BROWN ROAD KINDERCARE

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 one bottle of milk in infant 1 room with no date, and one bottle of milk in infant 2 room with no name or date. Ensure bottles are labeled properly. 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 two speciality milks with dates from previous weeks. Ensure speciality milks are sent in unopened at the beginning of each week and sent home or discarded at the end of each week.

General Comment: 15A NCAC 18A .2807 (h) Metal stem-type, thin probe, numerically scaled indicating product thermometers, accurate to ± 3 degrees Fahrenheit shall be used to ensure the maintenance of the internal cooking temperatures of all potentially hazardous foods required under this Rule. Observed no thin probe thermometer in kitchen. Kitchen employee was out today and Director is unsure where she keeps it. No points deducted.

General Comment: 15A NCAC 18A .2812 (e) Multi-service articles, including highchair feeding trays, shall be washed, rinsed and sanitized in the child care center kitchen after each use. Through discussion with teacher in infant room, high chair trays are sprayed with soapy water and sanitizer and rinsed in the sink in classroom. Ensure high chair trays are sent to the kitchen to be washed, rinsed, and sanitized.

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 ranging from 112-118F in majority of classrooms throughout center. Ensure hot water accessible to children is between 80-110F. 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 at handsink in infant room and bathroom handsink in pre-k 2 room. Ensure all sinks are supplied with paper towels.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed 2 out of 3 sinks in infant room being used as storage for diaper creams, hand sanitizer, and paper towels. Ensure lavatories are not used for storage. REPEAT

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed goo gone, vomit cleanup powder, and aerosol modge podge stored in unlocked cabinet in toddler 2 room. Ensure hazardous items are stored behind lock and key.

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 in infant room and toddler 2 room. Ensure diaper creams are stored at least 5ft up. 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 below 5ft in infant room. Ensure hand sanitizer is stored at least 5ft up.

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 stained ceiling tile in infant room. Replace.

General Comment: 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 one bottle of milk in infant room with no name or date. Ensure all bottles are labeled with name of child and date brought in to center.

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 in majority of classrooms at 111-117F. Ensure hot water accessible to children is between 80-110F. REPEAT

General Comment: 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed diaper changing sink with container of diaper creams stored inside. Lavatories should not be used for storage.

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 container of diaper creams stored below 5ft in infant room. Ensure diaper creams are stored 5ft up.

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 a few children in various classrooms with no sheets on cots during nap-time. Ensure every child has individual linens.

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. Observed through discussion with infant teacher that mouth-contact toys are cleaned by spraying with soapy water and then spraying with sanitizer. Ensure procedure above is followed for mouth-contact toys. Toys should be submerged in sanitizer for at least 2 minutes.

General Comment: 15A NCAC 18A .2825 (a) In child care centers, the walls and ceilings, including doors and windows, of all rooms and areas, shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. Observed stained ceiling tile in infant room. Replace.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Repeat-Observed hot water in classrooms closest to water heater 111-114F. Adjust mixing valve on water heater down a little. 15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Observed hot water in washer 110F.

15A NCAC 18A .2815 (f).. The water pressure of a drinking fountain shall be regulated so that an individual's mouth does not come in contact with the nozzle and so that water does not splash on the floor. Observed water fountains with water pressure too high. Needs adjusting

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Observed a couple hand sinks without paper towels, maintain all hand sinks stocked with soap and paper towels

15A NCAC 18A .2812 (i) Provide a testing method for chlorine disinfectant to ensure compliance with prescribed chlorine concentration. Observed no disinfectant test strips. Must be able to read in test range of 500-800 ppm.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlocked white board cleaner in room 6, unlocked disinfectant cleaner in room 7. Unlocked aerosol air fresheners in toddler’s room. Rooms 6 and 7 are NC Pre-K rooms and are closed for the summer, but items still need to be stored properly unless doors to rooms are locked.

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 on front desk counter.

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 sheets on cots in toddler 2

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 plywood on ground behind dumpster. Needs discarding

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 member wash child’s and her own hands too briefly. Wash for 20 seconds. Staff member turned off water with hand. Staff needs training on proper handwashing procedures.

