CHILDCARE NETWORK #93

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 package of graham crackers on shelving in toddler classroom not properly resealed. -General comment.

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 high vegetation on playgrounds. Observed dilapidated furniture stored outside dumpster area. Remove.

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

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 dial thermometer stored in kitchen not thin probe. -General comment.

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’s classroom 115F. Maintenance staff arrived, went back to room and hot water maxed out at 110F using his and my thermometers. Monitor temps in this room.

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 diapering procedure in toddler classroom. Follow posted procedures. Steps skipped/omitted 4, 5, 10. Gloves left on until child’s handwash and disinfectant wiped off immediately.

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 large toys in housekeeping centers need cleaning. Sticky tape residue needs to be removed from surfaces in rooms. Vinyl couches in 2 classroom in disrepair.

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 walls needing holes filled where dispenser has been changed to new style or location. Observed some walls needing wiping down where splattered. Walls, door jambs chipped. Popcorn ceiling in pantry. Note: A considerable amount of touch up painting has been done.

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 rain gauge with water and algae outside classroom. Gutters full of leaves and plants are growing out of the gutter. Landscape timbers on toddler playground rotted/broken with screw exposed.

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 and children turning off water with hand. Several children touching garbage can lids when throwing away paper towels. Coach staff and children to wash hands according to posted procedures.

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 provided by parent with no date.

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 kitchen cabinets/drawers in poor repair, interiors of drawers hard to keep clean.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies. Observed vinyl climbers stored in bathroom on end classroom.

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 no disinfectant 3’s class

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 Calmoseptine ointment stored as a diaper cream. This does not meet the intent of a diaper cream and needs to be 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 diaper creams stored less than 5’ above the floor with the key in the 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. Repeat-Observed books, bins, soft toys need cleaning. Sticky tape residue needs to be removed from surfaces in rooms.

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 walls needing holes filled where dispenser has been changed to new style or location. Observed some walls needing wiping down where splattered. Baseboards need cleaning in gap between wall and taller baseboard. Walls, door jambs chipped, one baseboard falling off in last classroom. Popcorn ceiling in pantry.

15A NCAC 18A .2832 (g). Storage provided in the outdoor learning environment for children's toys shall be kept clean and in good repair. Storage areas that are accessible to children shall be kept free of equipment that is not intended by the manufacturer to be used by children. Observed damaged border on back playground

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. Repeat- Observed sanitizer somewhere between 250-500 ppm chlorine. Use test strip, you don’t want sanitizer too strong or it may not evaporate off leaving a chlorine residual behind. Sanitizer must be 50-200 ppm chlorine

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed kitchen cabinets/drawers in poor repair, interiors of drawers hard to keep clean.

15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Observed plastic cups stored in baggie with the cup lips towards the top, store where the bottom of the cup is grabbed.

15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Repeat- No repairs made to hot water going to washer. Hot water < 120F

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 books, bins, large toys need cleaning or replacement. Sticky tape residue needs to be removed from surfaces in rooms.

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 popcorn ceiling in pantry. 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 chipped paint on interior window sills. Repeat- Baseboard gap needs dusting.

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 wall vent in classroom.

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 a couple tires holding water on playground. Rain gauge needs to be emptied more frequently.

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, coached and uncoached. Staff turning off water with hands. Children touching garbage can lids after handwashing.

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 >1000 ppm. Use test strip to make sure it is in range of 50-200 ppm chlorine.

15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Repeat- No hot water going to washer.

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 child taken to wash hands at diaper changing hand sink after using toilet. Children washing hands after toileting are to use the bathroom hand sink. Children washing hands after diaper change must go to diaper changing hand wash 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. Repeat- Observed incorrect diaper change, remove wipes before starting diaper change so the whole pack doesn’t get contaminated. Staff pushed extra wipes back down into container. Steps missed or in wrong order 5, 11.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed cleaning closet unlocked with several bottles and brands of cleaners inside.

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 diaper cream and several spray bottles < 5 feet above floor.

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 bins, shelves, crib sides with sticky tape residue or dirty.

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 walls needing holes filled where dispenser has been changed to new style or location. Observed some walls needing wiping down where splattered. Baseboards need cleaning in gap between wall and taller baseboard. Window sills and window areas need repainting where chipped.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed dumpster door open. Keep closed.

15A NCAC 18A .2807 (d) Raw fruits and raw vegetables shall be washed with potable water before being cooked or served. Observed unwashed pears in basket by front door, Director said they were for parents to take on their way out. Pears must be washed and individually wrapped OR provide note on basket saying pears need to be washed before eating.

15A NCAC 18A .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair. Observed kitchen cabinets/drawers in poor repair, some drawers with bottoms falling out and taped together.

15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Observed no hot water going to washer.

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 step #5 came after step #7. Training needed in ways to not contaminate whole container of wipes if more are required in the middle of the diaper change.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlocked liquid correction fluid in 2 classrooms. 2 spray bottles unlabeled in staff bathrooms.

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 feet above floor at desk and lobby.

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 and vinyl couch with peeling cover in toddler’s class.

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 popcorn ceiling in pantry. 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 holes need filling and touch up painting needed. Baseboard gap needs dusting.

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 dumpster rusted through. Needs replacing

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 a couple tires holding water on playground. Rain gauge needs to be emptied more frequently so algae is not growing in it.