922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation and ECE-TRIS, the surveyor found one (1) staff member (DOH: 07/12/18) completed nine (9) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 07/01/23-06/30/24. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Kitchen Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found one (1) child’s file (DOE: 08/20/23) contained an immunization certificate that was no longer current after 04/15/24; therefore, the child care center failed to maintain a current immunization certificate for the child. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on review of documentation, the surveyor found the following: 1. A staff’s (DOH: 05/20/19) file contained documentation of a background check submitted through KARES that verified the staff’s eligibility date as 05/13/19. Upon review of the child-care center's KARES report, the surveyor found that the staff person's fingerprints were expired. Through interview with staff-in-charge, she stated that the staff person had not received new fingerprints and the staff person had not worked at the child care center since 05/13/24. 2. A staff’s (DOH: 03/19/24) file contained documentation of background checks submitted through the KARES that verified the staff's eligibility date as 04/09/24; therefore, the staff member was hired prior to clearance for employment. 3. A staff’s (DOH: 03/19/24) file contained documentation of a background check submitted through KARES that verified the staff’s eligibility date as 04/04/24. The documentation verified that the staff person lived in the state of Georgia within the last five (5) years. The staff’s file did not contain a completed out of state Child Abuse/Neglect Background Check (CAN) or a check of the state’s sex offender registry. The surveyor observed the staff person working with another staff person and children in Toddler Classroom on the day of the surveyor’s visit. During Interview with staff-in-charge, she stated that she was not aware that the staff person mentioned had lived in Georgia. Supervision In Compliance Staffing Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report General Administration Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found a seven-year-old child sitting in a chair in the hallways adjacent to the kitchen. At 11:45 am, the surveyor observed the child to stand up and walk over to the restroom with no socks or shoes on. The surveyor observed the child to proceed to enter the restroom to wash her hands; therefore, the health, safety and comfort of the child was compromised. During interview, staff confirmed that the child was seven-years-old.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 13. Reports.

General: Based on observation, the surveyor found that a seven-year-old child was sitting in a chair in the hallway adjacent to the kitchen area when the surveyor first arrived to the child-care center. The surveyor reviewed the child-care center's DRCC diagram to find that the space was not licensed for a classroom area. During interview with staff-in-charge, she stated that the area that the child was observed to be sitting in was the School Age Area and that the child-care center had switched the rooms a few months ago; therefore, the child- care center failed to notify the cabinet of any changes that resulted in a change of square footage and adding of a classroom. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 03/19/24) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found that the Preschool Classroom had twelve (12) children present, with the youngest child being three-years-old and the oldest child being eight (8) years old. The surveyor observed the Preschool Classroom to be set up for preschool aged children and did not have a separate area for school age children to participate in activities; therefore, the child-care center failed to ensure that the school age children had a separate space than the preschool age children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. The Two's Classroom had approximately ten (10) children present on the day of the surveyor's visit. The surveyor reviewed the child-care center's DRCC diagram and found that the space was licensed for nine (9) children; therefore, the child-care center failed to ensure there was at least thirty-five (35) square feet per child. 2. The Toddler Classroom had approximately twelve (12) children present on the day of the surveyor's visit. The surveyor reviewed the child-care center's DRCC diagram and found that the space was licensed for eleven (11) children; therefore, the child-care center failed to ensure there was at least thirty-five (35) square feet per child. Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found that a child's (DOE: 05/28/24) file did not contain an enrollment packet; therefore, the child-care center did not have a file that contained contact information to enable a person in charge to contact the child’s parents, the name of each person who is designated in writing to pick-up the child, the name and telephone number of each person to be contacted in an emergency involving or impacting the child, the name and contact telephone number for the child’s preferred hospital, the name and contact telephone number for the child's preferred physician, authorization by the parent for the child-care center to seek emergency medical care for the child in the parent’s absence or the child's medical information. Written Documentation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on a review of ECE-TRIS, the surveyor found a staff member (DOH: 10/30/23) did not complete CPR/First Aid training.