CHILDCARE NETWORK #95

General Comment: 15A NCAC 18A .2804 (d) Formula and other beverages that require refrigeration, baby food that has been opened, and human milk shall be labeled with the name of the child to whom the beverage, baby food, or milk belongs and shall be refrigerated at 45 degrees Fahrenheit or below. Observed refrigerator in infant room reading around 50F. CDI - All bottles were moved to the kitchen refrigerator. The facility has been keeping a log for temperatures but has not been adjusting when the temperature is too high. The facility has turned the temperature down to thaw out the freezer section. The temperature was adjusted by the assistant director and the refrigerator came down quickly to 44F. EHS and staff discussed holding temperatures and what to do when the refrigerator is not holding temperature.

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 set of bottles missing date labels in infant classroom. Needs date received.

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 cabinet for seasonings with debris on shelving. Observed sticky residue on outside of the same cabinet. Need wiping out. REPEAT.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilets in need of cleaning in School age and Room 4 bathrooms. REPEAT VIOLATION. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed sink faucet handle leaking in School Age room. Needs repair.

General Comment: 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed toys stored in handsink in Room 4.

General Comment: 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 less than 500 ppm. Needs to be 500-800 ppm.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed peach air freshener stored in unlocked drawer in Room 5. CDI - Air freshener was moved to a locked cabinet.

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 one crib mattress torn in Infant room. Needs replacement. REPEAT VIOLATION.

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 to wall edging pulling away from wall in Room 6 bathroom and room 2 storage room. Needs repair. Observed dead insects in some bathrooms/storage rooms of classrooms. Needs cleaning/removal. REPEAT VIOLATION.

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 cabinet for seasonings with debris on shelving. Need wiping out. REPEAT.

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed toilet seats worn and no longer smooth in Room 6. Observed broken toilets in Room 1. Needs repair.

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 one crib mattress torn in Infant room 3. Observed two cots torn in room 1. Needs replacement.

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 toy shelf with plastic backing broken. Needs repair.

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 broken in Room 8 bathroom. Needs repair. 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 ceiling peeling in Room 7. (This room is not in use). Needs repair.

General Comment: 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 vent in kitchen and Room 4 ceiling with dust build up. Needs cleaning.

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 in room 8 turning off water with hand not paper towel. Staff should be coaching children.

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. Repeat- Observed no digital thermometer

15A NCAC 18A .2812 (h) After sanitizing, all equipment and utensils shall be air dried. Observed sippy cups wet stacked. Space out so they can air dry. 15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed dirty bottle warmer in infant room. Clean and sanitize daily.

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 and drawers with debris. Need wiping out.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Repeat-Observed hand sinks with build-up around fixtures, bowls rusted and faucet fixtures corroded. Slow drains at hand sinks in room 8.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed powdered cleanser unlocked in bathroom of room 6.

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 cots stored where floor side of mat touched sheet side of another mat, room 5. 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 soiled sheet on cot, room 5. 15A NCAC 18A .2821 (f) Linens shall be large enough to cover the bed, cot, or mat's sleeping surface. Observed children napping without sheets on mats/cots, room 8.

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 throughout, particularly window sills and closets where cots are stored. keep paint in good repair. Window sills in classrooms need wiping of dust.

15A NCAC 18A .2826 (a). Light fixtures in all areas shall be kept clean and in good repair. Observed splattered light cover in room 1.

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 spike protruding from mulch barrier on 3 year old’s playground.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed 2 children (different classrooms) not wash hands upon arrival.

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 digital thermometer

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 empty cup on diaper changing table, 2’s classroom. Through discussion with teachers, they are using the diaper changing table as a food prep surface. Room needs a shelf/counter top to use as a food prep area.

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/grime in 3-comp sink vats. Needs scrubbing.

15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Repeat-Observed spoons stored with bowl side up on counter, infant room.

