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. One (1) staff (DOH: 06/28/23) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the second year review period of 06/29/24-06/30/24. 2. One (1) staff (DOH: 05/08/24) completed fourteen (14) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 05/08/24-05/08/25.

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 a broken baby gate at the bottom of a wooden staircase on the side of the childcare center building next to the playground. Staff- in-charge stated the gate had been placed there to prevent access to the staircase and the second story; however, the latch on the gate was broken. Therefore, this gate was not in good repair. Staff-in-charge stated she would have this fixed.

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 on the outdoor playground area: 1. Several items of paper debris consisting of what appeared to be discarded hand wipes or paper towels and a discarded Taco Bell bag. 2. An empty discarded plastic bag as well as a discarded empty plastic water bottle on the playground. Therefore, the playground was not free from litter. Staff-in-charge stated the apartment complex next door placed their dumpster right next to the center’s playground, so they have problems with litter blowing into the playground from the dumpster. Staff-in-charge stated she would have the playground area cleaned. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 20 of 32 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 overgrown grass and weeds inside the chain link fencing and in multiple areas around the playground; therefore, the playground area was not well-maintained. Staff-in-charge stated she would have someone take care of the overgrown areas on the playground.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on interview, the surveyor learned that a staff member fell asleep during nap time while supervising children in the Nursery. Staff-in-charge stated that there was a second staff member in the classroom during the time the staff member fell asleep. Programming 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 of the Nursery, the surveyor found an infant was propped upward on a boppy pillow while sleeping in a crib. The surveyor confirmed with a staff member that the infant was six-months-old and had been asleep for a few minutes. The surveyor reviewed the child's enrollment file and spoke with the staff-in-charge to confirm that the infant did not have documentation that the child required an alternate sleep position. Premises In Compliance Hygienic Practices In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A green highchair that was supposed to have safety straps did not contain straps in the Infant Classroom. Upon arrival, the surveyor observed a child seated in the highchair with the tray positioned in front of them while a staff member was seated in front of the child feeding them. Therefore, the health, safety, and comfort of the child was compromised. During interview, staff stated they had not been able to locate the straps to the highchair. Staff-in-charge stated the child was ten-months-old and staff should not be using the highchair. 2. An unsecured cord leading from a swing that was placed on the floor to an outlet in the Infant Classroom. 3. An unsecured cord coming down the side of the sink cabinet from a purple CD player in the Toddler Classroom. The items mentioned were observed to be accessible to the children; 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 ECE-TRIS, the surveyor found that a staff (DOH: 09/10/18) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 10/04/18; therefore, the training was not completed within the last five (5) years. Programming In Compliance Premises In Compliance Hygienic Practices 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found a rip/tear in the diaper changing pad in the Toddler Classroom; therefore, the diaper changing surface was not free of holes, rips, tears, or other damage. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found three (3) cribs in the Infant Classroom that contained loose fitting crib sheets; therefore, the crib sheets were not tight-fitted. One (1) sheet was pink and two (2) sheets were blue.

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.

Based on observation, the surveyor found two (2) cozy coupe cars on the playground that were missing doors; therefore, the cars were not kept in good repair. Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report 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 review of documentation, the surveyor discovered that a staff (DOH: 03/02/2023) personnel file did not contain a high school diploma, GED, or Commonwealth Child Care Credential; therefore, the surveyor was unable to verify the staff's proof of education. Staff reported that the staff plans to get a copy of her high school diploma. 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 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation and ECE- TRIS, the surveyor discovered that a staff (DOH: 05/11/2022) did not completed the required six (6) hours of cabinet-approved orientation completed within their first three (3) months of employment in a child-care program. Staff reported she would ensure that the staff completes the training. 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 a thick layer of dust on the air intake vent located in the Preschool Classroom. Staff reported that she would have the air vent cleaned. 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.

General: Based on observation, the surveyor observed the following: 1. There were multiple pieces of trash throughout the playground. 2. There were thick layers of leaves against the fence in multiple areas on the playground. Staff reported that she would have the playground cleaned.

