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

General: Based on review of documentation, the following was found: 1) A staff member (DOH: 07/24/23) only completed seven and a half (7.50) hours of the required fifteen (15) hours of early care and education training during the 07/24/23 to 07/24/24 training year. 2) A staff member (DOH: 08/30/21) only completed thirteen and a half (13.50) hours of the required fifteen (15) hours of early care and education training during the 07/01/23 to 06/30/24 training year. A review of ECE-TRIS verified this information.

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 review of documentation, the facility did not have a written policy stating that the staff will implement the procedures that were taught in the orientation training.

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 statement of deficiency and plan of correction from an investigation that was conducted on 05/30/24 was not posted for public inspection.

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 interview and review of documentation, on 09/11/24 three (3) toddlers were observed on video being inappropriately handled by a staff member in the Toddler 2 Room. At approximately 9:14 am, a nineteen-month-old child was swatted on the head and the hand by a staff member for touching a trash can in the Toddler 2 Room. Approximately five (5) seconds later, a twenty-one-month-old child was pulled by one (1) arm aggressively to another area of the room and harshly put in time-out because the child was going to climb on the table. At approximately 9:39 am, a twenty-month-old child was playing with the blocks in the Toddler 2 Room and was swatted on the hand by the staff member. In addition, based on interview, the same staff was observed putting her hand over a child's mouth so that she did not have to listen to him cry anymore. None of the children sustained an injury.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, a three-year-old child walked out of the center and into the parking lot and was unsupervised or in staff's scope of vision or range of voice for approximately one to five (1-5) minutes. The child was returned to the facility by another parent. Staffing Requirements In Compliance

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 review of documentation, one (1) staff (DOH 10/03/22) did not have the fifteen (15) hours of early care and education training recorded on ECE-TRIS for the July 1, 2022 – June 30, 2023, training year. 2) Six (6) staff (DOH 08/21/23, 06/14/23, 08/21/23, 07/24/23, 08/07/23 and 06/26/23), did not have evidence of completing cabinet-approved orientation training. A review of ECE- TRIS supports these findings. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, two (2) children had immunization records that were not current and had been enrolled longer than thirty (30) days. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, a copy of staff policies and procedures was not presented at the time of the survey for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a copy of the center's orientation policy was not presented for review at the time of the survey. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. Unprotected electrical outlets were observed in the Preschool 2 and 3 bathrooms. Both electrical outlets were located next to the handwashing sinks. Director Requirements In Compliance 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, this regulatory requirement was not met. A staff hired on 11/10/2022, did not have proof of education on file. 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, this regulatory requirement was not met. A staff hired on 8/22/2022, did not complete the required Orientation. This staff member has been employed for three months. The ECE-TRIS system was reviewed and confirmed this finding. Programming In Compliance 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

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Toys and Furnishings.

General: Based on observation, this regulatory requirement was not met. The following was found: 1. The bathroom in the Preschool 1 Room contained a dusty vent in the ceiling over the toilet. 2. The bathroom in the Preschool 3 Room contained a dusty vent in the ceiling over the toilet. 3. The Preschool 2 Room contained a step stool in front of the handwashing sink that the surfacing was coming off of one of the steps. Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, this regulatory requirement was not met. The facility did not have a written policy stating that the staff will implement the procedures taught in Orientation 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

Open / not marked corrected.

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

General: Based on review of documentation, this regulatory requirement was not met. The facility did not have any documented shelter-in-place/lockdown drills. Posted 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 8. General.

General: Based on review of documentation, this regulatory requirement was not met. The posted lesson plan in the School-Age Room was no longer current. The posted lesson plan was dated 10/10 to 10/14.

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, this regulatory requirement was not met. The Transition 2 Room did not have the proper methods for diapering posted by the diaper changing table in the classroom. Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280 - Section 4. Procedures and Payments.

