922 KAR 2:100 - Section 15. Food Requirements.

General: Based on observation and interview, this regulatory requirement was not met. The surveyor observed a can of formula on the kitchen counter. Interview with the provider found that a parent of a nine-month-old child does not supply the provider with an already prepared bottle. The provider mixes all the bottles for the child. Children's Records In Compliance Written Documentation In Compliance Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

922 KAR 2:100 · Correction status not published

922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, the surveyor found a portable trampoline accessible to the children in care. It should also be noted, the handle grip attached to the trampoline was loose. Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

922 KAR 2:100 · Correction status not published

922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, the child-care provider failed to keep the home free of clutter. The surveyor observed the following: Kitchen: 1. The kitchen counter was covered with notebooks, papers, several books, bins containing crayons and other items, small boxes, and numerous other miscellaneous items. 2. The kitchen sink was full of dirty dishes. The stove was covered with several pots and pans, a tea kettle, and potholders. The dishwasher door was slightly opened and full of dishes. 3. The kitchen table was covered with miscellaneous items. In addition, the child-care provider’s purse was on a chair. Dining room: 1.The dining room table was covered with miscellaneous items. Jackets, bags, and backpacks hung on dining room chairs. Numerous miscellaneous items were stacked against the wall and on the floor. Nap room: 1. Boxes of toys were on both toddler beds, and toys were inside of a crib. The provider stated that the nine-month-old child sleeps in the crib, and the preschool-age children sleep on the toddler beds. She stated that she removes the items from the beds and crib before they take naps. It should be noted, storing items in the crib and on top of beds promotes the transfer of germs. 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 Not In Compliance

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

General: Based on Observation, at the time of the survey the provider placed a one-year-old child's bottle in the microwave to warm before giving it to the child. The bottle contained whole milk and was fed to the child after the bottle was heated. Children's Records Not In Compliance

922 KAR 2:100 · Correction status not published

922 KAR 2:100 - Section 18. Records.

General: Based on Review of Documentation, it was found that earthquake and tornado drills are conducted on a monthly basis. However, one time is written to document different drills. There is no differentiation as to the time each drill was conducted. Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

922 KAR 2:100 · Correction status not published

922 KAR 2:100 - Section 18. Records.

General: Based on Review of Documentation, it was found that some of the children share the same enrollment form with a sibling. An interview with the provider found that the children's siblings are no longer enrolled. Written Documentation Not In Compliance

922 KAR 2:100 · Correction status not published

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

General: Based on Interview, it was found that the provider places a mat on the floor in a space that is connected to the kitchen and used as part of the children's play area for diaper changes. Further interview with the provider found that after changing the diapers hands are washed in the kitchen sink. The provider stated she has been changing the diapers in this space for a few months. She stated she had a changing table in the room where the children nap but it needs to repairing. She ordered another changing table but found that the mats do not fit on the table. Washing hands in a sink and area used for food preparation after diapering is unsanitary. Provider Requirements In Compliance Provider Records In Compliance Programming In Compliance Premises Not In Compliance

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

General: Based on Review of Documentation, and the Training Records Information System (TRIS), the provider's file (hire date: 3/28/03) contained a pediatric abusive head trauma training class certificate that was dated 2/2/12; therefore, this training is no longer valid. Programming In Compliance Premises In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Hygienic Practices Not In Compliance

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, this regulatory requirement was not met. The provider was observed to wipe the noses of the three (3) children in her care after they came inside from the outdoor play area. The provider did not wash her hands in between wiping each child's nose. First Aid/Medication Not In Compliance

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, this regulatory requirement was not met. During a tour of the children's bathroom the surveyor observed a tube of Destin diaper ointment lying on the counter top beside the hand washing sink. The medication was not stored in a locked area and was not labeled with a child's name. Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, it was found that a bottle of I love... lotion was on the back of the toilet, making it accessible to children. This bottle bore the label "Keep Out of Reach of Children." In the bathroom, the unlocked cabinet under the sink contained a bottle of antiseptic mouth wash and a bottle of Crest-Pro Health oral rinse. These bottles bore the labels "Keep Out of Reach of Children" and "Keep Out of Reach of Children Under the Age of Six." All of the children present in the home were under the age of six-years-old. Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report First Aid/Medication Not In Compliance

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, it was found that an eleven-month-old child was put down to sleep in a pack-n-play with a bottle. Children's Records In Compliance Written Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Posted Documentation Not In Compliance

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, it was found that the posted schedule of daily activities was dated for the month of February. Animals In Compliance Posted Requirements In Compliance

922 KAR 2:100 · Correction status not published

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

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

General: Based on Observation, it was found that the toothbrushes used by the children were not labeled with their names and they were all being stored in a cup. Several of the toothbrush bristles were touching the bristles of other toothbrushes. The provider stated that she did not see the need to label the toothbrushes because she knows what toothbrush belongs to each child. 70 - Overnight Care Not Applicable 922 KAR 2:100 - Section 12. Care Requirements for a Provider. (11) If overnight care is provided, a provider or an assistant shall: (a) Remain awake until every child in care is asleep; and (b) Sleep on the same floor level of the home as an infant or toddler.