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 observed multiple areas that the protected surface (mulch) was depleted exposing dirt on the playground. Staff reported she will have mulch added to the playground. Equipment In Compliance Transportation Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Kitchen Requirements 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, the surveyor observed a bottle without a covering that contained approximately four (4) ounces of liquid. Staff reported that she would talk to staff about covering the bottles when the bottles are not being used. Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found the following: 1. A white ceiling vent located in front of the exit door in the One Year Old Classroom that appeared to contain one (1) loose screw in the corner of the vent and was slightly hanging down; therefore, the ceiling vent was not kept in good repair. During interview, staff stated that she was not aware of the ceiling vent and would have the vent repaired. 2. A white ceiling vent located in front of the exit door in the Infant Classroom that appeared to missing one (1) screw in the corner of the vent and was slightly hanging down; therefore, the ceiling vent was not kept in good repair. During interview, staff stated that the ceiling vent had been in that condition since approximately May 2022. One (1) staff stated that she was aware of the ceiling vent; however, she was unsure how long the ceiling vent had been like that. Staff stated that she would have the ceiling vent repaired.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found multiple black droppings that appeared to be mouse droppings on the floor in the Infant Classroom between the diaper changing table and wall. One (1) black dropping that appeared to be a mouse dropping was located on the floor between two (2) cribs. During interview with staff, the surveyor learned that approximately three (3) to four (4) mouse droppings have been located on the floor beside the diaper changing table and under the cribs in the Infant Classroom when sweeping the floor in the evenings. One (1) staff stated that the child-care center was closed in approximately July 2022 due to COVID. Staff stated that she went to the child-care center before the children returned and discovered very few mouse droppings on the floor in the Kitchen. Staff stated that she had not seen any mouse droppings inside the classrooms. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

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 a staff (DOH: 09/24/2019) obtained zero (0) of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 07/01/20 – 06/30/21. 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found the toilet seat moved easily and was not tightly secured to the toilet in the girls' restroom; therefore, the toilet was not kept in good repair. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. Debris on the diaper changing table underneath the diaper changing pad in the Infant Classroom. 2. Debris on the diaper changing pad in the Infant Classroom 3. Debris on the diaper changing table underneath the diaper changing pad in the One's Classroom. Therefore, the diaper changing surfaces were not kept clean. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A crib located in the Infants Classroom had a mattress that contained dirt & stains on top of the mattress; therefore, the crib was not kept in clean condition. 2. A crib located One's Classroom contained dirt on top of the mattress; therefore the crib was not kept in clean condition. 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

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1.The following children’s (DOE: 1/4/22, 4/4/21 and 1/4/22) files did not contain the contact telephone number for the children’s preferred family physician. 2. A child’s (DOE: 11/23/21) file did not contain the name or contact telephone number of the child’s preferred hospital. 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 8. Kitchen Requirements.

