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

General: Based on interviews, the surveyor discovered that there was a cell phone policy at the child-care center. Staff members reported that cell phones are not to be out on the playground or in the classrooms. Staff-in-charge stated that she has been getting onto the staff member about having her cell phone out in the classroom. Programming 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 of the video that was provided, the surveyor discovered that a staff member recorded a thirty-three-month-old child stating that he "pissed" on himself. The video scanned the child to show that he had wet spots on his pants; therefore, the child was humiliated by the staff person. The staff member reported that she only sent the video to the child's parent, and it was after the staff member changed the child's clothes.

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, including review of the childcare center’s KARES roster, the surveyor found two (2) volunteers (DOH: 05/23/24 and DOH: 01/13/25) not listed on the center’s KARES roster. The surveyor observed one fifteen-year-old volunteer working with a qualified staff person in the School-Age Classroom, and one sixteen-year-old volunteer working with qualified staff in the Infants Room. There was no documentation of completed background checks in either volunteer’s file; therefore, the licensee hired these two volunteers prior to a determination of eligibility. During interview, staff-in-charge stated the volunteers’ parent was advised in May 2024 by staff at IdentiGo that volunteers did not have to have criminal background checks as they were not alone with children. Staff-in-charge stated she was unaware of the policy change regarding volunteers and would not allow the volunteers to return to the center until background checks were completed. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance Director Requirements In Compliance Employee Records 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 review of documentation, including review of ECE-TRIS, the surveyor found two (2) staff’s (DOH: 07/09/24 and DOH: 05/31/24) files contained no documentation of completion of required training on first aid and cardiopulmonary resuscitation (CPR); therefore, the center failed to ensure that every staff member has received training on first aid and CPR. Staff-in-charge stated she would ensure these staff completed the required training. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 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 11. Staff Requirements.

General: Based on review of documentation, including review of ECE-TRIS, the surveyor found: 1. One (1) staff (DOH: 12/20/22) completed zero (0) of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 12/21/23- 06/30/24. The surveyor reviewed ECE-TRIS and could not locate the staff person in ECE-TRIS. 2. One (1) staff’s (DOH: 12/20/22) file contained no documented date of completion of one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma (PAHT); therefore, the surveyor was unable to verify that this staff had completed PAHT training within one (1) year of employment as required. 3. One (1) staff (DOH: 02/01/10) completed fourteen and one-half (14.50) 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 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, interview and review of documentation, the surveyor found that there were 36 children present on the day of the inspection, exceeding the center’s capacity by one (1) child; therefore, the childcare center failed to maintain the thirty-five (35) square feet of space per child as required. During interview, staff-in-charge stated she knew they were over their approved capacity of thirty-five (35) children because schools were closed due to bad weather. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance 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 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on interviews, the surveyor learned the following: 1. On 03/12/24, a twenty-seven-month-old child was left unsupervised on the playground for approximately forty-five (45) seconds. The child was discovered and escorted back into the child care center by a parent who was walking into the child-care center. Based on video camera footage, it was confirmed that the child was unsupervised by child care staff for approximately forty-five (45) seconds. 2. A twenty-seven-month-old child leaves the Toddler Classroom unsupervised by staff and walks to the Preschool Classroom. This is a daily practice, at the end of the day, for the twenty-seven-month-old child when the child attends the child care center. Staffing Requirements In Compliance General Administration Discussed Employee Records Discussed

Open Not marked corrected in the state record

Category: supervision. 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 surveyor found the following: 1. A staff member (DOH: 02/01/10) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 12/31/17. 2. A staff member (DOH: 02/28/08) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 01/31/18. 3. A staff member (DOH: 02/01/10) completed fourteen (14) hours of cabinet-approved early care and education training during the review period 07/01/22-06/30/23. Staff reported the pediatric abusive head trauma training was overlooked and would be completed by staff. Staff reported a technical issue with the cabinet-designated database pertaining to the fourteen (14) hours of training, but did not verify the issue with documentation or further information. 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 and interview, the surveyor found the following: School Age Classroom 1. Two (2) drawers containing art supplies contained what appeared to be pest droppings inside the drawer. Staff reported that pest control services the premises monthly; however, the drawer had not been cleaned for an unknown amount of time. Toddlers Classroom: 1. The bathroom wall had a vent cover with peeling, chipped. missing paint, and contained layers of dust. Staff reported the vent cover would be replaced. Hygienic Practices In Compliance 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.

