CHILDCARE NETWORK #92B

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 opened packaging of baby cereal in infant classroom not properly resealed.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes (50-200ppm chlorine). Observed sanitizer measuring at 1000ppm chlorine in toddler classroom. EHS emailed center bleach dilutions chart.

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 bulk Similac milk stored in dorm sized refrigerator in infant classroom. EHS advises center to adhere to notated rule.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed hallway restroom toilet in need of detailed cleaning. Per Director, children do not utilize that restroom, center should still adhere to notated rule. -General comment.

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 disposable towels at handsink in hallway restroom. Disposable towels were supplied to handsink during time of inspection.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed hand soap not easily accessible at one hand sink in wobbler’s class. No paper towels in either bathroom. Must be stocked even if not used.

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 a couple cubby bins with debris and tape residue on shelf.

15A NCAC 18A .2804 (i) A water bottle that a child brings to the child care center from home and that is used only for water consumption by that child shall be exempt from the requirements of 2804 (h). Instead, the water bottle shall be labeled with the name of the child to whom the water bottle belongs, individually stored in the child's cubby, and sent home with the child at the end of the day. Observed sippy cups in toddler’s classroom that appear to be getting rinsed out and reused in classroom. Sippy cups cannot be washed or rinsed out in the classroom. The property of the parents must go home at end of the day. If center wants to provide sippy cups a 3-comp sink or a dishwasher will need to be installed

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 baby food stored on counter top in splash zone of hand sink.

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 staff cleaning high chair feeding trays in classroom, wobblers. High chair trays must be washed, rinsed then sanitized in 2-comp sink. In infant classroom food debris on high chair and high chair tray. Needs to be cleaned/sanitized in kitchen sink.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Repeat-Observed damaged vanity interiors in infants and toddlers rooms. Leak at hand sink in infant room.

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 < 500 ppm chlorine. Use test strip to check 500-800 ppm

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. Dirty. Gloves not removed before putting clean diaper back on. Child’s hands were not washed at end of diaper change. Diaper changing table cleaned and then sanitized, instead of cleaned and disinfected.

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 debris in cubby bins, torn books, frayed vinyl couch, sticky spills in large toys.

15A NCAC 18A .2825 (a) In child care centers, the floors, 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 damage to floors. Chipped areas on front door and walls.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed trash on ground around dumpster.

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 a lot of mouse droppings under hand sink in toddlers classroom.

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 Repeat -Observed no food prep area(table, shelf, etc) in waddler’s class. Area is needed to put bibs, sippy cups. No points today, PIC misunderstood and thought I meant installing splash guards (which were installed). A table, shelf is needed.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Through discussion, teacher said she is washing infants hands at the food prep hand sink. This sink is >120F, strongly recommend a mixing valve be installed. Temper 80-110F.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Repeat-Observed damaged vanity interiors in infants and toddlers rooms. Sink fixture with build up around base in middle classroom.

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 bathroom. Staff said this bathroom is not used. Still needs to be stocked

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Repeat- Observed storage in hand sinks. Keep hand sinks clear of toys, bibs,etc. All clean items must be stored away from the splash zone.

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 < 500 ppm chlorine. Use test strip to check 500-800 ppm

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 water intrusion below plexiglass in middle classroom, air out and reseal before wood starts to swell.

15A NCAC 18A .2822 (c) Toys, furniture, cribs, or other items accessible to children shall be free of peeling, flaking, or chalking paint. Observed shelf and shelving on screened-in porch with tape residue. Cubby bins need wiping out old debris.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair.Repeat- Observed floor damage throughout facility. Observed chipped wood interior front door.