General: Based on review of documentation, the surveyor found a food service permit with an expiration date of 12/31/20; therefore, the food service permit is no longer current. Staff- in-charge stated that they are waiting to receive the new food service permit in the mail. 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: nutrition. 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: 04/01/04) file contained an annual written performance evaluation dated for 04/01/19; therefore, the evaluation was not completed annually. 2. A staff’s (DOH: 09/10/18) file contained an annual written performance evaluation dated for 08/22/19; therefore, the evaluation was not completed annually. 3. A staff’s (DOH: 09/24/19) file did not contain a written performance evaluation. Through interview with staff-in-charge, the surveyor learned that the written performance evaluations were not available for review. Employee Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. The surveyor observed one (1) staff person providing care for five (5) two-year-old children, three (3) three-year-old children, and one (1) four year old child in the Preschool Classroom. 2. The surveyor observed one (1) staff person providing care for one (1) two-year-old child, one (1) eight-month-old child, and three (3) one-year-old children in the One Year Old Classroom. Through interview with staff, the surveyor learned that the children had been in the mixed-age groups for longer than one (1) hour. The surveyor was not presented with transition plans and observed the children to be grouped together for the duration of the survey which was from 12:10 p.m. until 2:00 p.m. Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A child’s (DOE: 11/09/20) file did not contain a contact telephone number for the child’s preferred hospital. 2. A child’s (DOE: 11/12/08) file did not contain a contact telephone number for the child’s preferred hospital. 3. A child’s (DOE: 09/10/18) file did not contain a contact telephone number for the child’s preferred hospital. 4. A child’s (DOE: 08/17/20) file did not contain the name of a preferred hospital or contact telephone number. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A staff’s (DOH: 04/30/2012) file contained a professional development plan dated for 11/29/18; therefore, the plan was not completed annually. 2. A staff’s (DOH: 09/10/18) file contained a professional development plan dated for 11/29/18; therefore, the plan was not completed annually. 3. A staff’s (DOH: 09/24/19) file did not contain a professional development plan. 4. A staff’s (DOH: 04/01/04) file did not contain a professional development plan. Through interview with staff-in-charge, the surveyor learned that the professional development plans were not available for review. 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 2:120 · 922 KAR 2:120. Section 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found a toilet seat was loose in one (1) of the restrooms. Staff was not aware of the issue stating the seat would be fixed immediately. 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 Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the playground contained five (5) Little Tikes climbing structures. Three (3) of the Little Tikes climbing structures contained slides. There was not an adequate protective surface around the climbing structures and slides. Staff reported they planned to get new mulch for the playground as soon as possible. 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 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, the surveyor found that a staff (DOH: 4/30/12) obtained a negative tuberculin result on 5/18/16; therefore, the result was no longer current as of 5/18/18. A copy of a current negative tuberculin result or statement from a health professional that the individual is free of active tuberculosis was not presented to the surveyor 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 review of documentation and ECE-TRIS, the surveyor found that a staff (DOH: 12/07/18) completed six (6) hours of cabinet approved orientation training on 3/9/18; thus, not within three (3) months of employment. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the childcare center, the surveyor found that one (1) staff person was providing care for six (6) children. Through interview with the staff, the surveyor learned that the children were one and two-year-old children and that they had been in the mixed-age group for longer than one (1) hour. 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 3. General Requirements.

General: Based on observation during a tour of the childcare center, the surveyor found that a staff’s purse was stored on a shelf of the computer table located in the kitchen. The kitchen is adjacent to the Preschool Room where six (6) three and four-year-old children were in attendance. The kitchen door was wide open; thus, the purse was within reach and accessible to the children. 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 6. Sleeping and Napping Requirements.

General: Based on observation, the surveyor found the following: 1. An approximate one (1) inch nonabsorbent pad/mattress did not properly fit a crib located in the Infant Room. A tightly fitting sheet covered the pad/mattress, which pulled both ends upward and off the crib base. 2. A crib contained two (2) approximate one (1) inch nonabsorbent pads/mattresses that were stacked and covered with a crib sheet. The pads/mattresses did not properly fit the crib located in the Infant Room. Therefore, neither crib contained a firm crib mattress as required by regulations. Transportation Not Applicable 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 9. Records.

General: Based on observation during a tour of the childcare center on 3/15/19, the surveyor found that seventeen (17) children were present. Review of the daily attendance record found that only fifteen (15) of the children’s arrival times were documented. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Posted Documentation In Compliance Animals Not Applicable

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 and interview, the surveyor found that there were fifteen (15) children between one-year-old and four-years-old combined in the School-Age Classroom with three (3) staff supervising. The maximum group size for one-year-old children was exceeded by three (3) children. Staff reported that the children had been eating breakfast. General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. 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 following were found: 1. A television was on a shelf approximatley one (1) foot off of the floor in the Two's Classroom. The television was not secured to the shelf thus presenting a safey risk to the children. Staff stated that the television is usually stored in the storage room but she had failed to return it to storage after a movie day the previous week. 2. A wall shelf was unlevel and loosely attached to the wall in the Two's Classroom. There were various items stored on the shelf and it was at risk of falling on the children. Staff reported that the shelf had only been loose for a few days. 3. There was a black area on the base board and drywall in the corner of the girl's restroom behind the toilet. The black area could pose a health risk to the children if it is mold. The owner reported that the landlord has looked at the area and states that it is not mold. 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 6. License Issuance.