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of ECE-TRIS, the surveyor found a staff member (DOH: 10/30/23) did not obtain the six (6) hours of cabinet-approved orientation within the first three (3) months of employment. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation, the surveyor found one (1) crib contained a fitted sheet in the Nursery that appeared to be soiled; therefore, the tight fitted sheet was not clean. Staff reported the sheet would be changed. Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found the following: 1. The toilet seat moved easily and was not tightly secured to the toilet in the first restroom located in the School Age Classroom; therefore, the toilet was not kept in good repair. 2. The toilet seat moved easily and was not tightly secured to the toilet in the second restroom located in the School Age Classroom; therefore, the toilet was not kept in good repair. Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on observation, the surveyor found the following in an unlocked gray desk drawer in the School Age Classroom, 1. A small white bottle with attached lid that contained a label on the bottle that read, "Walgreens" and "Ondansetron 4MG Tablets." 2. A small bottle with attached lid that contained a label that read, “Baptist Health Pharmacy” and "Nystatin 100000 Unit/GM Powder.” 3. An orange bottle with attached lid that contained a label that read, “Walgreens” and “Loratadine 5MG/ML Child Syrup.” 4. A box that contained a bottle of Children’s Tylenol that read, “Keep Out of the Reach of Children,” on the label. 5. A bottle of Children’s Motrin in a clear plastic zip lock bag that read, “Keep Out of the Reach of Children,” on the label. 6. A box that contained a bottle of Children’s Benadryl that read, “Keep Out of the Reach of Children,” on the label. 7. A small bottle of Allegra Allergy that read, “Keep Out of the Reach of Children,” on the label. 8. A bottle of Tums that read, “Keep Out of the Reach of Children,” on the label. 9. A tube of Extra Strength Benadryl Itch Stopping Cream that read, “Keep Out of the Reach of Children,” on the label. 10. An unopened box that read, “Neosporin,” and read, “Keep Out of the Reach of Children,” on the label. 11. A bottle of Neutrogena Sunscreen that read, “Keep Out of the Reach of Children,” on the label. The items mentioned were observed to be easily accessible to the children. The surveyor observed three (3) children in the School Age Classroom upon arrival at the child-care center at approximately 10:22 a.m. The children were observed to be moved to the Preschool Classroom at approximately 10:40 a.m. Through interview with staff, the surveyor learned that the children were four-years-old. The surveyor observed children to walk by the desk to go to the restroom located in the School Age Classroom. During interview, staff- in-charge stated that she would move the items mentioned to make them inaccessible to the children. Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Kitchen Requirements Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found the following: 1. The surveyor observed a bottle of Dove Antibacterial Soap on the sink in the Two Year Old Classroom that stated, “Keep Out of the Reach of Children,” on the label. The soap was observed to be accessible to the children. 2. The surveyor observed a small container of Source Depot Sanitizing Wipes on the sink in the Two Year Old Classroom that stated, “Keep Out of the Reach of Children,” on the label. The sanitizing wipes were observed to be accessible to the children. 3. A bottle of Dove Antibacterial Soap on the sink in the second restroom in the School Age Classroom that stated, “Keep Out of the Reach of Children,” on the label. The soap was observed to be accessible to the children. 4. Suave Deodorant inside an unlocked gray desk drawer in the School Age Classroom that read, “Keep Out of the Reach of Children,” on the label. The item mentioned was observed to be accessible to the children. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that none of the center's staff had a current certification in First Aid. The staff's files contained documentation that stated, "Basic Life Support (CPR and AED) Program." During interview, staff-in-charge stated that she was not aware the training did not include First Aid.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of ECE-TRIS, the surveyor found that a staff (DOH: 07/12/18) obtained fourteen (14) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/01/21 – 06/30/22. Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found that the lesson plan posted in the Toddler Classroom was dated for 12/26/22 - 12/30/22; therefore, the lesson plan was not current. During interview, staff-in-charge stated that she thought she had replaced the lesson plan with the current lesson plan. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found that the sink located in the first restroom in the School Age Classroom was observed to not drain properly; therefore, the sink was not kept in good repair.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found an approximate one-half (1/2) hole in the bottom of the wall beside the toilet in the second restroom that was located in the School Age Classroom; therefore, the wall was not kept in good repair. During interview, staff-in-charge stated that she would have the hole repaired.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.