Based on observation, the surveyor found the area underneath the swings was missing a protective surface and the ground was exposed. Staff reported the wooden mulch protective surface would be replaced. 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 13. Toys and Furnishings.

General: Based on observation and interview, the surveyor found the blue teeter totter was missing one (1) handlebar cover and two (2) handlebar covers were broken or ripped leaving the sharp handlebar ends exposed. Staff reported the handlebar covers would be replaced. 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 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 observed a staff member outside and walking down the sidewalk toward the child-care center building when pulling into the driveway of the child-care center at approximately 9:00 a.m. The surveyor walked inside the child-care center building at approximately 9:01 a.m. and found the staff member to be the only staff member present with the children in the Preschool/School Age Classroom. The surveyor observed seventeen (17) children in the classroom. During interview, a staff member reported the children ranged in age from two-years-old to eight-years-old. Staff stated she was the only staff member for the classroom and had went outside to the freezer to get more pancakes for the children; therefore, the children were not within scope of vision and range of voice. Staff reported there was supposed to another staff member in the classroom; however, the staff member was late arriving to the center. The surveyor observed two (2) other staff members present at the child-care center, one (1) in the Nursery and one (1) in the Two-Year-Old Classroom. The surveyor observed two (2) more staff members to arrive at the child-care center at approximately 9:05 a.m. and work inside the Preschool/School Age Classroom. 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, the surveyor observed a staff member outside and walking down the sidewalk toward the child-care center building when pulling into the driveway of the child-care center at approximately 9:00 a.m. The surveyor walked inside the child-care center building at approximately 9:01 a.m. and found the staff member to be the only staff member present with the children in the Preschool/School Age Classroom. The surveyor observed seventeen (17) children in the classroom. During interview, a staff member reported the children ranged in age from two-years-old to eight-years-old. Staff stated she was the only staff member for the classroom and had went outside to the freezer to get more pancakes for the children. Staff reported there was supposed to another staff member in the classroom; however, the staff member was late arriving to the center. The surveyor observed two (2) other staff members present at the child-care center, one (1) in the Nursery and one (1) in the Two-Year-Old Classroom. The surveyor observed two (2) more staff members to arrive at the child-care center at approximately 9:05 a.m. and work inside the Preschool/School Age Classroom.; therefore, putting the classroom within staff-to-child ratio. The surveyor reviewed the attendance records to verify when each children arrived at the child-care center and found that the classroom exceeded staff-to-child ratio beginning at approximately 8:00 a.m. General Administration 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 8. General.

General: Based on observation and interview, the surveyor found the following: 1. The surveyor observed a staff member outside and walking down the sidewalk toward the child-care center building when pulling into the driveway of the child-care center at approximately 9:00 a.m. The surveyor walked inside the child-care center building at approximately 9:01 a.m. and found the staff member to be the only staff member present with the children in the Preschool/School Age Classroom. The surveyor observed seventeen (17) children in the classroom. During interview, a staff member reported the children ranged in age from two-years-old to eight-years-old. Staff stated she was the only staff member for the classroom and had went outside to the freezer to get more pancakes for the children. Staff reported there was supposed to another staff member in the classroom; however, the staff member was late arriving to the center. The surveyor observed two (2) other staff members present at the child-care center, one (1) in the Nursery and one (1) in the Two-Year-Old Classroom. The surveyor observed two (2) more staff members to arrive at the child-care center at approximately 9:05 a.m. and work inside the Preschool/School Age Classroom. Therefore, the health, safety, and comfort of the children was compromised. 2. Through interview with staff members, the surveyor found that a former staff member had a loud tone that would have been considered screaming with the children in the Preschool/School Age Classroom. Through interview with staff, the surveyor learned the staff member could be heard "clear to the Nursery from the Preschool/School Age Classroom." The surveyor observed the Preschool/School Age Classroom to be located in the front part of the building and the Nursery and Two-Year-Old Classroom to be located in the back part of the building. The surveyor observed half doors to the classrooms. Through interview with staff, the surveyor learned the staff member could be heard shouting and instructions were given too loud such as "sit down," "get down," in the Preschool/School Age Classroom. Through interview with staff, the surveyor learned the former staff member would scream and yell at the children to "sit down," and "don't do that." During interview, staff-in-charge stated she would always address it and tell the staff member to get down on the child's level to talk to them and redirect them. Therefore, the health, safety, and comfort of the children was compromised.