General: Based on review of documentation and interview, the surveyor found that a staff file (DOH: 8/28/17) presented for review contained a criminal records background check that was submitted on 9/11/17; therefore, the background check was not submitted timely. Upon interview, the owner was not aware that the background check was not submitted timely.

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 ocumentation, review of ECE-TRIS, and interview, the following was found: 1. A staff file (DOH: 8/28/17) presented for review did not contain documentation of having obtained six (6) hours of state required orientation training. Review of ECE-TRIS, revealed that the staff member was not entered in ECE-TRIS. Therefore, the surveyor could not verify that orientation had been completed within three (3) months of the date of hire. 2. A staff file (DOH: 4/1/04) presented for review only contained documentation of the completion of fourteen (14) hours of annual training. Review of ECE-TRIS, revealed that fifteen (15) hours of training had been completed; however, only fourteen (14) of those hours counted towards the annual training requirement. Upon interview, staff did not realize that one (1) hour of training did not count towards the annual training requirement. 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 and interview, the surveyor found that the restroom floor covering is not in good repair as a section of a linoleum floor tile is missing in the boys' restroom. The owner stated she was aware of the damaged floor. 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: 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 and interview, the surveyor found that the base of the toilet in the boys' restroom was not maintained in a clean condition as there was a large yellow substance dried on the base of the toilet. Staff reported that the restrooms are cleaned daily and that the toilet had already been wiped clean one (1) time the morning of the survey. 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 11. Toys and Furnishings.

General: Based on observation and interview, the surveyor found the following: 1. The wooden cribs located in the nursery had chipped paint on the side rails. The owner stated she was aware of the chipped paint but was not sure how to fix it. 2. The Exersaucer located in the nursery was soiled in the crevices of the blue section of the activity trey. Staff reported that she had been working in the nursery for a week and the Exersaucer had not been cleaned in that time. Transportation Not Applicable Food Service In Compliance 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 surveyor found that a child's file (DOE: 12/5/16) contained an immunization certificate that was not valid. The immunization certificate did have a date documented on it for when the immunizations would need to be updated. Upon interview, the owner was not aware that the date was missing from the immunization certificate. 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, upon arrival to the childcare center on 02/24/17 at 9:05 a.m., the surveyor found that two (2) staff in the Preschool Room were providing care for thirteen (13) children whose ages ranged from one to eight-years-old. Staff informed the surveyor that the children were in the mixed-age group as they had just finished eating breakfast. Breakfast was reportedly served between from 8:30 a.m. and 9:00 a.m.; however, food nor plates were observed on the tables. Staff confirmed that for approximately thirty (30) minutes, the staff-to-child ratio and group-size exceeded regulatory compliance by one (1) child. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. 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 two (2) children in the Infant and Toddler Room were using pacifiers that had stuffed animal attachments. The stuffed animals could fall across the child’s face and inhibit breathing. 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 3. General Requirements.

General: Based on observation during a tour of the childcare center, the surveyor found the following: 1. A bottle of Wite-Out was observed on a computer desk located in the kitchen. The label on the Wite-Out bottle instructed that it should be kept out of the reach of children. The kitchen door was open and the Wite-Out was within reach of the children. 2. A bottle of Wite-Out was observed on top of an approximate four (4) foot high shelf located near the entry door in the Preschool Room. The oldest child was ten-years-old; therefore, the Wite-Out was within reach of the children. Written Documentation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found eleven (11) children in the preschool classroom with one (1) staff (DOH: 10/7/15). Through interview, staff confirmed she had a total of eleven (11) children with the youngest child being two years old and the oldest being four years old. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on interview, the surveyor found that the child care center director (DOH: 4/1/04) is employed at Cheddars during the hours the child care center is in operation. Through interview, the director (DOH: 4/1/04) confirmed working at Cheddars on Monday through Friday during the lunch shift. A manager at the restuarant confirmed that the director (DOH: 4/1/04) typically works Monday through Friday during the lunch shift. The center's hours of operation are Monday through Friday from 6:00 a.m. - 12:00 a.m. Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found an six-month-old infant sleeping in a bouncy seat. The infant was observed sleeping in the bouncy seat throughout the surveyor's visit at the center.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor observed a eight-month-old infant sleeping in a crib with a loose blanket and a boppy pillow. Based on interview with the infant classroom teacher, the child does not have permission from the parents or physican to use a boppy pillow in the crib.