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 on screened-in porch

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. Repeat-Observed trash on ground around dumpster. Keep area clean

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 staff touch garbage can lid with hand after washing hands, infants

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 waddler area need food prep area to store food,sippy cups, etc.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed damaged vanity interiors in infants and toddlers rooms

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed hand soap at 2-comp sink in infant room.Repeat- Keep hand soap at hand wash sink, do not wash hands in 2-comp sink.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Repeat- Observed storage in and under hand sinks. Keep hand sinks clear of toys, bibs,etc

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 stored at hand sink, waddlers. Hand sanitizer must be stored 5 feet above floor. Do not use hand sanitizer in lieu of hand washing with soap.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair.Repeat- Observed floor damage throughout facility.

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. Repeat-Observed trash on ground around dumpster. Keep area clean

15A NCAC 18A .2831 (d). Pesticides shall be stored in a locked storage room or cabinet separate from foods and medications. Observed rodent bait station under 2-comp sink, infants

15A NCAC 18A .2831 (i) Grass, fruit and vegetable gardens, vines on fences, and other vegetation shall be maintained to prevent the harboring and breeding of pests. Observed flowering vine growing over fence.Repeat- Observed “elephant ear” type vegetation growing in mulch bed on playground.

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 no water testing for lead in drinking water results for the 2-comp sink in the infant room (approved kitchen). 15A NCAC 18A .2816 (a) 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). Lead hazard investigation completed March 27,2024. EH has not received an approvable remediation plan. Remediation plan must be submitted by 6/17/24. Center will remain on either Provisional or Disapproved status until remediation completed. Visible chipped paint at old window over ramp to entrance.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed hand soap and paper towels at 2-comp sink in infant room, need to be moved to hand sink. No paper towels within reach at waddlers class.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed sippy cup in hand sink in infant 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. Repeat-Observed debris in children’s cubby/tubs. Rusted hand rails in bathroom.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Repeat-Observed damage to floors throughout. 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 damage to walls throughout. Peeling paint on exterior of building incl the chimney. Repair floors and walls throughout facility.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Repeat-Observed debris/trash on the ground around dumpster area. Clean debris.

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 mushrooms and other vegetation growing in playground mulch

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 teachers in waddlers and infant classroom turn off faucet with clean hands. Need to use paper towels to turn off the faucet.

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 food prep area in Waddlers classroom does not have adequate counter space. Needs more counter space.

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 through discussion with staff that facility is cleaning high chair feeding trays in food prep sink in waddlers classroom. Needs to be cleaned in kitchen sink.

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 under high chair trays in waddlers classroom.

15A NCAC 18A .2814 (b) Cleaned and sanitized utensils and equipment shall be stored above the floor in a clean, dry location and shall be kept clean while stored. The food-contact surfaces of fixed equipment shall be kept clean while stored or otherwise not in use. Equipment and utensils shall not be stored under exposed sewer lines. Observed refrigerator in waddlers classroom stored under diaper changing sink. Staining on top of refrigerator shows evidence of a possible past or present leak. Equipments shall not be stored under exposed sewer lines.

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 backflow preventor missing on front of building at spigot under screen porch. Needs backflow preventor.

General comment: 15A NCAC 18A .2816 (b) (1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation. Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets. The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection. Observed facility has had water tested in Toddler classroom handsink. Needs to be tested at two-compartment food prep sink in Infant room.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed damage to children’s bathroom sinks in toilet room. Needs repair/replacement.

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 employee perform a diaper change in waddlers classroom and cleaned the surface by spraying sanitizer, then soapy water, and wiping it up with a paper towel. Needs to spray with disinfectant and let air dry or remain on surface for two minutes. EHS and staff discussed following appropriate disinfection procedures.

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 change in waddlers room. Employee skipped steps 4 and 5. Needs to follow procedure.

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 stored less than 5ft up in waddlers room and at entrance. Needs to be stored 5ft above the floor or behind lock and key.

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 rusting rail in staff bathroom. Observed high chair rusting at legs in waddlers classroom. Observed build up in the bottom of storage bins in waddlers classrooms. Needs cleaning/repair.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed damage to floors throughout. 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 damage to walls throughout. Repair floors and walls throughout facility.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed debris on the ground around dumpster area. Observed dumpster doors open. Doors need to be closed. Clean debris.