General: Based on review of documentation and the Kentucky National Background Check Service (KARES), a staff person hired 12/6/2021, was not fingerprinted prior to hire; therefore, the staff person has not yet initiated the process to obtain a KARES background check. The staff person was not present on the day of the inspection, but scheduled to work later that day. The staff person in charge stated that the staff person does not work alone with children. 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 2:280 · 922 KAR 2:280. Section 5. Checks of Other States.

General: Based on review of documentation and interview, a staff person hired 12/6/2021, has lived in the state of Ohio within the past five years; therefore, would also require an out-of-state child abuse and neglect check, as well as the sexual offender check. 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 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation, a staff person hired 12/6/2021, did not have proof of education on file. 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 Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 6. License Issuance.

General: Based on review of documentation at the time of the survey, the liability insurance presented for review had an effective date of, 1/1/2020 - 1/1/2021. Documentation verifying the facility has current liability insurance was not available for review at the time of the survey. 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 12. Reports.

General: Based on observation and review of documentation upon arrival at the facility on 1/4/2021, a list of dates and the number of positive cases of COVID19 was posted on the front door of the facility. An interview with the staff person in charge found that the positive cases had been reported to the local health department. The staff person in charge stated this information had not been reported to the Division of Regulated Child Care. A review of the Division of Regulated Child Care documents confirmed that this information had not been reported to the Division of Regulated Child Care. 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 observation during a tour of the facility, toilet plungers were observed on the floor by the toilet in the bathrooms located between the Preschool 2 and the Preschool 3 Room as well as in the bathroom shared by the Transition Room and the Preschool 1 Room. A plunger was also observed on the floor by the toilet in the bathroom located in the 2's Room. The plungers pose a health risk due to them being accessible to the children. Employee Records In Compliance 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 3. General Requirements.

General: Based on observation, interview and review of documentation, at the time of the survey a group of eight two-year-old children were observed watching a children's music DVD. A review of the posted weekly lesson plan did not show documentation of the DVD as part of the planned programming for the day. A review of the posted daily schedule also found that television viewing was not listed. An interview with staff in the classroom found that the television is used a few days a week. Staff stated that they had allowed the children to view the DVD on the day of the survey while the chilren waited for lunch. 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 Preschool 1 Room, empty plastic Walmart bags were found in an unlocked drawer in a cabinet. In the 2's Room, an unlocked drawer located under a white counter top contained a pair of adult scissors. The child safety latch on the drawer was not working properly. The plastic bags and the adult scissors were accessible to the children. Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, interview and review of documentation in the Preschool 3 Room, a medication permission form indicated that on 10/19/2020, a parent requested that a nasal spray be administered to their child "as needed". The name of the nasal spray, the time to be administered and the dosage was not documented by the parent. A review of documentation found that a staff person administered the medication at 11:40 a.m. 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 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 5. Evacuation Plan.

General: Based on review of documentation, the last documented date that an evacuation plan had been submitted to local emergency management in accordance with KRS 199.895 and 42 U.S.C. 9858c(c)(2)(U) was 12/14/2017. The only updated document was an agreement between the local school system and the facility giving them permission to use their premises as a relocation site if the facility premises had to be evacuated. Posted Documentation In Compliance Animals In Compliance Emergency Regulation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:410 · 922 KAR 2:410E. Emergency Regulation.

General: Based on observation, interview and review of documentation, the following was found during a tour of the facility: 1) In several of the classrooms, soft-bodied dolls, dress-up clothing, pillows used in book areas and dramatic play areas, stuffed animals, doll clothes, cloth books and cloth puppets were found. 2) In the school-age room, none of the children were observed wearing masks. The children were doing activities at the table. The age of the children in the room were five to eleven-years-old.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the following was found: 1) There were chairs stacked on a sensory table in the Two-year-old Transition classroom posing a safety-risk. 2) There was a plunger located in the restroom area in both two-year-old classrooms. 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

Open / not marked corrected.