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 no disposable gloves in the first aid kit. Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable 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

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation of staff files, it was found that one (1) staff member's (DOH: 11-16-16) file did not contain a child abuse and neglect background check (CA/N). Based on observation, the staff member was observed to be alone with a child, i.e., the staff member was assisting a child in the bathroom without supervision of other staff. Based on interview, the director stated the CA/N check was submitted; however, the results have not been received. The director further stated that they did not keep any written documentation to show that the CA/N check had been submitted timely. 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 6. License Issuance.

General: Based on review of documentation of staff files, it was found that one (1) staff member's (DOH: 11-16-16) file did not contain a child abuse and neglect background check (CA/N). Based on observation, the staff member was observed to be alone with a child, i.e., the staff member was assisting a child in the bathroom without supervision of other staff. Based on interview, the director stated the CA/N check was submitted; however, the results have not been received. The director further stated that they did not keep any written documentation to show that the CA/N check had been submitted timely. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 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 of staff files, one (1) staff member (DOH: 8-17-16) has not completed the required orientation training within the first three (3) months of hire. Programming 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 and interview, the surveyor found that minimum staff-to-child ratios and group size were not being maintained on 6/1/16. When the surveyor arrived at the center, two (2) staff were observed to be sitting outside on the porch of the center while a yard sale was being conducted. One (1) staff got up and immediatley went back inside the center. The surveyor observed during a tour of the center that the staff member who had been outside upon the surveyor's arrival was supervising the One's classroom. Upon interview two (2) staff members reported that while the staff member was outside for approximately six (6) minutes there was one (1) other staff member supervising the School Age classroom and One's classroom by standing in the doorway between the two (2) classes. The surveyor observed that there were six (6) one-year-old children and ten (10) school age children that would have been supervised by the one (1) staff member. The Director stated that they did not realize it was not okay for one (1) staff person to supervise the sixteen (16) children ranging in age from one-years-old to ten-years-old for a few minutes during nap time. General Administration

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 6. Reports.

General: Based on observation, interview, and review of documentation, the surveyor found the center failed to provide written notification to the Cabinet for an increase in capacity. The center is licensed to provide care for thirty (30) children. On 6/1/16, the surveyor observed a total of thirty-two (32) children present inside the center whom were being provided care by center staff. Review of the center's attendance record for 6/1/16 showed that only thirty (30) children were signed in on that date. Upon interview, staff reported two (2) of the children who are enrolled at the center (DOE: 1/24/14, 1/24/14) were children of a staff member. Staff reported the two (2) children had been dropped off late by their father at approximately 8:30 a.m. on 6/1/16. Staff reported the children were not signed in that day as their mother gave them permission to stay outside and help the director with her yard sale. Staff confirmed the children had been permitted to come into the center for a few minutes on 6/1/16 and were sitting on their cots by the Two's classroom door at the time of the surveyor's inspection. Director Requirements

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 surveyor found that one (1) child's file presented for review (DOE: 1/24/14) did not contain a current record of immunization. The immunization record on file was due to be updated by 2/19/15. Upon interview, staff stated they were aware that an updated immunization certificate was needed. Written Documentation

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.

Based on observation and interview, the surveyor found that two (2) school-age children who are enrolled at the center were dropped off by their father at approximately 8:30 a.m. and were permitted to assist the director of the day care center with her yard sale which started at 9:00 a.m. and was located in the front parking lot of the center. During the inspection, the surveyor observed the two (2) school-age children inside the center, sitting on their cots. Through interview, it was learned that the two children came into the center throughout the day to cool off. A review of the attendance documentation revealed that a time had been scribbled for their arrival but at no time during the day was their arrival or departure time documented.

