922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation and interview, a provider (DOH: 09/27/13) completed one and a half (1 1/2) hours of Pediatric Abusive Head Trauma training on 9/10/19 and did not complete the training again within five (5) years. In addition, the provider (DOH: 09/27/13) completed three (3) hours of cabinet approved training between July 1 and June 30 of the subsequent year of employment.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation and interview, the following was found: 1) A staff member (DOH: 07/14/17) completed one and a half (1 1/2) hours of Pediatric Abusive Head Trauma training on 9/10/19 and did not complete the training again within five (5) years. 2) A staff member (DOH: 05/15/15) completed one and a half (1 1/2) hours of Pediatric Abusive Head Trauma training on 9/10/19 and did not complete the training again within five (5) years. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on review of documentation and interview, a child (SD: 10/03/22) enrollment form did not list the name of the child's family physician. Written Documentation In Compliance Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on interview and review of documentation, the personnel record for a staff member (DOH: 07/14/17) had TB documentation dated 12/28/21.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on interview and review of documentation, a staff member (DOH: 07/14/17) completed seven (7) hours of early care and education training during the training year 07/01/22 to 06/30/23. 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 Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 4. Statement of Deficiency and Corrective Action Plans.

A PLAN OF CORRECTION WAS DUE ON 01/03/2023 AND AS OF 04/20/2023, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Provider Requirements In Compliance Provider Records In Compliance Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on interview and review of documentation, a child, enrolled on 10/3/22, did not have authorization by the parent for the provider to seek emergency medical care for the child in the parent’s absence and information on file for the provider to contact the child’s physician and preferred hospital. Written Documentation In Compliance Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

The investigation revealed that on 3/10/2021, a child at the child care home received a scratch from a dog owned by the home care provider. In addition, the investigation revealed that the dog had free liberty of the area (not confined by any leash) when the child was playing with the dog as it was sleeping. Without any constraint available to control the animal, the dog scratched the child as a result of being disturbed from sleeping. Furthermore, the investigation noted that another small dog, a Shi Tzu, was in the presence of the children without any restraint mechanisms as the children played with the dog, who appeared to be at rest while laying on the couch. Moreover, the investigation revealed that over one-year ago, a child was bitten at the home care provider’s previous residence, which led to a quarantine of the dog by the Lincoln Trail District Health Department in Elizabethtown, Kentucky. Animals Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 17. Animals.

The investigation revealed that on 3/10/2021, a child at the child care center received a scratch from a dog owned by the home care provider. The investigation revealed that there was a written consent form from the parents, allowing the child to be in the presence of the dog and the dog was vaccinated against rabies. In addition, the investigation revealed that the dog had free liberty of the area (not confined by any leash) when the child was playing with the dog as it was sleeping. Without any constraint available to control the animal, the dog scratched the child as a result of being disturbed from sleeping. Furthermore, the investigation noted that another small dog, a Shi Tzu, was in the presence of the children without any restraint mechanisms as the children played with the dog, who appeared to be at rest while laying on the couch. Moreover, the investigation revealed that over one-year ago, a child was bitten at the home care provider’s previous residence, which led to a quarantine of the dog by the Lincoln Trail District Health Department in Elizabethtown, Kentucky. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Emergency Regulation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation and interview, the family child care home failed to maintain records in accordance with regulatory requirements. Review of the presented documentation revealed that the provider with hire date 9/27/13 had a file that did not contain documentation to verify recent completion of the one and one-half (1 ½) hours of pediatric abusive head trauma. Upon request, the provider did not present training documentation at the time of the survey.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation and interview, the family child care home failed to maintain records in accordance with regulatory requirements. Review of the presented documentation revealed two (2) assistants with hire dates 7/14/17 and 5/15/15 whose file did not contain documentation to verify recent completion of the one and one-half (1 ½) hours of pediatric abusive head trauma. Continued review of documentation revealed an assistant with hire date 5/15/15 whose file did not contain documentation to verify completion of the nine (9) hours of cabinet approved training. Review of ECE-TRIS verified that the assistant did not complete the nine (9) hours of cabinet approved training. Upon request, the provider did not present training documentation for the aforementioned assistants at the time of the survey. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 11. The General Requirements of the Family Child-Care Home Environment.