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

General: Based on observation and review of documentation, this requirement was not met as follows: 1) The lesson plan in the two-year-old classroom was not up to date, the plan was dated 11/11/19- 11/15/19. 2) The lesson plan in the one-year-old classroom was not up to date, the posted plan was dated for April. 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, the kitchen area, located between the two preschool classrooms, contained several bottles of cleaning supplies in an unlocked cabinet. This area is accessible to the children in care.

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: 1) The walls in dramatic play area and block center located in the Two-year-old Transition room had several areas of chipping and chalking paint. 2) There was chipping paint near the water fountain in the two-year-old classroom. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the changing pads located in the infant classroom and the two-year-old classroom, had small tears in the vinyl covering, rendering the pads unable to be properly sanitized. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Transportation In Compliance 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

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, one (1) staff member hired on 12/02/93 did not have a current staff evaluation on file. The last dated evaluation on file for this staff was 12/16/16. Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, two (2) staff did not complete fifteen (15) hours of cabinet-approved early care and education training within their completed training year. A staff hired on 6/01/16 completed 5.50 hours of training. A staff hired on 5/29/15 completed fourteen (14) hours of training. The ECE-TRIS system and the staff files were both reviewed. 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, two (2) ceiling tiles were stained in the Preschool Room (3-5 year-old's). 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 In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Animals.

General: Based on observation, the Preschool Room (3 year-old's) contained a fish. The staff in charge was unable to locate the permission slip for the children to be in the presence of the fish.

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 staff in charge could not locate the zoning documentation for the child care facility.

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 staff in charge could not locate the current Fire Marshal inspection for the child care facility. Director Requirements Not In Compliance

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, none of the staff, which had been employed for at least a year, had a current staff evaluation on file. 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

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, one (1) staff hired on 5/22/17 did not have proof of education on file.

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, two (2) staff did not have negative TB skin test documentation on file. These staff were hired on 7/31/17 and 1/16/17. Another staff hired on 5/22/17 did not have her TB skin test read until 5/24/17 and this was after her hire date. 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 walls in the first bathroom, in the four and five (4-5) year-old room, contained scuff marks. In addition, the wall behind the trash can in the transition room contained scuff marks.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, the four to five (4-5) year-old bathroom was very dimly lit. One (1) of the overhead lights in the bathroom was not working properly. Hygienic Practices In Compliance First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the four to five (4-5) year-old room contained a bottle of Tylenol Extra Strength caplets and a bottle of Children's Benadryl both with no names on them in the medicine box. The medication box was also unlocked. Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: health medication. 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 file was missing a physician's phone number. This child was enrolled in May of 2016. Written Documentation In Compliance Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the transition room did not have a posted daily schedule. Animals 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, this regulatory requirement was not met. A review of the facility's liability insurance documentation on file found that the coverage dates were 1/1/15 through 1/1/16; therefore, the policy was not current. Director Requirements In Compliance 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, this regulatory requirement was not met. Record review found that an employee hired on 7/26/16 has lived in Tennesse within the last five (5) years. There was no evidence on file that the facility submitted a Tennesse background check for processing. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, and interview, this regulatory requirement was not met. During an inspection of the medication procedures with staff in the one (1) year old classroom it was found that a bottle of Children's Tylenol was being stored in a child's diaper bag instead of the classroom lock box. The diaper bag was observed hanging on a hook under the children's cubbies and was accessible to the children in the classroom. A staff person working in the classroom identified the classroom lock box and stated, "It's supposed to be stored in here". 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 2. General.

General: Based on Review of Documentation, the copy of the regulations available for staff had been printed in 2012. Changes to the regulations were made in 2013. Therefore the copy available for staff was not current.