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, it was found that the children were being served 2% milk for lunch. The provider stated that the children do not like to drink the skim or low fat 1% milk.

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, it was found that a bottle of antiseptic mouth wash and a container of collagen gel were being stored on the counter of the sink located in the bathroom used by the children. Each container bore the label "Keep Out of Reach of Children." The provider stated that the children do not touch the items stored on the counter of the sink. 245 - Guns/Ammunition Not Applicable 922 KAR 2:100 - Section 11. The General Requirements of the Family Child-Care Home Environment. (5) In accordance with KRS 527.070(1), firearms and ammunition shall be stored away from the presence of children, in separate locked containers, which, in order to be opened, require a: (a) Key; or (b) Combination.

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

General: Based on Observation, the diapering mat that the provider stated they were using had stains and tears in it.

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, and interview, the provider failed to meet this regulatory requirement. One (1) crib used by the children did not contain evidence of complying with new federal guidelines (16 CFR 1219-1220). The provider stated that she kept the crib in the basement to use during emergencies and explained that children use the basement area during times of severe weather. The provider had indicated on a Plan of Correction submitted 12/6/13 that "The beds/cribs that I have that are not complying with the new federal guidelines will be removed and replaced with new complianct cribs as soon as I can afford to. I plan to dismantle and replace these cribs this weekend, 12/14 - 15, 2013. I will only purchase and use new compliant beds/cribs for the children/infants in my home that I care for now and in the future".

922 KAR 2:100 · Correction status not published

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

General: Based on Review of Documentation, the provider did not have a criminal records check (CRC) or child abuse/neglect check (CAN) for her eighteen (18) year old son that lives in the home. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 3 of 15 Web site: http://chfs.ky.gov/ Inspection Report

922 KAR 2:100 · Correction status not published

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

General: Based on Interview, this regulatory requirement was not met. The provider stated that she did not have a current copy of the certification standards available for parents.

922 KAR 2:100 · Correction status not published

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

General: Based on Review of Documentation, the provider did not have any T.B. test documentation on file for her eighteen (18) year old son that lives in the home.

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, it was found that two (2) playpens used by the children did not contain evidence of complying with new federal guidelines (16 CFR 1221).

922 KAR 2:100 · Correction status not published

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

General: Based on Observation, and interview the following was found: 1. Two (2) cribs used by the children did not contain evidence of complying with new federal guidelines (16 CFR 1219-1220). One (1) crib was observed in the children's playroom/sleeping area and the other crib was observed in the provider's basement. The provider stated that the crib in the basement is only used occassionally and explained that the crib is only used when they are in the basement due to severe weather. 2. The crib in the playroom/sleeping area contained bumper pads.

922 KAR 2:100 - Section 9

General: Based on Review of Documentation, provider had 2.5 hours of training. This does not meet the nine (9) hour requirement. 51 - Assistant CPR/FA, if applicable Not Applicable 922 KAR 2:100 - Section 9 (7) Prior to being left alone with a child, an assistant shall be certified by a cabinet-approved agency in infant and child: (a) CPR; and (b) First aid. 1) CPR Not Applicable 2) First Aid Not Applicable 53 - Assistant Training Requirements, if applicable Not Applicable 922 KAR 2:100 - Section 9 (9) An assistant used in the absence of the family child-care home provider in excess of fourteen (14) calendar days during a one (1) year period shall demonstrate completion of at least nine (9) hours of cabinet-approved training in: (a) Basic health, safety, and sanitation; (b) Recognizing and reporting child abuse; (c) Developmentally-appropriate child care practice; and (d) Early care and education. 1) Nine hours Not Applicable 2) Training from approved list Not Applicable An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 4 of 18 Web site: http://chfs.ky.gov/ Inspection Report Programming 63 - Television/Video Viewing 922 KAR 2:100 - Section 10 (10) Television or video viewing by a child shall be limited to: (a) Two (2) hours daily; (b) The planned program activities; and (c) Developmentally-appropriate child-related content, as designated by standardized content guidelines. 1) 2-hour limit daily In Compliance 2) Planned program In Compliance 3) Developmentally-appropriate content In Compliance

922 KAR 2:100 · Correction status not published