Open Not marked corrected in the state record

Category: recordkeeping. 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 the Kids First of Lily Employee Policy Handbook states that “Staff must have a clear T.B. skin test and a clear criminal history check completed before beginning employment at Kid’s First”. Therefore, staff did not follow the policies set forth by the child care center when an individual was found to be alone and providing care for the children without having a completed criminal records background check or copy of a negative tuberculin result.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on observation, on 03/24/15 at 3:30 p.m., the surveyor found that an individual (DOH: 03/21/16) was alone with five (5) children in the two-year-old room. Through interview with the Director, the surveyor learned that the individual did not have a personnel file and has worked as a "volunteer" for about two (2) weeks. The Director stated that the Criminal Records and Child Abuse and Neglect background checks had not been submitted. The surveyor observed that the individual was alone with the children on 03/24/16 at 3:30 p.m., 3:55 p.m., 4:35 p.m. and 5:25 p.m. Employee Records

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 observation, on 03/24/15 at 3:30 p.m., the surveyor found that an individual (DOH: 03/21/16) was alone with five (5) children in the two-year-old room. Through interview, the Director stated that the criminal records and Child Abuse and Neglect background checks had not been submitted and that the individual had "volunteered" since 03/21/16. The surveyor observed that the individual was alone with the children on 03/24/16 at 3:30 p.m., 3:55 p.m., 4:35 p.m. and 5:25 p.m.

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 observation, on 03/24/15 at 3:30 p.m., the surveyor found that an individual (DOH: 03/21/16) was alone with five (5) children in the two-year-old oom. Through interview with the Director, the surveyor learned that the person did not have a personnel file and has worked as a "volunteer" for about two (2) weeks. Review of documentation indicated that the individual had worked the following: (03/21/16) 8:50 a.m. until 12:00 p.m. and 1:00 p.m. until 5:00 p.m., (03/22/16) 9:00 a.m. until 12:00 p.m. and 1:00 p.m. until 5:30 p.m., (03/23/16) 8:30 a.m. until 12:00 p.m. and 1:00 p.m. until 7:00 p.m. and was observed to be providing care for the children on (03/24/16) from 3:30 p.m. until 5:25 p.m. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 4 Web site: http://chfs.ky.gov/ 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, the surveyor found no verification that a person (DOH: 03/21/16) that was providing care for the children on 03/24/16 had obtained a High School Diploma, GED or Commonwealth Child Care Credential.

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 no verification that a person (DOH: 03/21/16) that was providing care for the children on 03/24/16 had obtained a copy of a negative tuberculin result or a statement from a health care professional that the individual is free of active tuberculosis. Programming

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 during a tour of the child care center on 03/24/16 at 3:30 p.m., the surveyor found that seven (7) preschool-age children were seated at tables located in the Preschool Room while watching a Nickelodeon cartoon on television. The television program was not documented on the Lesson Plan.

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 during a tour of the child care center on 03/24/16 at 3:30 p.m., the surveyor found that a toddler-age child (DOE: 09/28/15) was being provided care with four (4) two-year-old children. During interviews with staff, the surveyor was informed that the child had been placed in the two-year-old room for about two (2) months for transition purposes. The child’s file did not contain a written Transition Plan nor was there documentation indicating the times of attendance in each classroom. Staff interviews conclude that when the staff-to-child ratio is exceeded in the Infant and Toddler Room, the oldest child is then placed with the preschool-age children. Equipment

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 child care center on 03/24/16 at 3:30 p.m., the surveyor found that a staff’s biological child was sitting at a desk while using a computer located in the kitchen of the Type-1 child care center. The staff person in the preschool room was standing close to the doorway and could observed the seven (7) children that were watching television in the classroom as well as the child in the kitchen. The staff person removed the child from the kitchen; however, he returned to the kitchen for an additional five to six (5-6) minutes.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on observation, during a tour of the Infant Room, the surveyor found that one (1) staff person was providing care for six (6) infant and toddler children whose ages ranged from seven to twenty-one (7-21) months of age. The staff to child ratio was exceeded by one (1) child.

