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

General: Based on interview and review of documentation, it was determined that the facility failed to ensure the health, safety, and comfort of a child in care. The child's finger was smashed in a closing door by a staff member. Medical attention was sought. The child's finger was bruised and swollen but not fractured. Director Requirements 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, a staff member (DOH: 06/21/23) did not have an evaluation on file.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation and interview, several medications that were stored in the kitchen, in a locked box, did not contain a name. The following medications were not labeled with a name: two (2) bottles of Tums, a bottle of aloe, a tube of hydrocortisone cream, a bottle of allergy relief pills, and a package of loperamide hydrocholoride tablets. The staff in charge indicated that this medication was for the staff members. Outdoor Play Area 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 6. Sleeping and Napping Requirements.

General: Based on observation, the following was found: Tiny Tots Room (big side) 1) A few of the nap mats in the closet contained tears on the surface and the foam was exposed. Thrilling Three’s Room 1) A few of the nap mats in the closet contained tears on the corners and the foam was exposed.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, in the Two-Year-Old room, there was an unlocked cabinet containing cleaning supplies and cords which should be inaccessible to children. 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 An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on review of documentation, one (1) staff (DOH 06/15/21) did not have an annual evaluation on file at the time of inspection. 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, two (2) staff (DOH 02/20/24 and 02/13/24) did not have documentation of education on file at the facility.

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 review of documentation, one (1) staff (DOH 10/23/23) did not have evidence of CPR/FA training on file at the facility. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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 4. Premises Requirements.

General: Based on observation, the Twos classroom had one (1) ceiling light that was not working at the time of inspection.

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 Tiny Tots Number One classroom did not have a sink immediately adjacent to the changing table. 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 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, one (1) staff (DOH 06/15/21) did not have a professional development plan on file at the time of inspection. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

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, the surveyor found the following: 1. A staff (DOH: 06/15/21) had a fingerprint submit date of 06/28/21 and an eligibility date of 06/28/21; therefore, the staff person was hired prior to clearance for employment. During interview, staff-in-charge stated that she was not aware that staff persons had to submit to fingerprints prior to employment. Staff-in-charge stated that the staff person did not work alone with children. The staff’s file did not contain a Child Abuse/Neglect Background Check or Criminal Records Background Check. 2. A staff (DOH:10/27/21) had a fingerprint submit date of 11/01/21 and an eligibility date of 11/01/21; therefore, the staff person was hired prior to clearance for employment. During interview, staff-in-charge stated that she was not aware that staff persons had to submit to fingerprints prior to employment. Staff-in-charge stated that the staff person did not work alone with children. The staff’s file did not contain a Child Abuse/Neglect Background Check or Criminal Records Background Check. 3. A staff (DOH: 02/22/21) had a fingerprint submit date of 02/02/22 and an eligibility date of 02/09/22; therefore, the staff person did not have a completed background check prior to 10/01/21. During interview, staff-in-charge stated that she was not aware that the staff person had to have a completed background check through KARES by 10/01/21. Staff-in- charge stated that the staff person did not work alone with children. The staff’s file contained a completed Child Abuse/Neglect Background Check dated 03/09/21 and a completed Criminal Records Background Check dated 02/24/21. 4. A staff (DOH: 08/21/20) had a fingerprint submit date of 02/14/22 and an eligibility date of 02/14/22; therefore, the staff person did not have a completed background check prior to 10/01/21. During interview, staff-in-charge stated that she was not aware that the staff person had to have a completed background check through KARES by 10/01/21. Staff-in- charge stated that the staff person did not work alone with children. The staff’s file contained a completed Child Abuse/Neglect Background Check dated 09/08/20 and a completed Criminal Records Background Check dated 08/28/20. 5. A staff (DOH: 06/15/20) had a fingerprint submit date of 11/01/21 and an eligibility date of 11/01/21; therefore, the staff person did not have a completed background check prior to 10/01/21. During interview, staff-in-charge stated that she was not aware that the staff person had to have a completed background check through KARES by 10/01/21. Staff-in- charge stated that the staff person did not work alone with children. The staff’s file contained a completed Child Abuse/Neglect Background Check dated 07/01/20 and a completed Criminal Records Background Check dated 06/23/20. Supervision In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report Staffing Requirements In Compliance 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 and review of the Kentucky National Background Check Service, the surveyor found the following: 1. There was an unsecured brown cord coming down behind a crib in the Infant Classroom. Staff-in-charge stated that she would move the cord to make it inaccessible to the children. 2. A telephone cord was hanging down from a wall mounted telephone in the Three Year Old Classroom. Staff-in-charge stated that she would move the cord to make it inaccessible to the children. 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 the following: 1. A staff’s (DOH: 08/21/06) file contained an annual written performance evaluation dated 08/13/21; therefore, the evaluation was not completed annually. 2. A staff’s (DOH: 06/15/20) file contained an annual written performance evaluation dated 06/15/21; therefore, the evaluation was not completed annually. 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 ECE-TRIS, the surveyor found the following: 1. A staff (DOH: 04/28/22) obtained zero (0) hours of the required six (6) hours of cabinet-approved orientation training; therefore, the training was not completed within the first three (3) months of employment. 2. A staff (DOH: 01/23/20) obtained six (6) hours of cabinet-approved orientation training on 09/14/20; therefore, the training was not completed within the first three (3) months of employment. 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 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. A brown residue was located on the countertop behind the faucet in the One Year Old Classroom; therefore, the countertop was not kept clean. 2. A metal soap dish placed on the wall beside the sink in the restroom in the Two Year Old Classroom contained a brown substance that was built up on the bottom of the soap dish; therefore, the soap dish was not kept clean. The Two Year Old Classroom was located beside the Three Year Old Classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report

