CHILDCARE NETWORK #325

General comment: 15A NCAC 18A .2804 (g) After opening, jars of baby food shall be covered, labeled with the date on which they were opened, refrigerated and used within two days of opening, provided that the baby food is not served directly from the jar. Observed date missing on opened baby food jar. CDI - Staff put date label on the jar.

General Comment: 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed build up in bottle warmers. Needs cleaning.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed diapers and wipes stored under sink in Toddlers room. To store under sink items need to be in a water proof container. (No food or utensils stored under sink even if in a waterproof container).

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 antiseptic cut/burn spray stored in outside bag. This would qualify as a medication that needs to be stored behind lock and key. CDI - Anitseptic sprays were taken to be locked in office.

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 coating wearing off cabinets in Twos classroom. Needs repair.

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 some ceiling damage in afterschool bathroom. Needs repair. REPEAT.

General Comment: 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 one refrigerator in pantry missing a thermometer. Needs thermometer.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer in infante room at 800 ppm. Needs to be 50 -200 ppm.

General Comment: 15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed build up in refrigerator in closed prek classroom. Needs cleaning.

General Comment: 15A NCAC 18A .2815 (e) (e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use. Observed hot water in kitchen reaching only 79F. Maintenance staff fixed mixing valve and water temperature rose to 130+F.

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 at infant room handsink and food prep sink reach only 71F. Needs to be 80-110F.

General Comment: 15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed wagon stored in toilet room in closed classroom 4.

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 upholstery on rocking chair in infant room. Observed brown chair with upholstery coming loose in 2s room. Needs repair. REPEAT.

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 cracks to ceiling in staff bathroom. Observed some ceiling damage in afterschool bathroom. Needs repair. REPEAT.

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 children turning off water with hands and lifting garbage can lid with hand to throw away towel, room 2. Children need coaching on proper hand washing procedures.

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 kitchen door not closed or locked. Kitchen must be locked when no staff is present in kitchen.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed kitchen hand sinks blocked by rack of clean dishes. Dirty sippy cups in hand sink room 8.

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 weak (between 250-500 ppm), use test strips to check for proper concentrations. Follow instructions on test strips for how to use.

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. Repeat- Observed improper diaper change in infant room, steps missing or done improperly, 3, 4, 5, and 6. Observed diaper changing procedure not posted near table. Retrain staff on proper diaper changing procedures.

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 large toys, doll crib, vinyl couch with dust & debris. Tape residue on shelving, room 1 .

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 loose wallpaper in upstairs staff bathroom. Observed chipped paint walls and behind cribs, infant room.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed child’s hand not washed at drop off.

15A NCAC 18A .2806 (g) Food shall be stored above the floor and in a manner to protect it from dust, pests, drip, splash, and other contamination. Observed case of apples and chips stored on floor. Bottled water needs to be stored off floor as well (used to hold refrigerator door closed at present).

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed both bottle warmers in infant room with very debris in bottom. Clean more frequently.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Repeat-Observed several classroom refrigerators with spill/debris. High chair tray with food on bottom. Return to kitchen for W/R/S after every use. 15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed broken gasket on refrigerator, needs repair ASAP, as door does not stay shut on its own, case of bottled water used to hold door closed.

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 in gang bathrooms. No paper towels in bathroom, upstairs classroom.

15A NCAC 18A .2819 (c) and 15A NCAC 18A .2819 (d) (10). Diapering surfaces shall be disinfected using an approved disinfectant by spraying the entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry. Observed staff not clean table before spraying disinfectant. Follow proper cleaning procedures

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unsecured air freshener with aerosol can. In infant room, door latch broken, room used for bulk bleach storage. If lock is broken/door cannot be secured remove items that are required to be locked (chemicals) and store where lock is functional.

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 tape residue and dusty large toys, room 1. Trash below cushions of metal furniture in school age room.

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 refrigerator water 54F. Setting on 1. Adjusted fridge setting, moved lunchbox to another refrigerator.