15A NCAC 18A .2809 (2) Food-contact surfaces shall be kept clean and in good repair. Repeat- Observed ice floe in interior of freezer. Get leak repaired

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 in 3 classrooms closest to water heater 111-112F. Adjust mixing valve on water heater down a little. 15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Observed hot water in washer 110F.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed large chunk of basin broken in general hand washing sink, older toddlers. Sink needs replacing

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

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 alcohol pads, burn cream in first aid kits. Go through all first aid kits and remove medication, ice packs or other items that need locking.

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. Repeat-Observed teacher purse stored < 5 feet above 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 coats, backpacks in cubbies protruding from cubby and touching floor or other children’s items.

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 sticky tape residue on furniture, shelving, doors. Clean toys, bins, buckets of debris. Vinyl couches with worn vinyl. Most rooms need organizing to make cleaning easier.

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 ceiling vents with debris/dust. Window in shed cracked (plexiglass) 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 bulb not shatterproof in laundry room

.2832(c) (2)A sandbox used in outdoor play shall be constructed to allow for drainage of water and shall be covered when not in use and kept clean. Observed sandbox with no cover available for when not in use.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed staff member wash hands upon entering classroom.

15A NCAC 18A .2809 (2) Food-contact surfaces shall be kept clean and in good repair. Observed ice floe in interior of freezer. Get leak repaired

15A NCAC 18A .2815 (e) Repeat-Hot water supplied to clothes washing machines shall be 120°F or above. Observed washing machine did not meet at least 120F.

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. CDI-all bottles remade after watching cook prepare solution. Gave bleach dilution chart handout, along with instructions on calculating gallons that 3-comp sink vat holds, then figuring out amount of bleach needed.

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 spray bottles hanging < 5 feet above floor

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 < 5 feet above floor, room 7

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 many mats with splits in vinyl.

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 sticky tape residue on furniture, shelving. Clean toys, bins, buckets of debris. Vinyl couches with slit vinyl.

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 moisture damaged paint in hallway and ceiling tiles in bathroom room 9. Some door casings with chipped paint.

15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair. Observed light not working in closet, room 11. 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 vents.

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 cracked window in shed, needs replacing. Gate to back side of sheds won’t latch. Non-slip coating torn/missing on climbers. Large car structures not secured to ground and rocks on base, secure to ground so it cannot fall over (in removal process). Some toys molded on playground. Artificial turf is loose, bubbled and a trip/fall hazard.

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 specialty milk for 1 child dated more than 1 week ago. CDI-through discussion

15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Observed washing machine did not meet at least 120F.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlocked hazardous items: staff lounge-sternos, incl screw cap type, room 12-unlocked and unlabeled cleaners

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 < 5 ft above floor in Rm 12 and an office and hand lotion < 5 feet in office

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 some mats with splits in vinyl. Several classrooms mats stored flat with no barrier so sheets and floor sides of mats touching.

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 sticky tape residue on furniture, shelving. Clean toys, bins, buckets of debris. Vinyl couches with slit vinyl.

15A NCAC 18A .2827 (e). Any employee with boils, sores, burns, infected wounds, or other draining lesions on exposed skin shall bandage the affected area to avoid exposing others to drainage. If such bandaging obstructs handwashing as set out in Rule .2803 of this Section, if the exposure to drainage cannot be prevented, or if otherwise required under the rules in Section 10A NCAC 41A .0200, then the employee shall be excluded from food preparation and work activities that involve contact with other employees or children while risk of transmission of the communicable disease or condition exists. Discussed employee health policy

15A NCAC 18A .2827 (d). The child care center employees shall follow the establishment's written procedures for vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the center. Gave poster

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 cracked window in shed, needs replacing. Gate to back side of sheds won’t latch. Non-slip coating torn/missing on climbers. Large car structures not secured to ground and rocks on base, secure to ground so it cannot fall over. Some toys molded on playground. Artificial turf is loose, bubbled and a trip/fall hazard.