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 the following children’s (DOE: 12/25/19 and 12/25/19) files did not contain a contact telephone number for the child’s preferred hospital. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 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 6. License Issuance.

General: Based on review of documentation, the surveyor found no documentation of a Fire Marshal report. During interview, staff-in-charge stated that the Fire Marshal had visited the child-care center; however, they did not provide her with any documentation to verify the visit.

Open Not marked corrected in the state record

Category: physical safety. 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 staff person to take over supervising five (5) children in the Preschool/School Age Classroom during nap time. The surveyor observed the staff person to sit in a chair in front of the open entry way of the classroom to supervise the children. The surveyor observed one (1) child asleep on a cot that was positioned back in an open closet. The child's head/face was observed to be out of view due to the positioning of the cot; therefore, the health, safety and comfort of the child was compromised. Through interview with staff, the surveyor learned that the child was approximately two-years-old. 2. The surveyor observed a child asleep on a cot that was positioned back in an open closet in the Preschool/School Age Classroom. The surveyor observed approximately seven (7) cots that were standing upright placed beside the child's cot. The cots did not appear to be secure; therefore, the health, safety and comfort of the child was compromised. Through interview with staff, the surveyor learned that the child was approximately two-years-old. 3. One (1) bottle of Anti-Bacterial Liquid Soap was observed to be placed on the sink in the Preschool/School Age Classroom that read, "Keep Out of the Reach of Children," on the label; therefore, the health, safety and comfort of the children was compromised. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 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 a staff’s (DOH: 06/06/22) 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. During interview, staff-in-charge stated that the staff person has had a TB skin test; however, the staff person was waiting on the test to be read. 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 surveyor found that the sink in the Preschool/School Age Classroom did not drain properly; therefore, the sink was not kept in good repair. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance 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 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 that a child’s (DOE: 12/25/19) file contained an immunization certificate that was no longer current as of 10/01/22.

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 that the daily attendance record for 10/19/22 had four (4) children’s arrival times documented; however, fifteen (15) children were present. Posted Documentation In Compliance Animals 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 6. License Issuance.

General: Based on interview, staff-in-charge stated that she could not locate the most recent documentation from the Fire Marshal; therefore, the surveyor was unable to determine if the center had a current Fire Marshal Report. During the interview, the staff-in-charge stated that the local Fire Marshal had recently passed away and that she had called to see if someone could come out to update her documentation. At this time, they do not know when someone can come out to her center to update the form. Director Requirements 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 10. Director Requirements and Responsibilities.

General: Based on review of documentation, the surveyor found the following: 1. A staff’s (DOH: 02/01/10) file contained an annual written performance evaluation dated for 02/07/20; therefore, the surveyor was unable to determine that the evaluation was completed annually. 2. A staff’s (DOH: 05/28/20) file did not contain a written performance evaluation; therefore, the surveyor was unable to determine that the evaluation was completed annually. Employee Records In Compliance Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 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 surveyor found that the restroom in the hallway, across from the Toddler Classroom had paper towels on the floor; therefore, the restroom 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 in the restroom located in the School Age Classroom, the surveyor found that the toilet seat moved easily and was not tightly secure to the commode. 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 of the diaper changing table located in the Toddler Classroom, the surveyor found dirt underneath the diaper changing pad; therefore, the diaper changing surface was not kept clean. First Aid/Medication In Compliance Outdoor Play Area In Compliance 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 2 of 3 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, a child’s (DOE: 01/02/20) file did not contain the authorization by the parent for the child-care center to seek emergency medical care for the child in the parent’s absence. 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 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation during a tour of the center, the following were found: 1. There were cobwebs found on the ceiling located in the dramatic play center above the window. 2. There was heavy dust found on the vent in the restroom located in the hallway. 3. There was a piece of brownie on the floor located in the school-age room. 4. There was a sock on the floor, by the brownie, located in the school-age room. During interview, staff stated that the issues mentioned would be taken care of immediately. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 5. Evacuation Plan.