Open Not marked corrected in the state record

Category: ratio. 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 two (2) year old room two (2) staff were observed wiping a child's nose. They did not have the child wash their hands after having their nose wiped. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 26 Web site: http://chfs.ky.gov/ Inspection Report

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, there was one (1) staff person with a hire date of 6/22/15 who did not sign the application for the results of a child abuse or neglect check until 7/6/15. There was an additional staff person with a hire date of 9/3/15 who did not sign the application for the results of a child abuse or neglect check until 9/14/15. The regulations require that the application for the results of a child abuse or neglect check be submitted within five (5) days of the staff person's date of hire. In addition both of these staff had the results of a criminal records check dated 7/10/15 and 9/30/15. There was no evidence available for review to verify that the application for the results of the criminal records check was submitted prior to or on the date of hire. There were three (3) additional staff with hire dates of 5/18/15, 5/29/15 and 9/10/15 who had the results of a criminal records check dated after the staff person's date of hire. There was no evidence available for review to verify that the application for the results of a criminal records check for these three (3) staff had been submitted prior to or on the date of hire.

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, there was one (1) staff person with a hire date of 6/22/15 who did not have the results of a T.B. test read until 7/13/15.

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, it was found two (2) staff hired as substitutes with a hire date of 11/9/15 did not have the results of a criminal records check or a child abuse and neglect check on file. In addition there was no documentation available for review to verify that application for the results of these records check had been submitted. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 7 of 26 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, there were five (5) staff with hire dates of 3/8/12, 11/26/96, 3/6/08, 4/18/1 and 3/21/00 who did not complete fifteen (15) hours of training during the 2014-1015 training year. There was an additional staff person hired 4/16/14 who had not completed nine (9) hours of training for the first year of employment. 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 3. General Requirements.

General: Based on Observation, during a tour of the infant area named the catepillars a spray bottle marked bleach water was observed sitting on a very low shelf against the wall.

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, while in the infant area called the caterpillars a spray bottle labeled bleach water was observed sitting on a low shelf. Behind the shelf the edge of a padded vinyl mat could be seen. There is not a sink in this area. An interview was conducted with the staff on the other side where a sink is located. The staff indicated that when children are present on the caterpillar side staff change the diaper on the mat observed behind the shelf and then walk to the other side of the infant area labeled butterflies and wash their hands. Let it be noted that the room is divided into two (2) separate infant areas with five (5) children on one (1) side and nine (9) children on the other side. Both areas operate independently. The sink is located in the back corner of the area with nine (9) infants.

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 two (2) year old room two (2) staff were observed wiping a child's nose. Neither staff person washed their hands after wiping the child's nose.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, during a tour of the Cub and Tiger room a tube of hydrocortizone cream was found in an unlocked box in a cabinet over the counter. 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 4. Premises Requirements.

General: Based on Observation, during a tour of the large playground the mesh ground cover under the mulch was exposed in several areas.

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, during a tour of the other two (2) playgrounds the mulch was very sparse under equipment used to swing, slide and climb. An interview with the staff person in charge stated that when it rains the mulch washes away from the areas and into the fence line.

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 both of the infant areas it was found the crib sheets fit loosely on the mattress.

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 large outdoor playground there were two (2) riding toys that were in disrepair. One (1) of the toys had a broken seat back and the other riding toy had a portion of the plastic broken off around the area where the wheel connects to the rest of the body. On one (1) of the smaller playgrounds there was a blue elephant slide that had a rust bolt hanging off the side where a piece of the plastic had broken off. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 17 of 26 Web site: http://chfs.ky.gov/ Inspection Report

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 area named the butterflies it was found that the freezer in the refrigerator did not have a thermometer. Several packets of breast milk were observed in the freezer.

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 Interview, it was found that the children in the one (1) year old classroom were being put down for nap at 11:30am and not being allowed to get up off of their cot/mat until 2:30pm.

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 Interview, it was found that the children in the two (2) year old classroom and the preschool classroom had a rest time that exceeded the two (2) hour nap period. Interview with staff found that the children napped from 12:00pm until 2:30pm. Premises

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, it was found that the front door to the facility was propped open not allowing for protection against the entrance of vermin.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Interview and record review, it was found that there was insufficient ground covering beneath the Backyard Discovery Sonora Cedar Wood Swing Set. On 4-24- 14, a child fell from the monkey bars, which are six (6) feet high, and broke his arm in three (3) places. Employee Records

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, it was found that the protective ground covering underneath and around the Backyard Discovery Sonora Cedar Wood Swing Set was insufficient. Grass was observed to be growing through the sparse mulch underneath the monkey bar section which is six (6) feet tall. It was also found that the protective ground covering did not provide an adequate fall zone behind the ladder to the monkey bars, which is three (3) feet tall.