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 employee bathroom not locked. Hot water 122F. Recommend a mixing valve be added to this sink.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed hand sinks with build-up around fixtures, bowls rusted and faucet fixtures corroded.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed kitchen with key in lock. Kitchen has locked cabinets, chemicals stored in unlocked cabinet in kitchen.

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.

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 books shelves, cubbys, toy shelves and vinyl couch with debris.

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 with infant room staff they said the soft toys get washed once a week and other toys get sprayed with sanitizer. Classrooms where the children mouth items, the toys need to be picked up and put in a dirty toy bucket after they have been mouthed and discarded, but before another child can mouth it. Follow above procedures for 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 chipped paint throughout, particularly window sills (lead check swabs negative) keep paint in good repair.

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 in office, staff bathroom.

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 knob removed from can wash hot water and now lost. Must have way go turning on hot water. If hot water is > 110F keep knob removed but accessible for when needed.

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 composite stair stringer cracked and exposed screw in 2’s playground

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Repeat-Observed debris build up in all 3 bottle warmers in infant room.

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 and drawers with debris. Microwave interior rusting

15A NCAC 18A .2814 (a) In child care centers, food-contact surfaces, equipment, utensils, and single service articles shall be protected from contamination. Observed spoons stored with bowl side up, bowls stored unprotected on counter, infant room.

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 114F in after school class. Adjust mixing valve

15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed one toilet bagged up (not in use), 4’s classroom, have repaired.

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 weak (< 500 ppm).

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 children’s coats/backpacks touching. Store items in cubbies since not enough hooks.

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 frayed vinyl cubes in one class. Repeat- Bins/cubbys with debris most classrooms. After school room with broken housekeeping play area cabinet, large toys with debris.

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 chipped paint on exterior of building. Mold growth on wall in mop closet. Textured ceiling in bathroom/class dirty in several classrooms. This ceiling will need to be scraped to remove the texture so can be easily cleanable. Kitchen ceiling splattered and dusty. Interior walls and door casings chipped, shelving in closets with chipped paint

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 moldy vent covers throughout.

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 bottles for 2 different children undated

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 digital thermometer.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed debris build up in both bottle warmers in infant room. 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 going to clean high chair tray in room, trays need to be taken to the kitchen for cleaning after every use. May need to get more than one tray. Some of the trays are not removable, but still need to be cleaned in kitchen.

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 staff bathroom with flimsy latch, lock needs to be replaced.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed sink faucets very corroded in Meck Pre-K. Fixtures need replacing

15A NCAC 18A .2819 (d). (9), Diapering surfaces shall be cleaned, prior to disinfection, by spraying the entire diapering surface with detergent solution and wiping clean, using disposable paper towels. Observed mulch and debris on changing table in 2’s classroom.

15A NCAC 18A .2819 (h) Signs that instruct child care center employees on proper methods of diaper changing and handwashing as set forth in the rules of this Section shall be posted in each diaper changing area. Observed diaper changing procedure signs too far from changing table to be read during diaper change. Move signs closer.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed cleaners/aerosols stored in staff bathroom with faulty lock. Replace lock with keyed lock. Observed first aid kit with alcohol swabs, white board cleaner in closets with eye hook latches. Hazardous items must be under lock and key, magnetic locks, or combo locks. 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 keys stored in locks.

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, diaper cream and chap stick stored < 5 feet 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 classrooms with unclear cot/mat labeling. One classroom was using cot sheets on mats so a large portion of mat not covered.

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 frayed vinyl climber in toddlers class. Bins/cubbys with debris most classrooms.

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 infant teacher said they just spray the toys off with sanitizer. Follow above procedure.

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 tile damage in bathroom, older 3’s class. 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 exterior of building. Mold growth on wall in mop closet. Textured ceiling in bathroom dirty in young 3’s class. This ceiling will need to be scraped to remove the texture so can be easily cleanable. Kitchen ceiling splattered and dusty.

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 water and mosquitos in one toy box. Keep all bins/boxes clean and drained