooder 2 and pre toddler 3. Repair needed and keep all furniture in good repair.

REPEAT 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed baby snack/food without date received at the center. Ensure to put name and date on items each day that come in. 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 left over snack in ziplock bag, unsealed properly inside the cabinet. Ensure to keep all food in resealable containers/bags and close properly while storing.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed paper towels are not available at many sinks in several classrooms. Missing hand soap in TK hand sink. Ensure to provide all hand washing supplies at all hand sinks at all time.

General Comment: 15A NCAC 18A .2812 (i) Provide a testing method for chlorine disinfectant to ensure compliance with prescribed chlorine concentration. Observed disinfectant concentration solution measured little less than 500 ppm. Ensure to provide correct concentration at all time between 500-800 ppm of chlorine solution.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed Emo body oil stored with diaper cream, little bottle of paint, and air freshener spray in unlock cabinet in classroom/restroom. All all hazardous items that has label “Keep out of reach of children “ and extra “warning” or “caution” in lock cabinet at all time. NOTE: **Lock storage rooms and cabinets shall include those which are unlocked with a combination lock, electric or magnetic device, key pad, key, or equivalent locking device, keep/store keys at least 5ft or higher at all time**

15A NCAC 18A .2820 (c) Bulk soaps shall be kept inaccessible to children by storing the product at least 5ft above the floor.- Observed bulk soap containers in unlock cabinet in staff restroom less than 5ft. Ensure to put items at 5ft or above at all time or lock the cabinet.

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 bags, personal bags, stored on the floor in closet or classroom. All personal belongings that contain no hazardous items shall be stored at 5ft or above at all time.

REPEAT 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 detailed conversation with teacher in several classrooms where mouthing/dirty toys present. The dirty toys were collected and put in dirty bin and get clean at the end of the day or down time. Teacher spray soapy, rinse and 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 .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 closets floor in several classrooms need cleaning and keep clean.

General Comment: 15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed a child was dropped off by parent in the classroom and not washing hand before playing with friends. Ensure to that everyone is washing their hand properly before engaging in activities.

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 lunches in thermos container without parent permission. Obtain parent or guardian permission. 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals containing potentially hazardous foods shall be refrigerated at 45 degrees Fahrenheit or below and stored in the child care center kitchen or approved food preparation area.- Observed mac and cheese in lunch box stored on classroom counter, temperature measured at 50F. NOTE: All hazardous cold food items shall maintain temperature at 45F or below and hot food items shall be at 135F or above.

15A NCAC 18A .2804 (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center.- Observed baby bottles in infant and toddler rooms without date that was received. Ensure to labeled both name and date received at the center. 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed baby snack/food, children lunch box without date received at the center. Ensure to put name and date on items each day that come in. 15A NCAC 18A .2804 (f) If food is prepared in a childcare center classroom, then the classroom shall be equipped with a food preparation area. Water from a hand wash lavatory shall not be used for bottle warning or to prepare formula, mix dry cereals, or other foods.- According to teachers, water from the warmers come from food prep hand sink in the classrooms. Use water from bottle water or kitchen provided.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions.- Observed soiled bottle warmers in pre toddler 1 need detail cleaning and keep clean.

General Comment: 15A NCAC 18A .2812 (f) Kitchen surfaces that are not food-contact surfaces shall be kept clean.- Observed refrigerator where specialty milk storing need detail cleaning and keep clean.

General Comment: 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 Benadryl store in the outside bag along with emergency medication in TK. Observed nausea medication in unlock drawer in preschool 3. All medications shall kept 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 outside bag that has emergency medication in it stored on the top of storage box less than 5ft. Keep the bag on teacher or place item right at 5ft or higher 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 sun screens and diaper cream stored less than 5ft in unlock/broken cabinet pre toddler 1. Items shall be stored at 5ft or higher, if not locking it up.