General: Based on review of documentation, the surveyor was presented with a food service permit that had an expiration date of 12/31/22. During interview, staff-in-charge stated she sent the paperwork in for the food permit and was waiting on an inspection. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.

General: Based on observation, the surveyor found that the freezer section of the mini refrigerator located in the Infant Classroom did not contain an indicating thermometer or other appropriate temperature measuring device; therefore, the surveyor was unable to determine that the freezer was kept at a temperature of zero (0) degrees Fahrenheit or below. The surveyor did not observe any items inside the freezer on the day of the visit. Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on review of the Kentucky National Background Check Service, a staff member (DOH: Unknown, listed as 1/1/1900) did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. During interview, staff-in-charge confirmed that a background check was not submitted through the Kentucky National Background Check Service and that no other type of background check was performed. Staff-in-charge stated that the staff person acted as the lead teacher in the Two- Year-Old Classroom for two (2) days in December 2021. Staff-in-charge stated that the child-care center is set up so that all of the rooms are visible to each other; however, the staff was responsible for a classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Supervision Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation during a walk-though of the child-care center, the surveyor found two (2) staff present providing care for children in four (4) classrooms: Toddler Classroom, Infant Classroom, Two-Year-Old Classroom and Preschool Classroom. There were three (3) children present in the Toddler Classroom. Staff stated that each child was one-year old. There were four (4) children present in the Infant Classroom. Staff stated that each child was one-year old. There were five (5) children present in the Two-Year-Old Classroom. Staff stated that each child was two-years old. There were seven (7) children present in the Preschool Classroom. Staff stated that the children ranged from four (4) to five (5) years old. One (1) staff person was standing in the Two (2) Year-Old Room and one (1) staff person was standing in the Preschool Room during the surveyor’s walk-through. Therefore, the children in the Toddler Classroom and Infant Classroom were unsupervised for an undetermined amount of time. In addition, the three (3), one-year-old children that were in the Toddler Classroom could not been seen until the surveyor walked into the classroom; therefore, the children were not within scope of vision during naptime. Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation during a walk-through of the childcare center, the surveyor found two (2) staff providing care for nineteen (19) children during naptime. When the surveyor arrived, staff-in-charge stated that two (2) staff were on lunch break and would be returning soon. Staff-in-charge reported the youngest child was one (1) year old and the oldest child was five (5) years old; therefore, the staff-to-child ratio was exceeded by seven (7) children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on interview, staff-in-charge stated that staff (DOH: Unknown, listed as 1/1/1900) only worked for a couple of days at the childcare center while she was on Christmas Break 2021. Staff-in-charge stated that a personnel file containing required documentation was not created for the staff member; therefore, the childcare center failed to maintain a personnel file for each childcare center staff person.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found the following: 1. A metal stake sticking out of the ground in front of a speed bump located directly in front of the exit door that leads inside the child-care building. Staff-in-charge stated that they were planning on removing the stake from the ground. 2. A large desk in the Two Year Old Classroom that contained the following items behind the desk: two (2) gray metal bars, two (2) outlet covers missing from an electrical outlet, exposed gray pipes and a small gray metal pipe coming out of the floor with an exposed hole opening, and a charging cable and cd player cord dangling off of the desk. A gate was observed to separate the back of the desk from the Two Year Old Classroom. Through interview with staff-in-charge, the surveyor learned that the children go through the gate and behind the desk to go to the playground. Staff-in-charge stated that a gate was supposed to be placed in the opening behind the desk. The surveyor observed the gate to be placed on the floor beside a table by the exit door. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 05/15/19) file contained a written performance evaluation dated for 09/16/20; therefore, the evaluation was not completed annually. Through interview with staff-in-charge, the surveyor learned that an up-to-date annual written performance evaluation was not available for review for the staff mentioned. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation and ECE-TRIS, the surveyor found that a staff (DOH: 01/03/19) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 01/11/16; therefore, the training was not completed within the last five years. