CHILDCARE NETWORK #91

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 at food prep sink in 3s classroom at 116F. Observed hot water at handsinks in NC Prek 1 at 114F. Needs to be 80-110F.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed fragrance spray stored in unlocked drawer in 3s classroom. Needs to be stored 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 lip balm, lotion, and hand sanitizer stored in unlocked drawer less than 5ft up in 3s classroom. Needs to be stored 5ft up or behind lock and key.

General Comment: 15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observed mats less than 18 inches apart when in use in 3s and NC Prek 1. Need to be 18 inches apart.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed floor damage in 4’s classroom. Observed floor damage in PreK 1 restroom. REPEAT.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed general cleaning needed to outside corners of toilets throughout center.

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 1 water play table filled with water in PreK classroom. EHS advises center to adhere to notated rule. -General comment.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed floor damage in 4’s classroom. Observed floor damage in PreK 1 restroom.

General Comment: 15A NCAC 18A .2812 (f) Kitchen surfaces that are not food-contact surfaces shall be kept clean. Observed build up/heavily worn kitchen cabinets. Need cleaning.

General Comment: 15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Observed single-use cups and plates stored on the floor in the storage room. Needs to be stored off the floor to protect from contamination.

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 at 114 in Threes and 113F in Twos at general handwashing sinks. Needs to be 80-110F.

General Comment: 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 staff member spray sanitizer instead of disinfectant after diaper change.

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 staff in infant room miss step 5 and only use a wipe instead of washing a child’s hands during diaper change. Needs to follow appropriate procedures.

15A NCAC 18A .2821 (d). Mats be stored so that the side of the mats that makes contact with the floor does not touch the side of a mat that any child sleeps on. The sleeping surface of one child's mat shall not come in contact with the sleeping surface of another child's mat during storage. Observed mats stacked in PreK and KPA4 classrooms in a manner where floor to sleeping side or sleeping and sleeping side are in contact. EHS recommended folding the mats.

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 play table filled with water and not being used in Threes and KPA4 classrooms. Staff in Threes classroom states she fills and changes water once a week. Water needs to be filled immediately before use and emptied at the end of each session.

15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day. Observed 1 child’s lunch stored in kitchen refrigerator not labeled with the date. -General comment.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed loose toilet seat in PreK 1 classroom and after school classroom (boys stall). Repair.

15A NCAC 18A .2822 (d) The water play centers, including toys, shall be cleaned and sanitized at least daily or more often if no longer clean. Water play is prohibited during the outbreak and investigation of a communicable disease or condition at the child care center. Observed water play table filled with water and not being used. EHS educated director on notated rule and water play table was emptied. -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 touch up paint needed to walling in toddler and 3’s classrooms.

15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day. Observed lunches brought into center without names or dates.

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

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 several children mouthing toys and the toy not being picked up and put in the dirty toy bucket upon discard by child.

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 exterior windows sill with chipping paint, needs repainting. Chipped paint on door jambs. Old carpeting in closets need removal. Cracked window in kitchen (lots of improvement, no points being taken)

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 ceiling vents dusty. Fan in kitchen dusty.

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. Repeat- Observed children in different classrooms turns off water with hands after hand washing. More coaching during hand washing needed.

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 clean cups on clean drain board of 3-comp sink. Tray with stuck on food soaking over 3-comp sink sanitizer vat and edge of clean side drain board. Keep dirty items away from clean areas so clean items don’t get splashed or contaminated.

15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area. Repeat- Observed several hand sinks without paper towels, you should not need to step over to another hand sink to get a paper towel. No soap in Pre-K 1

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed 2 hand sinks full of toys soaking or sitting in buckets. Keep hand sinks clear of all items so sink can be used for handwashing when needed.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed unlocked file cabinet with entire bottom drawer full of cleaning products in Pre-K 2. Unopened first aid kit with hazardous items 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. Repeat- Observed hand sanitizer on front desk < 5 ft above floor

15A NCAC 18A .2821 (d). Mats be stored so that the side of the mats that makes contact with the floor does not touch the side of a mat that any child sleeps on. The sleeping surface of one child's mat shall not come in contact with the sleeping surface of another child's mat during storage. Observed tri-fold mats folded where bottom side was of mat was touching clean sheets

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 damaged vinyl furniture, sticky tape residue, and dirt/debris on shelving and cubbys.

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 in walls where soap dispensers have been changed out. Exterior windows sill with chipping paint, needs repainting. Reoccurring water stain on ceiling tile in Pre-K 1, repair leak not just change tile.

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 PTAC filters dusty.

15A NCAC 18A .2831 (b). Sand toys, water tables, and other unfiltered items that can collect standing water in the outdoor learning environment shall be emptied and stored to prevent the collection of standing water. Observed several containers with rainwater. Keep emptied.

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 hands. Children need more coaching.

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 115F in 2’s classroom.

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 Keurig with water in reservoir in unlocked staff lounge. Staff lounge must be locked or remove Keurig.

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 food prep hand sink in infants. Keep paper towels at all handsinks.

15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed storage, dirty toys in and under hand sinks.

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 a couple keys < 5 feet above floor.

15A NCAC 18A .2820 (c ) Sanitizing, disinfecting, and detergent solutions shall be labeled with the product name (ex. "Sanitizer"). Observed hand sanitizer in Pre-K and hand lotion in different Pre-K stored < 5 ft above floor.

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 not labeled in toddler’s class. 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 in infant room all sheets but 1 were soiled in some way. A new procedure is needed for getting the dirty sheet off sooner and cleaning and sanitizing mattress it drool, spit-up etc bleeds through sheet

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 bins, shelving units, and large toys with dirt and debris. Frayed vinyl couch in 2’s classroom. 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 slimy water play table. Follow preceding rule

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 staff discussed toy cleaning in general handsinks without change of use, spraying with disinfectant. Spraying with sanitizer then disinfectant. Follow procedures for proper cleaning of mouth able toys.

15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair. Observed floor damage. Minor wall damage where dispensers have been removed. Baseboards fallen off wall. Broken window in Pre-K and cracked window in kitchen.

15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair. Observed light under hood not working. Fans, vents and PTAC filters dusty. Keep clean.