Open Not marked corrected in the state record

Category: ratio. 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 that a staff's (DOH: 02/13/15) criminal records background check was dated 03/03/15. Through interview, the surveyor learned that there was no available documentation to verify the date on which the background check had been submitted. Through interview, the surveyor learned that the staff person had not been left alone with the children until her background check had been received.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview, the surveyor learned that the children's lunch components consisted of bologna, bread, potato chips, a cookie and milk. The children did not receive a vegetable and fruit or two (2) vegetables or two (2) fruits with their meal. Children's Records

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 three (3) of the children’s enrollment files did not contain information to enable a person in charge to contact the preferred hospital.

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 same time of day had been recorded to indicate that a fire, earthquake and tornado drill had been practiced for April and July 2015. Therefore, it could not be verified that all three (3) drills had been conducted.

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 the following: 1. The same time of day had been recorded to indicate that a fire, earthquake and tornado drill had been practiced for April and July 2015. Therefore, it could not be verified that all three (3) drills had been conducted. 2. The surveyor found that the fire drill for September 2015 had been practiced; however, the time that the drill had been conducted was not recorded.

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 as many as seven (7) infants have been present in the child care center during the week of February 9-13, 2015, but only two (2) individual cribs are available. Equipment

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that on 2/23/2015, three (3) infants were present in the child care facility, but only two (2) individual cribs were available. Based upon interview, the surveyor was told by staff that as many as five (5) infants have been present at the center. A review of documentation indicated that as many as seven (7) infants were present at the center during the week of February 9-13, 2015.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during the DRCC follow-up visit on 01/29/15, three (3) infants ages three (3) months-old to eleven (11) months-old were present at the child care center; however, only two (2) compliant cribs were available for use. During an interview, staff stated that the director had purchased two (2) additional cribs. The surveyor inspected a crib (Manufactured by Sheffield on 11/2010) and could not determine federal crib standard (16 CFR 1219-1220) compliance. Additionally, at the time of inspection there was no available mattress for this crib as required by regulations. The surveyor then inspected another crib (Manufactured by Cosco on 08/2002) and could not determine federal crib standard (16 CFR 1219-1220) compliance.

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 review of documentation, the surveyor found that a staff (DOH: 05/18/09) person's most current annual performance evaluation was dated 05/07/13; therefore, it did not meet regulatory compliance. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 5 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found that an extension cord was secured to a shelf that was approximately five (5) feet high and located in the Preschool Room. The cord extended down to within approximately one (1) foot of the floor; therefore, it was accessible to the children.

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 that a staff's (DOH: 09/26/14) criminal background check had been submitted on 10/08/14; thus, it was not submitted prior to or on the date of hire. Through interview, the surveyor learned that the staff had not been alone with the children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the Infant Room, the surveyor found that a three-month-old infant child had been placed in a crib with her pacifier. The pacifier had a strap and was secured to the child's clothing via a clip.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that the paint had chipped on the toilet seat located in the boys' restroom, exposing the underlying surface; therefore, it cannot be properly cleaned and sanitized. Hygienic Practices

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 interview with a staff, the surveyor learned that mouth contact toys located in the Infant Room are sprayed with bleach water, wiped with a clean wash cloth and air dried. 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 during a tour of the playground, the surveyor found that a small tin bucket contained a substance similar to sand and numerous cigarette butts. The bucket had been placed beside the gravel pathway leading to the playground and was accessible to the children.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found while six (6) infant children were in attendance, only two (2) cribs were available to meet their needs. The surveyor learned through interview with a staff that some of the infants sleep on mats.

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 staff person in the two year old classroom wiped two (2) children's noses and did not wash her hands.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, none of the ten (10) children's records reviewed contained the name and number of the preferred hospital.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on interview, the staff person in the Infant/Toddler classroom stated that she was vacuuming while supervising 3-4 children, when a child fell and sustained a laceration to her eyebrow. The child was taken to the emergency room and received sutures as a result of the fall.

Open Not marked corrected in the state record

Open / not marked corrected.