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on observation, the surveyor found two (2) spray bottles that stated bleach on the front of the bottles placed on a large desk in the Two Year Old Classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. A blue square rug that contained stains in the Preschool Classroom; therefore, the rug was not kept clean. 2. A blue square star rug and square car rug that contained stains in the Two Year Old Classroom; therefore, the rugs were not kept clean. 3. An oval blue rug that contained debris in the Two Year Old Classroom; therefore, the rug was not kept clean. 4. A rocking chair with blue cushions that contained debris in the Infant Classroom; therefore, the rocking chair was not kept clean.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor was unable to flush the toilet due to the toilet handle appeared to be broken in the restroom located directly in front of the kitchen. During interview, staff-in-charge stated that they recently repaired the toilet handle and it broke again. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found debris on the diaper changing table underneath the diaper changing pad in the restroom located beside the kitchen; therefore, the diaper changing surface was not clean. First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on observation, the surveyor found a red first aid kit placed in the floor beside a drawing board in the Two Year Old Classroom; therefore, the first aid kit was not stored in an area that was out of reach of the children. During interview, staff-in-charge stated that there was currently no children in the Two Year Old Classroom. The surveyor did not observe any children inside the Two Year Old Classroom during the visit on 10/05/21. Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. A wooden board that borders the playground and was placed in front of the gate entrance; therefore, the board created a tripping hazard for the children. 2. A broken pink slide placed beside the exit door on the playground. 3. Two metal stakes sticking out of the ground in front of a speed bump located on the concrete portion of the playground. Equipment In Compliance Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: 1. The following children (DOE: 07/20/18, 11/09/20, 11/09/20) files did not contain the contact telephone number for the child’s preferred hospital. 2. The following children (DOE: 01/11/21, 10/22/18) files did not contain the name of the child’s preferred hospital or contact telephone number. 3. A child’s (DOE: 08/10/20) file did not contain the contact telephone number for the child’s preferred hospital or authorization by the parent for the child-care center to seek emergency medical care for the child in the parent’s absence. 4. A child’s (DOE: 11/04/20) file did not contain the contact telephone number for the child’s preferred hospital, authorization by the parent for the child-care center to seek emergency medical care for the child in the parent’s absence, or the name of each person who is designated in writing to pick-up the child. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 05/15/19) file contained a professional development plan dated for 09/16/20; therefore, the plan was not completed annually. Through interview with staff-in-charge, the surveyor learned that an up-to-date annual professional development plan was not available for review for the staff mentioned. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation, the surveyor found in the Nursery Classroom there was an electrical outlet that did not have a safety protector. Therefore, the children had access to the eletrical outlet. Staff reported that she would put a safetly protector in the electrical outlet. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on observation and review of documentation, the surveyor discovered that a staff person's (DOH:9/23/2020) file did not contain the Education Requirement. Staff reported that she would inform the Director. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found the following on the playground: 1. There was a Pepsi can located by the fence inside the playground. The children were able to have access to the Pepsi can. Staff stated that the children had not been on the playground due to the weather. 2. There was a cigarette package located under the fence where the children had access to the package. Staff stated that the chlldren had not been on the playground due to the weather. 3. There were multiple broken toys that resembled a gear located on the playground. The surveyor took pictures of the broken toys for reference. Staff stated that she would have them picked up. 4. There was a broken board that was used to keep the mulch off the walkway. The broken board had sharp edges. Staff stated that the children had not been on the playground due to the weather. Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation, the surveyor found that the changing pad on the changing table located between Toddler I Classroom and the Nursery Classroom had a rip in the vinyl. Therefore, the changing pad was not in good repair. Staff reported that she was unaware of the rip in the changing pad.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 11. Toys and Furnishings.

