CHILDCARE NETWORK #52

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 one sink in Twos only reach 75F. Observed sink furthest from the door only reach 77F in Toddler room. Needs to be 80-110F.

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 small flies around some sinks. Treatment needs to be done to remove flies.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. 15A NCAC 18A .2817 (b) Toilet fixtures shall be cleaned and disinfected daily and when visibly soiled. Observed detailed cleaning needed to main hallway toilets to include outside corners, under toilet seats, and top of toilet seats. REPEAT.

General Comment: 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed bin of sippy cups stored in sink in Toddler room. Lavatories shall not be used for storage.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b).Keys used to access hazardous item storage must be out of reach of children (5 ft above the floor) and stored separately from lock. Observed storage closet in Threes room unlocked with key in lock. Needs to be locked with key stored 5ft above the 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 torn couch cushion in Prek 3 classroom and torn pillow in Threes classroom. Needs removal. REPEAT. 15A NCAC 18A .2822 (d).Water play centers shall be filled with potable water immediately before children begin a water play session. Water shall be emptied after each play session and at a minimum each morning and afternoon, or more often if no longer clean. Observed water in water play center in Prek 3 classroom. Teacher stated the water is emptied and changed before each session. Water needs to be emptied and not allowed to sit in water play center until it is changed.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed some build up on floors around edges of rooms. Observed floor in need of cleaning in closed classroom. Observed damaged flooring in Threes and small square of space missing laminate and wall edging at Prek 3. REPEAT.

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, provided by center, stored in dorm refrigerator unit infant classroom. EHS educated center on notated rule. 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 1 child’s bottles stored in dorm refrigerator unit without date in infant classroom.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. 15A NCAC 18A .2817 (b) Toilet fixtures shall be cleaned and disinfected daily and when visibly soiled. Observed detailed cleaning needed to main hallway toilets to include outside corners, under toilet seats, and top of toilet seats.

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 on table below 5 feet in 4’s classroom. -General comment.

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 general cleaning needed to toys throughout center. -General comment.

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 staining on floor tiles and damaged floor tiles in kitchen (under 3 compartment sink). 15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed large carpets throughout center stained and in need of detailed cleaning. 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 detailed cleaning needed to walling in school age classroom due to tape residue build up. Observed minor touch up paint needed to walling throughout center.

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 litter on outdoor learning environment (plastic cups and yogurt containers) 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 dilapidated furniture stored within dumpster enclosure area. Remove.

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 76F in NC PreK classroom.

15A NCAC 18A .2820 (c ) Sanitizing, disinfecting, and detergent solutions shall be labeled with the product name (ex. "Sanitizer"). Observed spray bottle containing water not labeled in NC PreK classroom 1. Teacher disposed of water during time of inspection. -General comment.

15A NCAC 18A .2821 (f).Linens shall be kept clean, in good repair, and stored with the mat or cot that the linens are assigned to or stored apart from the mattress or cot in a manner that keeps the linens used for each child separate from the linens belonging to other children. Observed purple staining on 1 child’s fitted sheet in infant classroom. -General comment. 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 a couple crib mattress fraying/tearing at creases. EHS advises center to repair or replace crib mattresses as needed.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed a piece of floor tile missing in infant classroom near handsinks. 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 floor tiles cracking and in need of repair in kitchen.

15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered. Observed debris/litter surrounding dumpster. -General comment.

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 washing hands incorrectly and not being coached. Close to entire classroom opened garbage can with their hand.

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 water on floor in kitchen. 15A NCAC 18A .2807 (d) Raw fruits and raw vegetables shall be washed with potable water before being cooked or served. Observed direct plumbed sink used for washing strawberries. Plumbing must be indirectly drained. 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 undated bottles and misdated sippy cup in infants.

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. Repeat-Observed high chair trays with dried, crusted food. High chair trays must go back to kitchen for W/R/S after every use.

15A NCAC 18A .2815 (e) Hot water supplied to clothes washing machines shall be 120°F or above. Observed water heater for washing machine not operable. Hot water to washing machine < 120F 15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed several classroom hand sinks < 80F, including kitchen hand sink. Adjust mixing valve.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed bins and toys in hand sinks. Storage under hand sinks. No storage in sinks or under plumbing.

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 changing procedures. One staff member kept dirty gloves on clear through child’s hands being washed. The other staff member was reading sign but missing steps. Infant classroom diaper can not fully lidded.

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 prescription diaper cream in 2’s classroom.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlocked spray paint in 3’s, unlocked whiteboard cleaner in Pre-K right side.

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 in lobby and Pre-K right

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, vinyl furniture in disrepair.

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 infant teacher pick up toy from floor and put back in clean bin. If toys have been on floor the need to be W/R/S. Through discussion she said she sprays toys with sanitizer. Follow preceding procedures

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 damaged ceiling tiles in kitchen and laundry room. Dusty sills, high touch areas with dirt/grime. Exterior door 3/4’s classroom sticks and hard to open. Have repaired for safety

15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair. Observed light out in 3’s room. Work surfaces < 50 f.c. of light. 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/rusted vents and filters.

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 key not able to open lock to can wash. Can wash not checked today. 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, large toy and a rug in/behind dumpster corral

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. Repeat-Observed drain flies in several classrooms and gang bathrooms.

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 drainage and erosion issues side of building. Ponding in low areas.