General: Based on review of documentation and interview, the family child care home failed to maintain written documentation in accordance with regulatory requirements. Upon request documentation to verify that fire drills were conducted during the hours of operation at least monthly May 2019-July 2019 was not presented for review at the time of the survey.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 18. Records.

General: Based on review of documentation and interview, the family child care home failed to maintain written documentation in accordance with regulatory requirements. Review of the presented documentation revealed that the provider failed to have documentation to verify monthly practiced fire drills detailing the date, time and participants. Upon request, the provider did not present the documentation at the time of the survey. Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation and interview, the family child care home failed to maintain provider records in accordance with regulatory requirements. Upon request, the provider did not provide verification of nine (9) hours of cabinet-approved early care and education training. Review of a TRIS report did not verify the nine (9) hours of training had been completed.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation and interview, the family child care home failed to maintain provider records in accordance with regulatory requirements. Upon request, documentation to verify that the provider’s assistant had completed nine (9) hours of cabinet-approved training was not presented for review. Review of the TRIS report did not verify that the nine (9) hours of training had been completed. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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/Available Documentation In Compliance Animals Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 16. Animals.

General: Based on observation, review of documentation and interview, the family child care home failed to comply with regulatory requirements regarding animals. Observation of the child care home revealed a dog. Review of the rabies certificate for the aforementioned dog revealed it expired 9/21/18. Interview with the provider revealed the rabies certificate had expired. Posted Requirements In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. Care Requirements for a Provider.

General: Based on observation, the child care home failed to comply with regulations regarding general administration. Observation in the bathroom revealed there was a plunger and toilet brush next to the toilet. Provider Requirements In Compliance Provider Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on review of documentation and interview, the child care home failed to maintain provider records in accordance with regulations. Review of staff files revealed two (2) staff members with a hire date 05/16/2015 and 05/15/2015 had not completed state approved orientation training. Interview with the provider revealed this documentation was not on file at the time of survey. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 18. Records.

General: Based on review of documentation and interview, the child care home failed to comply with regulations regarding written documentation. Review of the attendance records and interview with the provider revealed not all four (4) children present during time of survey were signed in on the daily attendance records; only two (2) were signed in on the daily attendance record for that day. Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Certified Family Child-Care Home Program.

General: Based on review of documentation and interview, the child care home failed to post documentation in accordance with regulations. The daily activities for the certified home were not posted. Interview with the provider revealed this information was not available at the time of survey. Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on Review of Documentation, the family child care provider failed to maintain provider records in accordance with regulatory requirements. Based on a review of records, the family child care provider failed to have documentation of receiving 9 hours of annual cabinet approved training .

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on Review of Documentation, the family child care home provider failed to maintain provider records in accordance with regulatory requirements. Based on a review of documentation, two (2) staff members who are used in excess of fourteen (14) calendar days in a one year period failed to complete nine (9) hours of training during a one (1) year period. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 11. The General Requirements of the Family Child-Care Home Environment.

General: Based on Observation, the family child care home failed to maintain the outdoor play area in accordance with regulatory requirements. Based on observation of the large climbing structure, two (2) protruding screws were observed coming out of the wood in the area where the slide attaches to the structure. Equipment In Compliance Transportation In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 14. Food Requirements.

General: Based on Review of Documentation, the family child care home failed to maintain the food service in accordance with regulatory requirements. Based on a review of menus, there were no menus to review for all meals on 10/13/16, and 10/14/16. Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 18. Records.