General: Based on observation, the staff found the following: 1. In the Toddler I Classroom there was a blue vinyl round chair that had frayed spots where one sits in it. Therefore, the chair was not in good repair. Staff reported that she was unaware of the chair not being in good condition. 2. In the Toddler II Classroom the blue vinyl couch had a hole in it. Therefore, the couch was not in good repair. Staff reported that she was unaware that the couch had a hole in it. Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation, the surveyor found that the lesson plan in the School Age Classroom just had January listed on it with no date. Staff reported that she was unaware of the lesson plan not having a date on it. Animals Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Emergency Regulation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

Based on review of documentation presented, the surveyor found that there were six (6) infants in the classroom with only one (1) teacher listed as being in the classroom on 01/07/2020. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Food Service Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Meal Requirements.

General: Based on interview and review of documentation, the surveyor found that the child-care center was preparing foods in a staff person's home and the food was transported by private vehicle to the center to serve to the children. During interview, staff stated that she would not have food prepared at her home and transport to the child-care center.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found a lesson plan was not posted in the following classrooms: Preschool Classroom, Twos Classroom, Infant Classroom, or the Toddler Classroom. Staff confirmed through interview that lesson plans had not been provided to them for their classrooms. The surveyor observed the classrooms to be chaotic with no structure for the children.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor observed the following: (1.) The staff in the Preschool Classroom was sitting in a chair looking down at her cell phone. The children in the Preschool Classroom were screaming and climbing on top of the furniture inside the classroom. Staff in the classroom was not properly supervising the children as she was utilizing her cell phone. No additional staff was present in the classroom. (2.) A four-year-old child was observed to walk from the Preschool Classroom to the restroom without a staff present. A staff realized the child was walking to the restroom just prior to the child entering the restroom. The child walked from the Preschool Classroom, into the Twos Classroom, entering the School Age Classroom before walking into the restroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 7 Inspection Report Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor found seven (7) one-year-old children present in the Toddler Classroom with one (1) staff present. Staff confirmed through interview the age of the children. Therefore, the staff-to-child ratio was exceeded by one (1) child. General Administration In Compliance Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on interview, the surveyor found that staff meetings were not documented in writing. Staff confirmed that the staff meetings were conducted; however, the staff meetings were not documented in writing.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation, the surveyor found the following: (1.) A large flat screen television was observed on a countertop in the Preschool Classroom. The television was not secured to the countertop. Based on the surveyor observing children climbing on shelves and tables, the unsecured television creates a safety risk for the children as the television could turn over on the children. (2.) An uncovered electrical outlet was observed in the Infant Classroom. Staff was not aware of the issue. (3.) A two-year-old child was observed to be sleeping on the tile floor in the Twos Classroom. Staff reported the child had been asleep for five (5) minutes. When the surveyor questioned the staff why the child was sleeping on the tile floor, the staff reported the child refused to get up off of the floor. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found a staff’s (DOH: 10/28/19) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. Staff reported the documentation was not obtained for the staff’s file. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 7 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found the following: (1.) Staff’s (DOH: 5/15/19) file contained a copy of a negative tuberculin result dated 8/18/17; therefore, the result was no longer current. (2.) Staff’s (DOH: 10/28/19) file did not contain a statement from a health professional that the individual was free from active tuberculosis or a copy of a negative tuberculin result. Staff reported the documentation had been obtained for the staff’s file; however, the documentation could not be presented during the surveyor’s visit. Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation, the surveyor found an infant child was sleeping in a swing in the Infant Classroom. Staff confirmed the child had been asleep for approximately fifteen (15) to twenty (20) minutes. According to staff, the child does not have a written statement from a healthcare professional indicating that the child requires an alternate sleeping position. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found a glue like substance on the floor surrounding shelves in the Preschool Classroom. Staff reported the substance was liquid nail from where the shelves had moved away from the floor.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found a liquid substance, yellow in color, on the toilet seat in the restroom; therefore, the toilet was not kept in a clean condition. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 7 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found debris underneath the diaper changing pad in the Infant Classroom and the Twos Classroom. First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on observation, the surveyor found the first aid kit did not contain the following required items: (1.) Medical Tape (2.) Scissors (3.) Thermometer (4.) Cardiopulmonary resuscitation mouthpiece protector (5.) Flashlight An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 7 Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on observation, the surveyor observed a ziplock bag located inside the unlocked first aid kit. The ziplock bag contained one (1) Tylenol. The first aid kit was located on top of cubbys inside the Preschool Classroom. Children were observed climbing on the furniture inside the classroom; therefore, the medication was not stored in a separate and locked place and was accessible to the children. Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.