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 a small circular hole toward the bottom of the wall located beside the exit door in the One Year Old Classroom; therefore, the wall was not in good repair. Hygienic Practices 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found the following: 1. There was debris on the diaper changing table underneath the diaper changing pad in the One Year Old Classroom; therefore, the diaper changing surface was not kept clean. 2. There was debris on the diaper changing table underneath the diaper changing pad and two (2) small rips/tears in the diaper changing pad in the Two Year Old Classroom located beside the Office; therefore, the diaper changing surface was not kept clean or free of holes, rips, tears, or other damage. 3. There was debris on the diaper changing table underneath the diaper changing pad in the Two Year Old Classroom located beside the Three Year Old Classroom; therefore, the diaper changing surface was not kept clean. 4. There was debris on the diaper changing table underneath the diaper changing pad in the Tiny Tots Classroom; therefore, the diaper changing surface was not kept clean. The diaper changing table was located in front of the sink area. First Aid/Medication In Compliance Outdoor Play Area 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 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. What appeared to be two (2) large mushrooms were located on the ground beside a tree on the playground that was located along the side of the Tiny Tots and One Year Old Classrooms. During interview, staff-in-charge stated that they have tried to cut the mushrooms down; however, they grow back. Staff-in-charge stated that they have moved the children to the other playground located on the opposite side of the building and have scheduled times for the children to go out to the playground. 2. The top layer of the material on the sides of the bridge on the play structure located on the playground behind the child-care center building was peeling and contained a sharp edge. 3. Approximately three (3) areas on the bottom steps of the play structure located on the playground behind the child-care center building were cracked/peeling and exposed what appeared to be metal beneath which contained rust. 4. The top layer of the material on a small section of the bridge on the play structure located on the playground behind the child-care center building contained an area that was peeling. During interview, staff-in-charge stated that she had bought the materials to repair the play structure. 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 13. Toys and Furnishings.

General: Based on observation, the surveyor found a small brown two (2) drawer shelf that was peeling on the top front part of the shelf located beside a crib in the Infant Classroom ; therefore, the shelf was not kept free of peeling, flaking, or chalking paint. Transportation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report 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 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 interview and review of documentation, the child care center failed to maintain employee records in accordance with regulations. Review of staff files revealed a high school diploma, GED, or Commonwealth Child Care Credential was not presented for review at the time of survey for a staff member hired on 4/23/2021. Interview with the staff in charge revealed the document was not there for review.

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 interview and review of documentation, the child care center failed to maintain employee records in accordance with regulations. Review of staff files revealed there was no written documentation from a health care professional for three (3) staff members with the hire dates of 4/23/2021; 2/22/2021 and 11/30/2017 to verify that each one was free from active TB. Interview with the staff in charge revealed the documentation was not there for review. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service 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

Open / not marked corrected.

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

General: Based on observation, interview and review of documentation, one staff member with an unknown hire date worked with children prior to initiating a criminal background check and a Criminal Abuse and Neglect background check. Interview with the staff member in charge revealed that the background checks for the aforementioned were not initiated, nor were the results returned, prior to working with children. The aforementioned staff member was observed working alone with children. Additionally, another staff member with an unknown hire date, who is under the age of eighteen (18) was observed to work alone with children, prior to completing a Criminal Abuse and Neglect background check. Review of employee files revealed that background checks were not present. Staffing 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 11. Staff Requirements.