15A NCAC 18A .2810 (c) A separate food preparation sink with drainboards or countertop space of adequate size shall be required when a review of construction plans, modifications, or change in child care procedures indicates that separate facilities are needed based on volume and preparation frequency. Observed kitchen is too small. Previous center did not prepare food, children brought in their meals/snacks. Current center does prepare some lunches, and is planning on serving all children. Refrigerator moved to room without hand sink, a hot holding unit was put in kitchen where refrigerator was located. Center does not have the kitchen capacity to prepare for 280 children. Refrigerator in school age classroom moved to other refrigerator’s location.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed several classroom refrigerators with spill/debris.

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. The center has water testing bottles on site. They need to test the 2-comp sink (dishwashing) and the next sink (sanitizing sink). All fountains turned off. Testing will need to be done beforehand if you decide to turn them back on.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed loose faucet fixture in infant room. 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilets in after school need cleaning.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed staff bathroom without soap

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 first aid kit with medications stored near exterior door, key stored in lock. Cannot store key in lock.

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 large toys, bookshelves, visibly dirty in classrooms. Metal furniture had stained cloth seats. Areas under cushions with build-up. Observed wall cabinet breaking away from its backing and leaning, repair ASAP, room 1.

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.Repeat- Observed water damage to ceiling, girl’s after school. Observed touch up painting needed at the front door and areas of block walls where paint bubbling due to moisture behind paint.

15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair. Observed a couple light fixtures that don’t turn on properly. 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 several dusty vents.

15A NCAC 18A .2832 (a). Child care center premises, including the outdoor learning environment, shall be kept clean, drained to minimize standing water, free of litter and hazards, and maintained in a manner which does not create conditions that attract or harbor pests. Observed back of shed rotted and large hole needs repair, school age playground. Large pile of wood and bricks need removal from premises. Paint cans under deck.

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. Repeat-Observed gallons of milk stored in dorm refrigerators and not holding <45F.

15A NCAC 18A .2810 (c) A separate food preparation sink with drainboards or countertop space of adequate size shall be required when a review of construction plans, modifications, or change in child care procedures indicates that separate facilities are needed based on volume and preparation frequency. Observed kitchen is too small. Previous center did not prepare food, children brought in their meals/snacks. Current center does prepare some lunches, and is planning on serving all children. Refrigerator moved to room without hand sink, a hot holding unit was put in kitchen where refrigerator was located. Center does not have the kitchen capacity to prepare for 280 children. Observed no hand washing sink near refrigerator in school age classroom.

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 kitchen doors left unlocked, front and infant side.

15A NCAC 18A .2816 (b) (1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation. Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets. The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection. Observed correct sinks were not tested in kitchen. Hand sinks do not need to be tested for lead. The 2-comp sink labeled wash/rinse and the 1-comp sink labeled sanitize must be tested for lead.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed leak at hand sink in 2’s class. Loose faucet fixture in infant room.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed staff bathroom used as storage room with bulk supplies. 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed paper towels and single service cups stored below hand sink, rm 5.

15A NCAC 18A .2819 (c) and 15A NCAC 18A .2819 (d) (10). Diapering surfaces shall be disinfected using an approved disinfectant by spraying the entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry. Observed staff not clean/disinfect table before putting another child up. Disinfectant wiped back off immediately. Follow proper cleaning procedures

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 = 0 ppm chlorine. Use test strips to check strength.

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 improper diaper change, steps missing 4, 5, 10. Observed diaper changing procedure not posted near table. Retrain staff on proper diaper changing procedures.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed 2 unsecured aerosol air freshener dispenser. Pine cleaner unlocked in bathroom rm 6. Unlocked Windex in staff bathroom.

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 fungal growth on ceiling in girls bathroom, AS. Observed leak in ceiling and floor wet, girl’s after school (raining heavily)

15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair. Observed light fixture in upstairs bathroom comes on intermittently. 15A NCAC 18A .2826 (a). Shielded or shatterproof bulbs shall be used in food preparation, storage, and serving areas and in all rooms used by children. Observed light fixture without cover or shielding in room where freezer and refrigerator are.

15A NCAC 18A .2831 (b). (b) Pests shall be excluded from the child care center. Traps set for pests shall only be placed in areas that are inaccessible to children. Observed mouse droppings and torn up pieces of TP under the hand sink in staff bathroom. Have rodents eradicated from building.