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, there was no mulch under the swings or slide on the playground.

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, there was a bottle of Disenfecting Bathroom cleaner sitting on a shelf in the Preschool classroom accessible to the children.

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 changing pad in the One (1) year old classroom had several tears.

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 Observation, there were several tears on the blue couch and red chair in the Preschool classroom exposing the foam padding underneath.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 2 (4)

2 year old room: Based on Review of Documentation, during the complaint investigation it was found that a lesson plan was posted in this classroom; however, the information on the lesson plan did not adequately describe the activities that children would be involved in throughout the day. The lesson plan contained one (1) word descriptions such as "play dress up", "rice tub", "summer", "bugs", "picnic" on two (2) of the weeks on the form and the other two (2) weeks just had the name of the theme "Farm Animals" listed. Due to the small amount of information listed, it could not be determined if the lesson plan met the individual needs and developmental levels of each child. 176 - Electronic Viewing/Listening Devices 922 KAR 2:120 - Section 2 (4) (d) 12. Use of electronic viewing and listening devices if the: a. Material is appropriate to the child using the equipment; b. Material does not include any violence, adult content viewing, or inappropriate language; c. Viewing or listening is limited to two (2) hours per day; d. Viewing or listening is discussed with parents prior to viewing or listening; and e. Viewing or listening is designed as an educational tool. 3) 2 hours In Compliance 185 - Electronic Viewing/Listening planned program 922 KAR 2:120 - Section 3 General Requirements. (1) Electronic viewing and listening devices shall only be used in the center as a part of the child's planned program of activity described Section 2(4)(d). 1) Viewing devices In Compliance Posted Documentation - Classroom 114 - Daily Activities 922 KAR 2:110 - Section 4 (1) (h) Post a schedule of daily activities, to include lists and dates of activities to be conducted with the children in each classroom; 2) List of Activities Not In Compliance Findings: 2 year old room: Based on Review of Documentation, during the complaint investigation it was found that a lesson plan was posted in this classroom; however, the information on the lesson plan did not adequately describe the activities that children would be involved in throughout the day. The lesson plan contained one (1) word descriptions such as "play dress up", "rice tub", "summer", "bugs", "picnic" on two (2) of the weeks on the form and the other two (2) weeks just had the name of the theme "Farm Animals" listed.

Open Not marked corrected in the state record

Open / not marked corrected.

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

One Years: Based on Observation, there were two (2) children in the one (1) year old classroom that were two (2) years old as of March and April. Interview with staff person in charge stated that children are moved to the next classroom as soon as there is space available for them. Hygienic Practices 283 - Diapers/Clean clothing supply 922 KAR 2:120 - Section 10 (6) An adequate quantity of freshly laundered or disposable diapers and clean clothing shall be available. 2) Clean clothing In Compliance 285 - Soiled Diapers/Clothing 922 KAR 2:120 - Section 10 (8) Diapers or clothing shall be: (a) Changed when soiled or wet; (b) Stored in a covered container temporarily; and (c) Washed or disposed of at least once a day. 1) Changed as needed In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 7