General: Based on observation and interview, a staff member, who is under the age of eighteen, was observed working alone with children. Interview with the staff member in charge revealed that the aforementioned staff member is under the age of eighteen. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Emergency Regulation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:400 · 922 KAR 2:400E. Emergency Regulation.

General: Based on interview, the child care center combined children from separate classrooms after groups had been established for the day. Interviews with staff members revealed that children from seperate groups were combined after groups had been established for the day on several occasions. Regulations pertaining to Covid-19 state that each child shall remain in the same group of ten (10) throughout the day without interacting with another group.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 11. Status of Employment.

General: Based on observation, interview and review of documentation, the child care center failed to comply with regulatory background checks requirements. Review of the Kentucky Applicant Registry and Employment Screening (KARES) system on the Kentucky Online Gateway (KOG) on 3/11/2020 revealed an individual listed as teacher/assistant teacher with an eligible for employment date of 4/20/2018. However, an interview with a management official disclosed the above-mentioned individual had separated employment with the child care center prior to 3/11/2020. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance Director Requirements In Compliance Employee Records In Compliance Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Animals 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 child care center failed to comply with regulatory programming requirements in regards to bedding. Surveyor observed four (4) out of the five (5) cribs in the "Wonderful 1's" room had loose fitted sheets bunched on the crib mattress. Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Equipment Not In Compliance

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 child care center failed to maintain equipment in accordance with regulatory requirements. Observation in the "Wonderful 1's" room revealed two blue play mats with palm sized rips and exposed foam. Also in the "Terrific Two's" room there was a child-sized blue chair at the entrance that had a quarter sized rip in several spots and exposed foam. Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance 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 5. Evacuation Plan.

General: Based on review of documentation, the child care center failed to maintain written documentation in accordance with regulatory requirements. Review of Emergency Disaster Preparedness Plan presented showed a date of 11/1/2017. Documentation was also posted in front entrance with 2017 date; therefore, the plan was not updated annually before December 31st. 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 11. Staff Requirements.

General: Based on review of documentation and interview, the child care center failed to maintain employee records in accordance with regulatory requirements. Upon request, the child care center director failed to provide documented evidence of a high school diploma, GED or qualifying documentation from a comparable educational entity or Commonwealth Child Care Credential as described in 922 KAR 2:250 for staff with a hire date 03/31/18. 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 and interview, the child care center failed to comply with regulatory programming requirements. Observation of the Little Lambs Nursery revealed four (4) cribs with toy mobiles attached to the side of each crib as the children rested. Interview with staff revealed the children in the classroom ranged in age from six (6) weeks to twelve (12) months. Premises In Compliance Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment 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 and interview, the child care center failed to maintain equipment in accordance with regulatory requirements. Observation of the Thrilling Three's classroom revealed several mats with torn surfaces and exposed foam. Interview with staff revealed the mats observed were used at naptime. Transportation Not Applicable Food Service/Food Program In Compliance Food Service 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 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

General: Based on Observation, the child care center director failed to assure compliance with regulatory requirements. There was an exposed electrical outlet located above the mini-fridge in the Little Lambs room. Employee Records In Compliance Programming In Compliance 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 child care center failed to maintain the premises in accordance with regulatory requirements. The white tile baseboard located under the light switch in the bathroom in the Terrific Two’s Room was cracked. There was peeling green paint located in the dramatic play area in the Terrific Two’s Room. The baseboard located next to the sink in the Tiny Tot’s Room was not attached to the wall. The baseboard located in the books area under the window in the Tiny Tot’s Room was not attached to the wall. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report

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 child care center failed to maintain the premises in accordance with regulatory requirements. The handle on the soap dispenser located by the sink in the Wonderful One’s Room was broken. The handle on the soap dispenser located by the sink in the bathroom in the Terrific Two’s Room was broken. The handle of the faucet on the sink located in the Tiny Tot’s Room was broken.

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 child care center failed to maintain the premises in accordance with regulatory requirements. There was a brown and black substance indicative of mold around the water spout and down the wall next to the toilet in the bathroom located in the Thrilling 3’s room. Hygienic Practices In Compliance First Aid/Medication In Compliance 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 child care center failed to maintain an outdoor play area in accordance with regulatory requirements. The fence was not attached to the metal pole located by the green tunnel on the outside play area. The fence was not attached to the metal pole located by the central air unit on the outside play area. Equipment Not In Compliance

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 child care center failed to maintain equipment in accordance with regulatory requirements. A blue and white jumper located in the Little Lambs room had an attached tray that was soiled with food debris. There were two (2) holes on the back of the door leading into the Terrific Two’s Room: one by the top latch of the door and the other by the bottom latch of the door. The door knob was not attached to the door in the bathroom located in the Tiny Tot’s Room. The red vinyl couch and blue vinyl chair located in the Thrilling 3’s room in the reading area were both torn.