General: Based on Review of Documentation, the family child care home failed to maintain children's records in accordance with regulatory requirements. Based on a review of documentation, children enrolled on 11/03/15 and 09/06/16 failed to have contained in their enrollment information a physician's phone number to enable a staff person to contact the child's physician if necessary. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on Review of Documentation, the family child care home provider failed to maintain written documentation in accordance with regulatory requirements. Based on a review of documentation, the family child care provider failed to maintain attendance records recording the arrival and departure time of each child. Posted Documentation In Compliance Animals In Compliance Posted Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on Review of Documentation, it was determined the provider failed to comply with certification standards regarding provider records, specifically provider CPR/First Aid. The provider failed to provide documentation at time of survey verifying she is currently certified by an agency approved in accordance with 922 KAR 2:240 in infant and child cardiopulmonary resuscitation (CPR).

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on Review of Documentation, it was determined the provider failed to comply with certification standards regarding provider records, specifically training requirements. The provider failed to provide documentation at time of survey verifying the completion of at least nine (9) hours of cabinet-approved early care and education training annually.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on Observation, and review of documentation, it was determined the provider failed to comply with certification standards regarding provider records, specifically assistant CPR/FA. At 2:05 p.m. observation revealed a staff member self-identified as the assistant, alone in the home supervising the children. The provider failed to provide documentation at time of survey verifying that the assistant is certified by a cabinet-approved agency in infant and child cardiopulmonary resuscitation (CPR) and first aid.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 15. Medication and First Aid.

General: Based on Observation, it was determined the provider failed to comply with certification standards regarding first aid/medication, specifically supplies. Observation revealed the provider failed to provide a CPR mouthpiece for review at time of survey among the first aid supplies.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. Care Requirements for a Provider.

General: Based on Observation and interview, it was determined the provider failed to comply with certification standards regarding equipment, specifically infant rest time. Observation revealed the provider failed to provide an individual non-tiered crib that meets Consumer Product Safety Commission standards established in 16 C.F.R. 1219-1220 for an infant; at 2:05 p.m. the infant was observed sleeping in a swing. Interview revealed the child had been asleep in the swing since 1:30 p.m.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Toilet and Diapering Requirements.

General: Based on Review of Documentation, it was determined the provider failed to comply with certification standards regarding posted documentation, specifically diapering requirements. Provider failed to post the proper methods of diapering at the diaper changing area.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 16. Animals.

General: Based on Observation and review of documentation, it was determined the provider failed to comply with certification standards regarding animals. Observation revealed three (3) dogs in the presence of the children in care. Review of documentation revealed the provider failed to have documentation at time of survey to verify the Shih Tzu is certified as vaccinated against rabies; the documentation provided listed an expiration date of 8/31/15. Posted Requirements

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 18. Records.

General: Based on Review of Documentation, the provider failed to comply with children's records requirements. Review of documentation revealed that a child enrolled 8-1-14 did not have current Immunization Certificate on file at the time of the survey.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on Observation, the family child care home provider failed to comply with regulatory requirements. Based on a review of documentation the provider failed to have an assistant who could provide care for an eight hour period of respite when the provider is open 24 consecutive hours.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 18. Records.

General: Based on Review of Documentation, the family child care provider failed to maintain children's records in accordance with regulatory requirements. Based on a review of documentation, the family child care provider failed to have emergency authorization for the provider to seek emergency medical care for the child in the parent's absence.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on Review of Documentation, the family child care home provider failed to maintain written documentation in accordance with regulatory requirements. Based on a review of documentation the family child care provider failed to maintain documentation showing commercial liability insurance of at least $50,000.00 per occurrence.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 18. Records.

General: Based on Review of Documentation, the family child care home provider failed to maintain written documentation in accordance with regulatory requirements. Based on a review of documentation, the family child care provider failed to maintain a current written evacuation plan in the event of fire, natural disaster, or other threatening situation that may pose a health or safety issue to a child in care.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Certified Family Child-Care Home Program.

General: Based on Review of Documentation, the family child care home failed to post documentation in accordance with regulatory requirements. Based on a review of documentation, the family child care provider failed to post each statement of deficiency issued by the cabinet during the current certification period and also based on a review of documentation the family child care provider failed to post a plan of correction submitted by the family child care home provider to the cabinet during the current certification period. Animals

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.