General: Based on review of documentation presented, the surveyor found that the last documented date of review on the center's emergency preparedness plan was from 2016. During interview, staff stated that the plan is reviewed annually; however, it was not documented with a date of review or signature of the reviewer. Posted Documentation In Compliance Animals In Compliance Emergency Regulation 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 contained in ten (10) children’s enrollment information, the surveyor found the following: 1. Four (4) of the children’s enrollment documentation did not contain authorization by the parent for the childcare center to seek emergency medical care for the child in the parent’s absence. 2. One (1) child’s enrollment documentation did not contain the child’s general health status and medical history. 3. Three (3) of the children’s enrollment documentation did not contain information to enable a person in charge to contact the child’s preferred hospital. 4. One (1) child’s enrollment documentation did not contain information to enable a person in charge to contact the family physician or preferred hospital. 5. One (1) child’s enrollment documentation did not contain the child’s date of enrollment. Interview with staff found that the child’s enrollment date was not available for review. 6. One (1) child’s written record was not signed or dated by the parent. 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 the annual written plan for professional development for staff (DOH: 2/1/10) was not signed.

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 list containing the children’s full names and dates of birth was posted on the wall in the Preschool Room and in the classroom for the one and two-year-old children. Therefore, the children's information was not kept confidential. 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 11. Toys and Furnishings.

General: Based on observation during a tour of the playground, the surveyor found that paint was flaking and peeling from the posts of the wooden swing set. Transportation Not Applicable Food Service/Food Program Not 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 documentation, the surveyor found that a seventeen-year-old individual (Start Date: 6/3/19) volunteers at the childcare center. Verification of a Child Abuse and Neglect background check was not found for the individual. Through interview with staff, the surveyor learned that the childcare center has not completed the Child Abuse and Neglect background check. The staff person stated that the individual is not alone with the children. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report 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. The surveyor found no verification of a staff’s (DOH: 2/1/10) annual written performance evaluation. Interview with staff found that the annual performance evaluation was not available for review. 2. The surveyor found no verification of a staff’s (DOH: 8/16/16) annual written performance evaluation. Interview with staff found that the annual performance evaluation was not available for review.

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 during a tour of the childcare center, the surveyor found the following: 1. While touring the Infant Room, the surveyor observed that a pacifier with a strap attachment was clipped to an infant’s shirt. A staff person sat down on the floor with the child. On multiple occasions, the pacifier fell from the infant’s mouth onto the floor. The staff placed the pacifier back in the child’s mouth without sanitization. 2. While touring the Preschool Room, the surveyor found that child-size cots were leaned against the wall. Plastic storage totes and blankets were stacked on top of the cots. The cots and totes easily toppled; thus, presenting a safety risk to the children. 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 and ECE-TRIS, the surveyor found the following: 1. No verification was found that a staff (DOH: 2/22/19) has completed six (6) hours of cabinet-approved orientation training. 2. No verification was found that a staff (DOH: 4/15/19) has completed six (6) hours of cabinet-approved orientation training. 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 during a tour of the Preschool Room on 1/6/2020, the surveyor found that the daily planned program was posted on the wall. The daily planned program was dated 12/2019; therefore, was no longer current. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Premises In Compliance Hygienic Practices In Compliance 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 9. Food and Meal Requirements.

General: Based on observation, the surveyor observed that staff served pasteurized two (2) percent milk rather than pasteurized one (1) percent low-fat milk or pasteurized fat-free skim milk to the children whose ages ranged from three-years-old to five-years-old. 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 8. Kitchen Requirements.

General: Based on observation during a tour of the Infant Room, the surveyor observed a bottle stored in the refrigerator. The bottle was not labeled. 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

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor was not presented with documentation of one (1) staff identified as a substitute to meet the staff requirements of this administrative regulation for a Type 1 center based on lack of cabinet-approved early care and education annual training hours. During interview, the director stated she was not aware that the hours of training were not met. General Administration In Compliance Director Requirements 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 10. Director Requirements and Responsibilities.

General: Based on observation, the surveyor found small rodent droppings in a cabinet with drawers in the Preschool Room, that is used for supplies. The cabinet is not locked and the children have access to the drawers used for supplies. During interview, the director stated she was not aware of the droppings. Based on observation, the surveyor found an approximate three (3) foot cable wire was stretched across the wall in the Toddler Room. The cord was attached to the television and was within reach of the children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 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 9. Records.

General: Based on review of documentation, a personnel file presented to the surveyor for review was not completed on a volunteer in accordance with regulations, as the following required documentation was not in the record: 1) Date of hire; 2) Date of birth; 3) Proof of education; 4) Criminal record check; 5) Central Abuse/Neglect Registry check. During interview, the director stated that the volunteer had not been in the center for quite some time due to an illness and they were not expecting her back; however, the file had been on the premises before the volunteer became ill. The Director stated that due to unexpected circumstances, the volunteer was in the center today and could possibly be in the center other days. The Director stated they would have the file on the premises.