General: Based on observation, the surveyor observed an uncovered bottle with milk on top of a cubby inside the Toddler Classroom. The surveyor observed the bottle not being utilized at approximately 10:20 a.m. Staff reported that the bottle was used to feed a child at breakfast at 8:30 a.m. The bottle was not promptly refrigerated, covered when not in use, or consumed within one (1) hour of being heated and removed from the refrigerator. Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found a child’s (DOE: 3/28/19) file contained an immunization certificate dated 10/15/19; therefore, the immunization certificate was no longer current. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 7 Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: (1.) A child’s (DOE: 8/2/19) file did not contain contact information for the child’s preferred physician. (2.) A child’s (DOE: 8/2/19) file did not contain contact information for the child’s preferred physician. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on review of documentation, the child care center’s chain of command needed to be updated. The current chain of command that was documented list staff that are no longer employed by the child care center.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on observation and review of documentation, the surveyor found the following: (1.) Seven (7) children were present in the Preschool Classroom with only five (5) children’s arrival times documented on the daily attendance record. (2.) Five (5) children were present in the Infant Classroom with only two (2) children’s arrival times documented on the daily attendance record. (3.) Seven (7) children were present in the Toddler Classroom with only five (5) children’s arrival times documented on the daily attendance record. (4.) Five (5) children were present in the Twos Classroom with only three (3) children’s arrival times documented on the daily attendance record. Staff reported parents forget to sign their children into the child care center on the daily attendance record. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 6 of 7 Inspection Report

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: (1.) A written record of the children who participated in the fire drills were not documented for the following dates: 1/9/19, 2/20/19, 3/14/19, 4/30/19, 5/15/19, 6/24/19, 7/2/19, 8/2/19, 9/6/19, and 10/14/19. (2.) A written record of the children who participated in the earthquake drills were not documented for the following dates: 1/16/19, 4/18/19, 7/1/19 and 10/14/19. (3.) A written record of the children who participated in the tornado drills was not documented for the following dates: 1/16/19, 4/18/19, 7/1/19 and 10/14/19. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation during a tour of the Infant Room, the surveyor found that an infant child was sleeping in a Rockaroo. Based on interview, the surveyor learned that the child’s health professional had not submitted a statement indicating the child needed an alternate sleeping position.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation during a tour of the Infant Room, the surveyor found that an infant child was lying down in a crib while drinking from a sippy cup. Premises In Compliance Equipment In Compliance Posted Documentation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation upon entry to the childcare center on 11/13/18 at 2:00 p.m., the surveyor observed that one (1) staff person was caring for six (6) children in the Preschool Room and an additional four (4) preschool-age children that were napping in an adjacent room. The surveyor observed that the staff person periodically checked on the four (4) sleeping children by looking around the corner into the adjacent room. The four (4) preschool-age children were not consistently within the staff’s scope of vision. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation upon entry to the childcare center on 11/13/18 at 2:00 p.m., the surveyor observed that a staff person picked up a child and removed the child from the Preschool Room. Based on interview with staff, the child was one (1) year old. The staff person took the child to the classroom for the one-year-old children. The surveyor found that one (1) staff person in the Preschool Room was providing care for ten (10) children. Based on interview with staff, these children two to three-year-old children. Through staff interview, the surveyor learned that one (1) staff person provided care for the one-year-old child along with ten (10) children over age one (1) for five to ten (5-10) minutes. Therefore, five (5) children exceeded the staff-to-child ratio for five to ten (5-10) minutes. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation during a tour of the childcare center on 11/13/18 at 2:00 p.m., the surveyor found that a large stepladder was horizontally propped against a half wall near four (4) preschool-age children that were napping, The ladder was accessible and presented a safety risk to the children. Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on interview with multiple individuals, the surveyor found that on 11/1/18, a staff person used an inappropriately loud tone, described as yelling, when redirecting the preschool-age children.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation during a tour of the childcare center, the surveyor found the following: 1. Upon arrival to the childcare center on 10/12/18 at 10:45 a.m., the surveyor observed an individual outside the center at her car. The individual returned to the building and left with a toddler-age child. Upon interview with staff, the surveyor learned that the child is an eighteen-month-old relative that was provided care in the Preschool Room for a reported five (5) minutes. A tour of the Preschool Room found that one (1) staff person was supervising eight (8) preschool-age and four (4) school-age children; therefore, seven (7) children exceeded the staff-to-child ratio for the reported five (5) minutes. 2. A second tour of the Preschool Room conducted on 10/12/18 at 12:20 p.m., found that one (1) staff person was supervising eight (8) preschool-age and four (4) school-age children. The age of the youngest child was two-years-old; therefore, two (2) children exceeded the staff-to-child ratio. General Administration In Compliance Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on observation during a tour of the childcare center, the surveyor found the following: 1. Windows extended approximately eighteen (18) inches from the floor to about the ceiling in the School-age Room and Toddler Room. A brick ledge extends across the bottom interior of the windows. No barrier prevented the children from running into the windows or brick window ledge. 2. An uncovered electrical outlet was observed in the Preschool Room. Employee Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on review of documentation, the surveyor found that a planned program of activities was not posted in the School-age Room. Premises In Compliance Hygienic Practices In Compliance First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.

General: Based on observation, the surveyor found the following: 1. The following medications were stored in an unlocked area: Tylenol, Motrin, two (2) tubes of Neosporin Ointment, Benadryl Ointment and children’s’ Ibuprofen and Acetaminophen. 2. The surveyor observed an Epi-Pen in a locked bag. A staff person confirmed that the Epi-Pen belonged to a child enrolled in the program. Through review of documentation and interview, the surveyor learned that no staff on the premises had training on the administration of the Epi-Pen. Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Food Service/Food Program Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Meal Requirements.

General: Based on observation, the surveyor found that the preschool-age and school-age children were served pasteurized two-percent milk with their lunch. Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Meal Requirements.

General: Based on interview, the surveyor learned that the staff mix and measure the infant’s formula and water. The staff confirmed they do not participate in the food program. Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found that a child’s (DOE: 7/29/18) file contained an immunization certificate that was no longer current as of 8/30/18.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation contained in ten (10) children’s files, the surveyor found that none contained information to enable a person in charge to identify or contact the preferred hospital. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: 1. Three (3) children were present in the Infant Room. Review of the Daily Attendance Record found that the arrival times of only two (2) of the children were documented. 2. Four (4) children were present in the School-age Room. Review of the Daily Attendance Record found that the arrival times of only three (3) of the children were documented. 3. Five (5) children were present in the Toddler Room. Review of the Daily Attendance Record found that the arrival times of only four (4) of the children were documented. 4. Eight (8) children were present in the Preschool Room. Review of the Daily Attendance Record found that the arrival times of only five (5) of the children were documented.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor was not presented with verification that third quarter earthquake and tornado drills were practiced. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.