General: Based on Interview, it was found that on 1-25-12, a child showing signs and symptoms of hand, foot and mouth disease was allowed to be dropped off at the facility at 6:30 a.m. The child reportedly had filled blisters on her hands. According to interviews and the attendance record, she remained in the classroom until she was picked up at 12:00 p.m. 246 - Sick Child Protocol 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 ch 1) Supervised, isolated area Not In Compliance Findings: General: Based on Interview, it was found that on 1-25-12, a child showing signs and symptoms of hand, foot and mouth disease was kept in the classroom with other children from 6:30 a.m. until 12:00 p.m. 246 - Sick Child Protocol 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 ch 2) Parent contacted In Compliance 3) Removed as soon as possible In Compliance Director Requirements 113 - Staff Supervision 922 KAR 2:110 - Section 4 (1) (g) Supervise staff conduct to ensure implementation of program policies and procedures; 2) Implementation of Procedure Not In Compliance Findings: General: Based on Review of Documentation, it was found that page eight (8) of the facility’s handbook includes a “Childhood Infection/Disease Policy. This policy states, “Other Infectious Diseases – The child may return to [the facility] when written approval has been received from the private physician and submitted to the Day Care Staff.” Record review found that five (5) children that were absent due to having hand, foot and mouth disease were allowed to return to the facility without a doctor’s note stating that they were well enough to return to daycare. In addition, the health policy on page seven (7) of the facility’s handbook states, “Only children who are well are permitted to attend [the facility] or allowed to remain at the Center.” Staff reported that on 1-25-12, a child showing signs and symptoms of hand, foot and mouth disease was allowed to be dropped off at the facility at 6:30 a.m. The child reportedly had filled blisters on her hands. She remained at the center until she was picked up at 12:00 p.m. The policy and procedure manual of the hospital that owns the facility contains a policy entitled “Health & Safety for Employees of the Day Care Center.” Number nine (9) of this policy states “Children who become ill shall be isolated in the Director’s office until his/her parent arrives.” This statement is also made in the policy entitled “Illness in Day Care.” This policy states “Any child who becomes ill while staying in the day care center will be taken to the day care director’s office. The parent will be called immediately to come and remove him/her. The child will remain in the director’s office until the parent arrives.” Staff in the one (1) year old classroom report that on 1-25-12, a child showing signs and symptoms of hand, foot and mouth disease was kept in the classroom with other children from 6:30 a.m. until 12:00 p.m.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, it was found that six (6) children in the infant classroom were sleeping in swings or bouncy seats. The teachers stated that the children regularly sleep in this manner. Only one (1) of the children had a doctor’s note indicating that the child must sleep in this manner. A child in the infant classroom was observed to be sleeping in a swing that had been placed in a crib. It was also observed that two (2) infants had blankets covering their entire bodies, including their heads. Interview found that toys in the one (1) and two (2) year old classrooms are washed once a week in bleach and water. Proper cleaning and sanitizing procedures are not followed. On 1-25-12, a child showing signs and symptoms of hand, foot and mouth disease was allowed to be dropped off at the facility at 6:30 a.m. The child reportedly had filled blisters on her hands. She remained at the center until she was picked up at 12:00 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 Programming 176 - Electronic Viewing/Listening Devices 922 KAR 2:120 - Section 2 (4) (d) 12. Use of electronic viewing and listening devices if the: a. Material is appropriate to the child using the equipment; b. Material does not include any violence, adult content viewing, or inappropriate language; c. Viewing or listening is limited to two (2) hours per day; d. Viewing or listening is discussed with parents prior to viewing or listening; and e. Viewing or listening is designed as an educational tool. 2) Appropriate Content Not In Compliance Findings: Preschool: Based on Observation, it was found that the radio was tuned to 98.1 The Bull. The song “Felt Good on My Lips” was playing. This song contains the lyrics “She ordered us a drink it was a purple kind of pink. She said it's got a shot of a little bit of everything.” These lyrics are not appropriate for the three (3) through five (5) year old children in the classroom. Two Year Olds: Based on Observation, it was found that the radio was tuned to 98.1 The Bull. The song “One in Every Crowd” was playing. This song contains the lyrics “He’s a six pack up when he walks in,” “Good time Charlie with a Harley, whiskey bent and hell bound,” “Got a flip top box of Marlboro's,” “He's a hard drinking man’s man and women love him when they can.” These lyrics are not appropriate for the two (2) year old children in the classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infants: Based on Observation, it was found that six (6) children in the infant classroom were sleeping in swings or bouncy seats. The teachers stated that the children regularly sleep in this manner. Only one (1) of the children had a doctor’s note indicating that the child must sleep in this manner. This is not in accordance with the American Academy of Pediatrics safe sleep practices which states, "Place babies to sleep only in a safety-approved crib with a firm mattress and a well-fitting sheet." It was also observed that two (2) infants had blankets covering their entire bodies, including their heads. This is not in accordance with the American Academy of Pediatrics safe sleep practices which states, "If a blanket is used, place the child’s feet to the foot of the crib and tuck in a light blanket along the sides and foot of the mattress. The blanket should not come up higher than the infant’s chest. Don’t cover the heads of babies with a blanket or overbundle them in clothing and blankets." Hygienic Practices 188 - Child Personal care/Handwashing 922 KAR 2:120 - Section 3 (4) A child shall; (a) Be helped with personal care and cleanliness; and (b) Wash his or her hands with liquid soap and warm running water: 1. Upon arrival at the center; 2. Before and after eating or handling food; 3. After toileting or diaper change; 4. After handling animals; 5. After wiping or blowing nose; 6. After touching items soiled with body fluids or wastes; and 7. After outdoor or indoor play time. 2) Handwashing upon arrival In Compliance 3) Handwashing before eating/handling food and after eating/handling food In Compliance 4) Handwashing after toileting or diaper change In Compliance 6) Handwashing after wiping/blowing nose In Compliance 7) Handwashing after touching soiled item In Compliance 189 - Staff Hygiene/Hand Washing 922 KAR 2:120 - Section 3 (5) Staff shall: (a) Maintain personal cleanliness; (b) Conform to hygienic practices while on duty; and (c) Wash their hands with liquid soap and running water: 1. Upon arrival at the center; 2. After toileting or assisting a child in toileting; 3. Before and after diapering each child; 4. After wiping or blowing a child's or own nose; 5. After handling animals; 6. After caring for a sick child; 7. Before and after feeding a child or eating; 8. Before dispensing medication; and 9. If possible, before administering first aid. 3) Handwashing upon arrival In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 3 of 4 Web site: http://chfs.ky.gov/ Inspection Report 4) Handwashing after toileting or assisting child In Compliance 5) Handwashing before/after diapering In Compliance 6) Handwashing after wiping nose In Compliance 8) Handwashing after caring for a sick child In Compliance 9) Handwashing before and after feeding a child In Compliance 10) Handwashing before dispensing medication In Compliance