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 was not presented with documentation of one (1) staff identified as a substitute to meet the staff requirements of this administrative regulation for a Type 1 center based on lack of cabinet-approved early care and education annual training hours. During interview, the director stated she was not aware that the hours of training were not met. 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 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 and interview, the surveyor found that the bathtub in the restroom off of the School-Age Classroom was being utilized for storage. There was a high chair and bouncy seat stacked on top of several bags of clothing. The high chair and bouncy seat were not secure and were at risk of falling out of the tub; therefore, placing the safety of the children that utilize the restroom at risk. Staff acknowledged safety concern regarding the high chair and bouncy seat falling out of the tub onto a child. Employee 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 5. Staff Requirements.

Based on review of documentation and interview, the surveyor found that a substitute file (DOH: 9/25/17) did not contain proof of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential. The Director confirmed that proof of education had not yet been obtained. 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

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation and interview, the surveyor found that the center did not have adequate substitutes as one (1) substitute file (DOH:9/25/17) did not have proof of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential. The substitute is not qualified. Upon interview, the Director acknowledged that the substitute was a new hire and she did not have a copy of proof of education.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation and interview, the surveyor found that the center did not have two (2) qualified substitutes as one (1) substitute file (DOH:9/25/17) did not have proof of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential. Upon interview, the Director acknowledged that the file for a substitute did not have a copy of proof of education.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation and interview, the following was found: 1. A staff file (DOH: 2/1/10) presented for review contained documentation of having completed Pediatric Abusive Head Trauma (PAHT) training on 5/15/12; therefore, the PAHT training had not been completed every five (5) years per requirements. 2. A staff file (DOH: 2/13/08) presented for review contained documentation of having completed Pediatric Abusive Head Trauma (PAHT) training on 5/15/12; therefore, the PAHT training had not been completed every five (5) years per requirements. 3. A staff file (DOH: 2/28/08) presented for review contained documentation of having completed Pediatric Abusive Head Trauma (PAHT) training on 5/15/12; therefore, the PAHT training had not been completed every five (5) years per requirements. The Director related that she was not sure that the training was required every five (5) years. 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 In Compliance Children's Records In Compliance Written Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 2. General.

General: Based on observation and interview, the surveyor found that the Consumer Product Safety Program or the website were not posted in the center. Upon interview, the Director confirmed that the information was not posted. Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation and ECE-TRIS, a staff (DOH: 06/15/15) did not obtain nine (9) hours of cabinet approved early care and education training within the first year of employment including one and one-half (1 1/2) hours of pediatric abusive head trauma training. 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) child sleeping in a crib using a boppy pillow. After interviewing the director, it was learned that the child does not have written permission for use of the boppy pillow in the crib. 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 2 Inspection Report Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable 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 3. General Requirements.

General: Based on observation, the surveyor observed one (1) infant lying in a swinging chair with a bottle propped on the child's shoulder. 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, one (1) child's (DOE: 08/15/16) immunization certificate was no longer current. 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 2:110 · 922 KAR 2:110. Section 3. Records.

General: Based on review of documentation, there were two (2) children's (DOE: 09/02/14 and 02/04/15) files that did not contain a preferred hospital in case of an emergency.

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 had documentation of a written evacuation plan; however, the plan was last updated on 07/16/14. Therefore, the evacuation plan was not updated annually as required.

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, at 10:35 a.m. the director walked out of the classroom into the school age classroom toward the child care center office, a child from the toddler’s classroom followed the director out of the toddler classroom and into the preschool classroom. As the director turned around to go back into the toddlers classroom, she witnessed the child out of the toddler classroom. The child was unsupervised by a staff person for less than one (1) minute.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation, there was one (1) staff (DOH: 10/23/15) file that did not contain documentation of negative TB results.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 5. Infant and Toddler Play Requirements.

General: Based on observation and interview, there were six (6) children present in the toddlers classroom. A staff person stated during interview that the children ranged from one to two (1 -2) years of age and that the children had been combined all day on the day of the survey. Therefore, the toddler children were combined with older children for more than one (1) hour.