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 turn of water with hand after assisting child wash their hands.

15A NCAC 18A .2810 (f) If food is prepared in a child care center classroom, then the classroom shall be equipped with a food preparation area. This food preparation area shall contain a countertop that is kept clean and in good repair, a handwash lavatory, and refrigeration when items are stored that require refrigeration. Observed refrigerator needs to move to other side of room to be next to the food prep hand sink, Rm 4.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed water < 80F at majority of hand sinks throughout center.

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. Testing drinking water is past due, send me results when completed.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed leaking hand sink, room #2.

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 weak disinfectant, had staff make a new batch to see procedure. Was using >130F water. Remade with cold water, procedure correct except for hot water. Corrected strength put into classrooms.

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 unlocked medication, parent was saying the prescription. Benadryl was emergency med. Director had emailed DCD on whether it needed to be locked or not. Miscommunication happened somewhere. Staff now knows that it is not qualified as emergency medication

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 cubbies doubled up with 2 children’s belongings, Rm #8.

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 tape residue on furniture. Dog bed with debris build up. clean cabinets/drawers of debris.

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 ceiling damage in gang bathroom for afterschool room. Chipped paint on walls, doors throughout. Several doors paint no longer cleanable.

15A NCAC 18A .2826 (a). Shielded or shatterproof bulbs shall be used in food preparation, storage, and serving areas and in all rooms used by children. Observed unprotected fluorescent lighting in gym.

15A NCAC 18A .2830 (b) Facilities shall be provided at the child care center for the washing and storage of solid waste containers and mops. The facilities shall include a faucet with a threaded nozzle that delivers water of at least 80 degrees Fahrenheit. The faucet shall be located in either a designated utility sink or above a curbed impervious pad that is sloped to drain to the approved sewage system. Observed can wash not draining and full of standing water.

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 outdoor play structures mildewed.

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 turn off water with hand, twice. Short wash times when assisting children. Coaching children to turn off water with hands.

15A NCAC 18A .2806 (d) Bulk food stored in a refrigerator shall be stored at 45 degrees Fahrenheit or below. Observed milk at 48F in dorm fridges, 2 classrooms. One fridge had a bad gasket and didn’t seal properly the other fridge was frozen up on the interior.

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 children’s drinks and food not properly labeled or dated in one classroom. 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 gallons of milk stored in dorm refrigerators and not holding <45F.

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 no digital thermometer.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed majority of refrigerators need cleaning of spills and debris.

15A NCAC 18A .2815 (e) (e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use. Observed hot water in kitchen 111F. Must meet min of 120F

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed water < 80F at majority of hand sinks throughout center.

15A NCAC 18A .2816 (b) (1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation. Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets. The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection. Observed water testing for lead past 3 years. 2023 water testing tested wrong sinks. Areas that need testing are 2-comp sink and large 1 comp sink used for sanitizing (not hand sink). 2 interior water fountains turned off and playground fountain broken (if these will be used at some point they need water testing as well.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed hand sink in one classroom turned off, repair and turn back on.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed storage under handsinks in several classrooms.

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 improper diaper change, steps omitted/wrong 3, 4, 5, 10, 11. Staff need training. Put diaper changing procedures closer so staff can reference.

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 contact paper peeling on tables in after school room. Large toys and toy/doll storage areas with debris. Sticky tape residue on shelves, cubbies. Observed table that child sneezed/blew nose on wiped off with a baby wipe. Spray with soapy water and then sanitize.

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. Through discussion staff said that toys were sprayed with disinfectant for cleaning. Follow above steps for cleaning mouthable toys.

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 ceiling damage in gang bathroom for afterschool room. Chipped paint on walls, doors throughout. Several doors paint no longer cleanable.

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 dusty ceiling fan blades.

15A NCAC 18A .2830 (b) Facilities shall be provided at the child care center for the washing and storage of solid waste containers and mops. The facilities shall include a faucet with a threaded nozzle that delivers water of at least 80 degrees Fahrenheit. The faucet shall be located in either a designated utility sink or above a curbed impervious pad that is sloped to drain to the approved sewage system. Observed can wash not draining and full of standing water.