CHILDCARE NETWORK #90

Observed bulk milk brought from home not labeled in the kitchen. This week dates were added. GENERAL COMMENT **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 rusted sink in the 2 year old room. Observed slow drain in infant room. **15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair

Observed sitting chairs stored in the bathroom in toddler room. **15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.

Observed wall peeling near the toilet in the restroom in 2 year old room. Observed window sills in need of retouch of paint. **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.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed fronts of cabinets in kitchen sticky.

15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Observed unwrapped plastic cups in outside bags. Cups discarded

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed slow drain at staff bathroom hand sink.

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 incorrect diaper changing procedure. Clean diaper put on before steps 4 and 5 were done.

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 cots in 4’s classroom need relabeling, many unreadable, a couple had different children sleeping on the labeled cot.

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 cubby bins with debris, torn books, tape residue on furniture.

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 smudges/grime on high touch surfaces. Keep working on touch up painting interior and exterior. Window sills dusty in areas. Outside bags with debris on inside, clean out more frequently.

15A NCAC 18A .2830 (d) Solid wastes shall be disposed of to prevent conditions that attract and harbor pests and other public health nuisances. Repeat-Observed trash on ground around dumpster including wet cardboard next to dumpster

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 broken soffit on way to playground. Exterior siding damaged along backside of building. Rotted landscape timbers and protruding spikes on walkway outside trailer.

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 child in afterschool room turn off water with hand. Staff and children need to follow proper handwashing steps.

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 almost empty specialty milk provided by parent with no name or date. Specialty milks need to be new at beginning of week.

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 broken ambient air thermometer in refrigerator. Needs replacing.

15A NCAC 18A .2812 (h) After sanitizing, all equipment and utensils shall be air dried. Observed wet stacked sippy cups. Let air dry before stacking

15A NCAC 18A .2815 (c). A child care center's water supply plumbing shall not include cross-connections as set out in 15A NCAC 18C .0102(c)(8). If the potential for back siphonage or backflow conditions exist, an atmospheric vacuum breaker or backflow prevention device shall be installed. Repeat- Observed no backflow preventer on water faucet on playground

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). Repeat- Observed disinfectant ~250 ppm. Use test strip to check for proper concentration

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosol sunscreen unlocked in toddler room. Recommend parent supply non-aerosol sunscreen, then it only needs to be 5’ above the floor.

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 bags and belongings stacked together on floor of after school room.

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 some debris in cubby bins, tape residue on furniture. Considerable improvement

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/paint damage to ceiling at back door to playground. Keep working on touch up painting.

15A NCAC 18A .2830 (d) Solid wastes shall be disposed of to prevent conditions that attract and harbor pests and other public health nuisances. Observed trash on ground behind dumpster and wet cardboard next to dumpster

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 broken swing. Gate in disrepair at bottom (near tree roots).

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed staff not wash hands after returning to kitchen and before handling clean items.

15A NCAC 18A .2806 (f) Food and containers of food shall not be stored under exposed sewer lines. Food shall not be stored in toilet or laundry rooms, except that child care centers licensed for fewer than 13 children and located in a residence may store food in laundry rooms if the food is stored and protected as required in rule 2806 (g). Observed reach in freezer in laundry room.

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 > 200 ppm chlorine. Use test strip to make sure bleach water is 50-200 ppm.

15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Observed paper napkins and cups stored in bathroom in 1 classroom. CDI-items removed

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 and laundry room doors not locked. Keep laundry room locked at all times. Keep kitchen locked when no staff present.

15A NCAC 18A .2815 (c). A child care center's water supply plumbing shall not include cross-connections as set out in 15A NCAC 18C .0102(c)(8). If the potential for back siphonage or backflow conditions exist, an atmospheric vacuum breaker or backflow prevention device shall be installed. Repeat- Observed no backflow preventer on water faucet on playground

15A NCAC 18A .2812 (i) Provide a testing method for chlorine disinfectant to ensure compliance with prescribed chlorine concentration. Observed disinfectant > 800 ppm chlorine. Use test strip to provide a strength of 500-800 ppm chlorine.

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. Repeat-Observed blankets stored under sheets causing sheet to touch upper cot.

15A NCAC 18A .2822 (a) Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. Repeat-Observed shelving, bins, cubby tubs with debris.

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 on toy cleaning in infant room, above rules are not being followed. More stringent cleaning is needed where children are not potty trained.

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 many areas where walls grimy looking, repaint if paint damaged or not cleanable. Repeat- Observed chipped paint on interior surfaces throughout.

15A NCAC 18A .2826 (a). In child care centers, all rooms and enclosed areas shall be lighted by natural or artificial light. Lighting shall be capable of illumination to at least 50 foot-candles at work surfaces. Lighting shall be capable of illumination to at least 10 foot-candles of light, at 30 inches above the floor, in all other areas, including storage rooms. Observed lighting in afterschool bathroom < 10 fc. Provide more lighting, should be able to see well enough for proper cleaning.

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. Repeat- Observed holes in siding and peeling paint on exterior of building. Repair holes in the side of the buildings.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed staff member not wash hands at end of diaper change, toddlers.

15A NCAC 18A .2806 (f) Food and containers of food shall not be stored under exposed sewer lines. Food shall not be stored in toilet or laundry rooms, except that child care centers licensed for fewer than 13 children and located in a residence may store food in laundry rooms if the food is stored and protected as required in rule 2806 (g). Observed no door between laundry area and kitchen. A door needs to be installed/reinstalled.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed grime build-up in corners and interior of 3-comp sink. Thorough scrubbing needed.

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 112F in staff restroom. Adjust mixing valve

15A NCAC 18A .2815 (e) Hot water that exceeds 120 degrees Fahrenheit is a burn hazard and shall not be provided in areas accessible to children. Observed hot water at can wash (exterior of building) 125F. Remove knob or make inaccessible. (Maintain knob for can wash operation)

15A NCAC 18A .2815 (c). A child care center's water supply plumbing shall not include cross-connections as set out in 15A NCAC 18C .0102(c)(8). If the potential for back siphonage or backflow conditions exist, an atmospheric vacuum breaker or backflow prevention device shall be installed. Observed no backflow preventer on water faucet on playground

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed grime build-up in hand sinks in 2’s classroom.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosol spray can and aerosol mister in staff bathroom, both containers empty. Aerosols must be locked

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 blankets stored under sheets causing sheet to touch upper cot.

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 shelving, bins, cubby tubs with 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 many areas where walls grimy looking, repaint if paint damaged or not cleanable. Observed chipped paint on interior surfaces. Ceiling in kitchen is peeling over clean containers. Repair ceiling.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed dumpster with no drain plug. Critter is pulling trash out through hole. Bags of trash behind dumpster.

15A NCAC 18A .2831 (f), and (g). All exterior non-painted wood installed before 1/1/06 must be sealed or stained at least every 2 years. Seal wood with either an oil-based, semi-transparent sealant, oil-based clear stain, or water-based clear stain. Observed what looks like old CCA wood landscape timbers. Supply date they were installed, seal or replace

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 rotted wood and peeling paint on exterior of building. Repair rot and holes in the side of the buildings.