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 child care center failed to maintain equipment in accordance with regulatory requirements. The three (3) bottom steps of the sliding play set located on the three-year-old outside play area were missing portions of the cushions exposing the rusted metal. The yellow slide attached to the sliding play set located on the 3- year-old outside play area was wobbly and not securely attached to the play set. Transportation Not Applicable Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 3. Records.

General: Based on Review of Documentation and interview, the child care center failed to maintain children’s records in accordance with regulatory requirements. Review of the presented children files revealed ten (10) records that did not contain the name of the family's preferred hospital. Review of the presented children files revealed a child’s record with enrollment date 3/7/17 that did not contain the contact information for the family physician. Upon request, the Director did not provide the documentation at the time of the survey. 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 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

General: Based on Interview, and review of documentation, the child care center director failed to assure compliance with regulatory requirements. Based on interviews, a child was restrained by a staff member caring for approximately ten (10) children, ranging in age from two years to three years, along with another staff member while in the Tiny Tots room prior to being picked up at the end of the day by a parent. Based on interviews, staff members stated that restraint had been used on a child while in care in the Tiny Tots room. Based on further interviews, the restraint had been observed by the parent of the victim when she entered into the room, and also by an additional parent picking up her child from the center. Based on documentation, staff members' written statements reveal a staff member had been viewed on video restraining a child. Additional documentation of written statements reveal restraint was used on a child who was not following directions as observed by staff members.

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 child care center failed to comply with regulatory programming requirements. Observation in the Little Lambs Room revealed bouncy seats hooked on the end of two (2) cribs for storage. Ongoing observation revealed an infant in one (1) of the cribs with the bottom of the bouncy seat protruding into the interior of the crib area at the time of the inspection.

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 child care center failed to comply with the regulatory requirements regarding medication. Observation in the Little Lambs Room revealed diaper ointment that failed to be stored in a locked place at the time of the inspection. Outdoor Play Area

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 4 (1)

Little Lambs: Based on observation, an awake infant was inside a bouncer that was placed inside of a crib. 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 1) Toxic cleaning supplies, poisons, and insecticides In Compliance 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff In Compliance 197 - Premises Requirements 922 KAR 2:120 - Section 4 Premises Requirements. (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with a land-line telephone accessible to a room used by a child. 1) Suitable In Compliance 2) Clean In Compliance 3) Good repair In Compliance 4) Land-line phone accessible In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 11 of 38 Web site: http://chfs.ky.gov/ Inspection Report 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 1) Windows In Compliance 2) Doors In Compliance 3) Stoves In Compliance 4) Heaters In Compliance 5) Furnaces In Compliance 6) Pipes In Compliance 7) Stairs In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 11

Terrific 2's: Based on observation and interview, staff members sanitize toys and other items that are considered mouth contact surfaces by a child not toilet trained with disinfectant. Wonderful 1's: Based on observation and interview, staff members sanitize toys and other items that are considered mouth contact surfaces by a child not toilet trained with disinfectant. First Aid/Medication 244 - First aid supplies 922 KAR 2:120 - Section 7 (3) If a child becomes ill while at the center: (a) The child shall be placed in a supervised area isolated from the rest of the children; (b) The parent shall be contacted immediately; and (c) Arrangements shall be made to remove the child from the child-care center as soon as practicable. 1) Availability In Compliance 2) Storage In Compliance 3) Inventoried In Compliance 4) Sanitized, if reusable In Compliance 5) Maintained in sanitary manner In Compliance 6) Liquid soap In Compliance 7) Adhesive bandages In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 20 of 38 Web site: http://chfs.ky.gov/ Inspection Report 8) Sterile gauze In Compliance 9) Medical tape In Compliance 10) Scissors In Compliance 11) Thermometer In Compliance 12) Flashlight In Compliance 13) Cold pack In Compliance 14) First aid book In Compliance 15) Disposibale gloves In Compliance 16) Cardiopulmonary resuscitation mouthpiece protector In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 2

General: Based on observation, the medical informaton of children was not kept confidential, as several parents used the same form to sign permission for medicine to be administered to their child(ren); which allowed parents to have access to medical information of other children than their own. Further observation revealed that personal information in regards to the allergies of two (2) children were not kept confidential as it was posted in the Tiny Tots classroom.

Open Not marked corrected in the state record

Open / not marked corrected.