BABIES & BEYOND ACADEMY

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 baby bottles without date in infant refrigerator. Ensure to label all items send from home with name and date received at the center.

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 infant refrigerator without a indicator thermometer inside, obtain an indicator thermometer and put it at the warmest part of the refrigerator. Observed the center without a thin probe food thermometer. Obtain a thin probe food thermometer and have it available at anytime for use.

General Comment: 15A NCAC 18A .2810 (f). Water from a handwash lavatory shall not be used for bottle warming or to prepare formula, mix dry cereals, or other foods.- Observed water in the bottle warmer. When asked teacher where the water come from, teacher stated water comes from food prep sink. EHS, director, and teacher discussed proper process. Water needs to come from the kitchen or bottle water, not from the hand sink.

REPEAT 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 solution bottle in infant room measured more than 1000 ppm and the other bottle in share restroom measured less than 50 ppm. Ensure to provide correct chlorine sanitizer solution between 50- 200 ppm at anytime.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed slow draining at food prep sink in infant room. Observed draining pipe is leaking at the 3 compartment sinks in the kitchen need repair.

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 solution bottle in share restroom measured at 0 ppm. Provide correct chlorine disinfectant solution between 500-800 ppm at anytime.

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 cream in a basket on shelving in ABA room and a diaper cream in drawer in girl restroom stored less than 5ft. Ensure to put all diaper cream at 5ft or higher at anytime . REPEAT 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/ hand lotion bottle in basket on shelf in ABA room, hand sanitizer on a desk in unlock office. Ensure to put all non hazardous items at 5ft or higher at all time.

General Comment: 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 staff and teacher personal bags and purses on the floor/shelf/chair less than 5ft in infant room, unlock office, and ABA room. Ensure to keep/store all personal belongings that contain no hazardous items inside at 5ft or higher at all time. 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 book bag and jackets in the cubbies touching and over lapping each other. Ensure to keep all individual items separate and not allow in contact at anytime while storing at anytime.

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 two damaged at corners of the mats on top of the cots in hallway. Provide good repair mats and cots for children.

REPEAT 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 wall edging peeling around hand sink in girl restroom. Observed dropping ceiling tiles in restrooms, water stained ceiling tiles in part of the building. Needs repair.

Provide15A NCAC 18A .2812 (j) (j) A sanitizing solution shall be provided for cleaning purposes. Observed sanitizer in infant reading below 50 ppm and not labeled. Observed sanitizer in boys bathroom reading 500 ppm. Needs to be 50-200 ppm. REPEAT.

15A NCAC 18A .2819 (c). Approved disinfectants and detergent solutions shall be kept in separate and labeled bottles at each diaper changing station. Observed no disinfectant at diaper station in girls bathroom. Needs disinfectant. REPEAT. 15A NCAC 18A .2819 (b). Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair. Observed tears in diaper pad in infant room and in boys bathroom. Observed build up on diaper pad in girls bathroom. Needs repair/replacement/cleaning.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed one Lysol aerosol stored unlocked in infant room. Needs to be stored locked.

General Comment: 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 soapy water less than 5ft up in infant room. Observed hand sanitizer/lotion from therapists less than 5ft up in therapy room.

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 one mat within 18 inches of others in toddler 1/2 room. 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 no sheets on cots in Toddler 1/2 room.

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 some tearing on couch and chair in Toddler 1/2 room. Needs repair/replacement.

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 wall edging peeling in therapy room next to door. Observed some peeling on wall in PreK classroom. Needs repair.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed child’s hands not washed after diaper change.

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 too strong (bleaching out strip). Use test strip to check for proper strength (50-200 ppm chlorine)

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 paper towels and soap not located at both hand sinks in infant room.

Approved Disinfectant" means a chlorine solution containing 500 to 800 parts per million (ppm) of chlorine or a disinfectant as defined at 40 C.F.R. 158.2203 that is registered with the United States Environmental Protection Agency (EPA) in accordance with 40 C.F.R. 152 with use indicated in schools and child care settings and that is prepared and maintained in accordance with Rule .2812(i) of this Section. .2812(i) An approved disinfectant shall be provided for cleaning purposes. Throughout this Section, when an approved disinfectant is used in a child care center, the manufacturer's Safety Data Sheets for the disinfectant product shall be kept on file at the child care center and the instructions for use of the disinfectant product shall be followed. Observed disinfectant being used in spray bottles is a cleaner/disinfectant this must be locked. Labeling on spray bottles will need the name of the product unless using bleach and water mixture. SDS sheets for commercial disinfectants must be kept on site for review.

15A NCAC 18A .2819 (c). Approved disinfectants and detergent solutions shall be kept in separate and labeled bottles at each diaper changing station. Observed no disinfectant at diaper changing station in bathroom. 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 incorrect diaper changing procedure. Most posted procedures where they can be viewed when diaper changing. Steps missing 5,8, 10.

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 on ground around dumpsters.

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 turning off water with hand. Use paper towel to turn off water.

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 from home not labeled or dated.

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 multi-use being stored in 3rd compartment of dish sink. More shelving needed

15A NCAC 18A .2817 (a) In child care centers, toilet tissue paper shall be provided in each toilet room and stored in a clean, dry place. Observed toilet paper too far to reach in boy’s bathroom, have toilet paper accessible. 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 several hand sinks. Paper towels must be located at hand sinks

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 disinfectant is a Mr. Clean product that is diluted by staff. No contact times on original packaging. Use a bleach and water solution measuring 500-800 ppm. PDI wipes are approved but SDS sheet must be available for review 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 diaper changing table just sprayed with sanitizer. Follow posted cleaning procedures.

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 jock itch cream unlocked in a child’s diaper bag.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed toy and highchair cleaner stored unlocked. Mr. Clean disinfectant not locked. Storage room door not locked, alcohol, cleaners, large first aid kit inside. Small first aid kits in classrooms need alcohol pads removed.

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 cribs not labeled with child’s name. Names were located on wall behind cribs, cribs themselves must also be labeled

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 on ground, bags may have been mauled by animals. Whole dumpster area covered in spilled trash. Community dumpsters. Staff said regular garbage pick-up wasn’t done because of the holidays.