Open Not marked corrected in the state record

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

Two Year Olds: Based on Interview, it was found that mouth contact toys in the two (2) year old classroom are washed once a week in bleach and water. They are also sometimes sprayed with Clorox Anywhere Spray. This procedure does not meet the requirements of the regulation. Toddlers: Based on Interview, it was found that mouth contact toys were cleaned once a week in a bleach and water solution. Bigger items, such as the slide and large toys were sprayed daily with Lysol. Staff reported that other than using a disinfecting wipe, there was not a cleaning procedure used when a toy was observed to be mouthed by a child. This procedure does not meet the requirements of the regulation. Equipment - Classroom 238 - Sheets/Covers 922 KAR 2:120 - Section 6 (3) Individual sheets and covers shall be: (a) Provided for a child; (b) Laundered a minimum of once per week or more often, if necessary; and (c) Stored in a sanitary manner. 3) Sanitary Storage Not In Compliance Findings: Infants: Based on Observation, it was found that five (5) swings and bouncy seats were being stored in the cribs in the infant classroom. Storage in this manner contaminates the sheet in the crib. 296 - Toys 922 KAR 2:120 - Section 11 (3) Toys shall be: (a) Used according to the manufacturer's safety specifications; (b) Durable; and (c) Without sharp points or edges. 1) Used according to manufacturers specifications Not In Compliance Findings: Infants: Based on Observation, it was found that a child was sleeping in a swing that had been placed in a crib. Manufacturer’s specifications state that swings are designed for use on the floor.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, Eight (8) staff did not have an annual evaluation on file.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.