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 container of Clorox and degreaser in the kitchen not being lock away in the storage room. Hazardous items and how to store them discussed with chef and director at the time of inspection. Items put away in the locked storage room inside the kitchen at the time of inspection. Key put up at least 5ft. Observed essential oil little bottles in unlock cabinet in infant 1. Keep all hazardous items with label “Keep out of reach of children” and extra warning/caution lock 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.**

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 ointment in unlock drawer less than 5ft in preschool 3. Ensure to put all non hazardous items at 5ft or higher at all time.

REPEAT 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/book bag/personal belongings stored in unlock closet floor, cabinet less than 5ft (pre toddler 1, Infant 1& 2, preK1, preschool 3). Ensure to put item at 5ft or higher at all time.

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 unlock gate where access to HVAC units next to playground. Put lock on the gate.

15A NCAC 18A .2804 (k) Lunches, snacks, and other meals containing potentially hazardous foods shall be refrigerated at 45 degrees Fahrenheit or below and stored in the child care center kitchen or approved food preparation area. Observed gallons of milk with strawberry added sitting on counter in kitchen at 54F. Strawberry milk is for snack, cannot leave PHF sitting on counter. Do not save any of the leftover milk after snack.

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 sippy cup from home not labeled or dated. 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 several cartons of specialty milk, all labeled with name of child, half labeled with date. 15A NCAC 18A .2806 (h) Raw meats, poultry, fish, shellfish and eggs shall be stored in a refrigerator or freezer on shelving beneath and separate from other foods. Observed raw shell eggs stored above ready to eat foods.

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 that food thermometer could not be located.

15A NCAC 18A .2812 (h) After sanitizing, all equipment and utensils shall be air dried. Observed pans and pitchers being wet stacked.

15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Observed cartons of single service stored on floor in kitchen, more shelving needed.

15A NCAC 18A .2818 (c) Lavatories shall be cleaned and disinfected with each change of use, when visibly soiled, and at least daily. Change of use occurs when a handwash lavatory is used outside of its original intent. Observed classrooms where the food prep hand sink and the diaper changing hand sinks were used interchangably. Use correct sink for its intended use.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed paper towels missing at over half of hand sinks.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed toys, dirty spoons, clean plates, dirty paintbrushes, foil used as cover for food bowl in hand sinks throughout center. Do not store/put anything in hand sinks. Observed toys, paint, art supplies stored below hand sink plumbing. Observed one classroom rinsing plates before being sent back to kitchen, hand sink full of food.

15A NCAC 18A .2812 (i) Provide a testing method for chlorine disinfectant to ensure compliance with prescribed chlorine concentration. Observed no disinfectant test strips, test strips only measured to 500 ppm. Test strips must be able to test full range of disinfectant levels. Range should include 500-800 ppm chlorine.

15A NCAC 18A .2819 (b). Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair. Observed dirt/debris under pad on diaper changing tables. 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 wipes stored on diaper changing tables. 15A NCAC 18A .2819 (c). Approved disinfectants and detergent solutions shall be kept in separate and labeled bottles at each diaper changing station. Observed spray bottles not located at al diaper changing stations. 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 diaper changes where step 5 was omitted.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed hand wipes containing alcohol in outside bags. Observed bottle of personal cleaner stored unlocked in pre-toddler ii room.

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 overstuffed cubbys. Many cubbys had large backpacks taking up half the room inside the cubby. 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 purses stored < 5 ft above the floor in 2 classrooms.

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 cribs themselves not labeled, label was on wall behind crib. 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 no sheets on cots in pre-k i room.

15A NCAC 18A .2821 (f). Linens shall be laundered between users, when soiled, and otherwise once per week in rooms with children 1 year old or greater. Observed soiled sheet on cot. Remove soiled sheets before returning cot to closet

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 in water play table from day before, toddler ii. Observed broken hinges on cabinets in 3 classrooms. 15A NCAC 18A .2822 (a) Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair.

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. Will email procedure.