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 and interview, there was one (1) potty seat located in the restroom of the toddlers classroom. The potty seat had a brown substance located on the top of the seat and the seat was accessible to the children. A staff person informed the surveyor that the potty seat was no longer used by the children in the classroom.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the diapering pad in the under one-year-old classroom had brown substance located on the top of the pad. The surveyor raised up the changing pad out of the changing table; the pad had an unpleasant odor when raised from the changing table.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on interview, a staff person stated that the mouth contact toys were sanitized by spraying the toys with soapy water then wiping the toys with a clean cloth. This procedure does not meet the regulatory requirements. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 14 of 26 Web site: http://chfs.ky.gov/ Inspection Report First Aid/Medication

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 following was found on the outdoor playground: 1. There was a pipe protruding out of the ground, the pipe had pieces broken from it and had sharp edges. 2. The lower playground roof is a black plastic covering. The playground is partially under the child care center building. The black plastic was falling from the ceiling, exposing the building's insulation.

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 observation, the thermometer located in the freezer in the kitchen indicated that the temperature was twenty-four (24) degrees Fahrenheit. Therefore, the frozen food was not kept at a temperature of zero (0) degrees or below on the date of the inspection.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on observation, there was one (1) child's (DOE: 12/09/12) file that contained an immunization certificate; however, the expiration date on the certificate (8/25/15) had been marked out and a later date (12/25/16) had been written in the place of the original date. Therefore, it could not be determined if the immunization certificate was valid. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 2. General.

General: Based on observation during a tour of the child care center, the surveyor found the following: 1. Lists of the children's full names and dates of birth were posted in the Infant and Toddler Room and Preschool Room. 2. A doctor's statement identifying a child’s (DOE: 01/15/14) medical diagnosis and need for an alternate sleeping position had been posted in the Infant Room.

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 surveyor found that an infant child was wearing a bib while sleeping in a crib.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation in personnel files and ECE-TRIS, the surveyor found that a staff (DOH: 06/21/10) had obtained only twelve (12) hours of cabinet- approved early care and education annual training. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found an unlabeled bottle in the refrigerator located in the Infant and Toddler Room.

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 during a tour of the child care center, the surveyor found that the proper methods for diapering were not posted over the diaper changing area located in Preschool Room. Animals 1175 - Animals in the Presence of Children Not Applicable 922 KAR 2:120. Section 13. Animals. (1) An animal shall not be allowed in the presence of a child in care: (a) Unless: 1. The animal is under the supervision and control of an adult; 2. Written parental consent has been obtained; and 3. The animal is certified as vaccinated against rabies; or (b) Except in accordance with subsection (3) of this section. 1185 - Prohibited Animals Not Applicable 922 KAR 2:120. Section 13. Animals. (3) An animal that is considered undomesticated, wild, or exotic shall not be allowed at a child-care center unless the animal is: (a) A part of a planned program activity lead by an animal specialist affiliated with a zoo or nature conservatory; and (b) In accordance with 301 KAR 2:081 and 301 KAR 2:082. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 25 of 26 Web site: http://chfs.ky.gov/

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

General: Based on review of documentation, the surveyor found that four (4) staff (DOH: 02/13/08, 02/01/2010, 09/28/2010 and 06/21/2012) files did not contain current annual performance evaluations.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation, the surveyor found that the file for a staff (DOH: 02/01/10) contained a copy of a negative tuberculin result that was no longer current as of 03/31/2013.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation, the surveyor found that the file for a staff (DOH: 06/21/10) contained documentation of only twelve (12) hours of annual cabinet- approved early care and education training. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty one (21) years old; (b) Complete the background checks as described in 922 KAR 2:110; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

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 during a tour of the child care center, the surveyor found that a large screw had been used to permanently close a sink drawer located in the restroom used by the children. The screw was observed to be protruding upward out of the wood and was accessible to the children. The surveyor found that the air vents located in the Infant Room and children’s restroom were coated with a thick layer of dust.

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. Animals.

General: Based on review of documentation, the surveyor found that the child care center had not obtained written parental consent for the children to be in the presence of a fish.

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 that the first-aid kit contained a non-working flashlight. 660 - Medication Administration Not Applicable 922 KAR 2:120. Section 7. First Aid and Medicine. (4) Prescription and nonprescription medication shall be administered to a child in care: (a) With a daily written request of the child’s parent. (b) According to the directions or instructions on the medication’s label. 665 - Administration Record Not Applicable 922 KAR 2:120. Section 7. First Aid and Medicine. (5) The child-care center shall keep a written record of the administration of medication, including: (a) Time of each dosage; (b) Date; (c) Amount; (d) Name of staff person giving the medication; (e) Name of the child; and (f) Name of the medication. 670 - Medication Not Applicable 922 KAR 2:120. Section 7. First Aid and Medicine. (6) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child; (b) Kept in the original bottle; and (c) Properly labeled. (7) Medication shall not be given to a child if the expiration date on the bottle has passed. Outdoor Play Area

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

Based on observation, the surveyor found that the child care center's fish tank contained dark murky water and had a green-colored film on the interior glass.

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 surveyor found that the metal chain that holds the swing to its base was broken, presenting a safety hazard to the children. Additionally, the surveyor found that a plastic rail located on the top of a large climbing apparatus was broken, presenting a risk for fall.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that a black mold-type substance was on the exterior of a freezer located on the back porch of the child care center. Through interview, the surveyor learned that the freezer contained food that is to be served to the children.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the posted menu did not have a current date.

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, the surveyor found that the file for a child (DOE: 05/07/13) contained an immunization certificate that was no longer current as of 07/30/13. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that two (2) staff (DOH: 02/13/08 and 06/21/2012) files did not contain current written annual plans for professional development.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 3

General: Based on review of documentation, the records for staff members (DOH: 9/28/10, 1/21/11, 6/21/10, 11/16/10, and 2/28/08) did not contain professional development plans. 107 - Maintenance of Background check/Out of State 922 KAR 2:110 - Section 3 (12) For the director, employee, volunteer, or any person with supervisory or disciplinary control over, or having direct contact with a child, results of the: (a) Criminal records check in accordance with KRS 17.165; (b) Child abuse and neglect check in accordance with 922 KAR 1:470; and (c) Background check from: 1. Previous state of residence, if the individual has been a resident outside of Kentucky in the previous five (5) years; or 2. Current state of residence, if other than Kentucky; 1) Criminal Records Check In Compliance 2) Child Abuse/Neglect Check In Compliance 3) Previous State of Residence In Compliance 4) Current State other than KY In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 5 Staff Requirements.

General: Based on review of documentation, the records for staff members (DOH: 9/28/10 and 11/16/10) did not contain education documentation.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 3

Infant Room: Based on observation, an infant child was sleeping in a swing rather than a crib as recommended by the American Academy of Pediatrics.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 5

Toddler Room: Based on observation, the surveyor found three (3) two-year-old children in the Toddler Room. The two-year-old children were mixed with the toddlers all day. 282 - Toilet Training Not Applicable 922 KAR 2:120 - Section 10 (5) Toilet training shall be coordinated with the child's parent. Premises - Classroom

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infant Room: Based on interview, the surveyor found the following: 1). Staff members are not scrubbing mouth contact toys with a scrub-brush. 2). Mouth contact toys are not being submerged in a sanitizing solution for at least two minutes. The staff stated that they are soaking the mouth contact toys in a bleach/water solution for approximately thirty (30) seconds and then allowing the toys to air dry. 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 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 4 (1)

Toddler: Based on observation, the surveyor found that the return air vent in the restroom was rusty. The vent was located low to the ground and within reach of the children. 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 11 of 40 Web site: http://chfs.ky.gov/ Inspection Report 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 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 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 7) Shielded/shatter proof bulbs Not In Compliance Findings: Preschool: Based on observation, the surveyor found that the bulbs in the light fixture in the preschool room were not shielded. The director and owner stated that they did not know if the light bulbs were shatter proof. Toddler: Based on Observation, the surveyor found that the bulbs in the light fixture in the toddler room were not sheilded. The director and owner stated that they did not know if the light bulbs were shatter proof. Infant: Based on Observation, ceiling fun W/ bulbs not protected 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 40 Web site: http://chfs.ky.gov/ Inspection Report 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

Toddler: Based on interview, the surveyor learned that the toys are sprayed with bleach at the end of each day and washed in the diswasher at the end of the week. The center's santizing procedure did not include scubbing with a brush, rinsing, or submerging in a santizing solution for at least two (2) minutes and then letting them air dry as required. 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 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 3

General: Based on review of documentation, the file presented for review for a child (date of enrollment - 08/12/11) contained an immunization certificate that was no longer current as of 10/15/11.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.