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

General: Based on observation, there was no first aid book found within the first aid supplies at the time of the survey. Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, there was not an orientation policy on file at the facility stating that the child care staff would implement what was taught in the orientation training. It should be noted that there was a policy on file stating that staff members must complete the required orientation and pediatric abusive head trauma trainings. 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 9. Records.

General: Based on review of documentation one child had an immunization certification that did not have an indicated expiration date for immunizations. There is no way to tell if the child's immunizations are current. Written Documentation In Compliance Posted Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Animals In Compliance Emergency Regulation 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 11. Staff Requirements.

General: Based on interview, this regulatory requirement was not met. An interview with the director found she is the only subsitute avaiable in case of need.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS records, this regulatory requirement was not met. A review of five (5) staff files found that a staff person hired 10/12/15 only had evidence of having completed eleven (11) hours of cabinet-approved training for the 2017-2018 training year. 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 In Compliance First Aid/Medication 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 7. First Aid and Medicine.

General: Based on observation, this regulatory requirement was not met. An inspection of the first aid kit located in the classroom used for care found six (6) individual packets of anitibiotic ointment. The packets of ointment were not in a locked box or area and were not labeled for an individual child. Outdoor Play Area In Compliance Equipment In Compliance 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 Not Applicable

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Review of Documentation, one staff member with date of hire if 07/28/2016 did not have evidence of completing the pediatric abusive head trauma training on file or in ECE-TRIS 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 Children's Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Written Documentation In Compliance Posted Documentation In Compliance Animals 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 4. Director Requirements and Responsibilities.

General: Based on Review of Documentation, it was found that a staff person with a hire date of 10/12/2015 did not have an annual written performance evaluation in her file. 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 6. License Issuance.

General: Based on Review of Documentation, it was found that a staff person with a hire date of 08/08/2016 did not have record of an out of state criminal records check. The staff lived in Ohio within the last five (5) years. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, tt was found that a staff person with a hire date of 10/12/2015 had no evidence of being free of TB. It was found that a staff person with a hire date of 04/16/2016 did not have her TB skin test read until 04/20/2016. It was also found that a staff person with a hire date of 11/22/2016 did not have her TB skin test read until 11/29/2016. 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 In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, it was found through a review of file that a child with an enrollment date of 08/10/2016 did not contain an immunization certificate. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the facility did not have a written policy that specifies that the procedures that were taught at orientation training shall be implemented by each child-care staff. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the only section of the regulations available to the facility staff was 922 KAR 2:110. 922 KAR 2:090 and 2:120 were not available.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the file for one (1) eligible employee did not contain evidence of an annual evaluation being completed.

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, it was found that the file for an employee hired on 9-25-08 contained the results of a TB skin test that was completed on 4-14-14. This date is not within the two (2) year timeframe required by the regulation. It was also found that the files for employees hired on 7-26-15, 1-15-16, 2-17-16 and 4-6-16 contained documentation of TB skin tests and/or screenings that were dated 7-27-15, 2-6-16, 3-1-16 and 4-20-16. These dates are not prior to the dates of hire as required by the regulation.

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 that the ECE-TRIS record and the file for an employee hired on 9-25-08 contained evidence of only six (6) hours of training being completed during the last completed training year. The ECE-TRIS record and file for this same employee did not contain evidence of the six (6) hour cabinet-approved orientation training being completed. In addition, it was found that the ECE-TRIS record and file for an employee hired on 8-13-15 contained evidence of the six (6) hour cabinet- approved orientation training being completed on 12-27-15. This is not within the ninety (90) day timeframe required by the regulation. 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 7. First Aid and Medicine.

General: Based on Review of Documentation, it was found that a six-year-old child was being given enzyme pills twice a day due to having Cystic Fibrosis. The permission form on file for this medication had been signed by the parent at the beginning of the 2015-2016 school year. The form specifically stated that the stopping date for the medication was the end of the school year, which was 5-26-16.

Open Not marked corrected in the state record

Category: ratio. 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 weed guard was pulled through the pea gravel on the playground, creating a tripping hazard.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the facility did not have evidence of a written third party contact between the facility and the school system, which provides transportation for field trips.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the facility did not have written policies regarding the safety procedures used during the loading, unloading and supervision of the children while transporting.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the facility did not have transportation records that included the first and last names of the children transported, the times the children got on the vehicle and off the vehicle for any of the field trips taken. The facility has taken trips to the Newport Aquarium, the pool and Legends Ball Park.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on Observation, it was found that a snack menu and a lunch menu were not posted.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the parents are not signing in each child of a sibling group separately. After the first child is signed in, a line is being drawn down through the sibling's attendance boxes. In addition, several parents are signing the end of the week verification prior to the week being over.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the file for one (1) eligible employee did not contain evidence of an annual professional development plan being completed. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 24 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 3. General Requirements.

General: Based on Review of Documentation, it was found that the fire drill documentation did not include evidence of a fire drill being conducted in May of 2016.

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 Observation, it was found that a schedule of daily activities was not posted for any of the age groups in the facility. 1170 - Diapering/Handwashing Not Applicable 922 KAR 2:120. Section 10. Toilet, Diapering, and Toiletry Requirements. (9) The proper methods of diapering and hand-washing shall be posted at each diaper changing area. Animals 1175 - Animals in the Presence of Children Not Applicable 922 KAR 2:120. Section 13. Animals. (1) An animal shall not be allowed in the presence of a child in care: (a) Unless: 1. The animal is under the supervision and control of an adult; 2. Written parental consent has been obtained; and 3. The animal is certified as vaccinated against rabies; or (b) Except in accordance with subsection (3) of this section. 1185 - Prohibited Animals Not Applicable 922 KAR 2:120. Section 13. Animals. (3) An animal that is considered undomesticated, wild, or exotic shall not be allowed at a child-care center unless the animal is: (a) A part of a planned program activity lead by an animal specialist affiliated with a zoo or nature conservatory; and (b) In accordance with 301 KAR 2:081 and 301 KAR 2:082.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, seven (7) staff eligible for an annual performance review did not have current documentation of a review on file in the facility.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, the facility failed to meet this regulatory requirement. A review of staff files during the inspection found four (4) staff that did not have the date of employment listed in their file. After speaking with the facility's central office and comparing the dates with her personal documentation, the staff person in charge presented the surveyor with hire dates for the staff.

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, one (1) staff file (hire date: 12/7/12) contained results of a negative T.B. test that is no longer current. The test was dated 8/20/12 which exceeds the two (2) year time frame.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the following was found: 1. One (1) staff file (hire date: 8/15/14) did not contain evidence of the six (6) hours of cabinet-approved training being completed within the first three (3) months of employment. 2. Four (4) staff files (hire dates: 12/7/12, 9/25/08 and 2 on 8/6/12) did not contain the required fifteen (15) hours of training.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, the facility failed to meet this regulatory requirement. The surveyor entered the infant room at 9:20AM and observed a two (2) month old asleep in a swing and a three (3) month old asleep in a bouncy seat. The surveyor toured the infant room a second time at 9:40AM and observed the children still sleeping in the same position. Documentation stating that the children required an alternate sleeping position was not provided.

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 facility failed to meet this regulatory requirement. A can of disinfectant spray was found sitting on top of a shelf along with dramatic play materials in the preschool classroom. The label on the bottle read "Keep Out of Reach of Children."

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the facility failed to meet this regulatory requirement. The cloth mat on top of the dorm-size refrigerator in the infant classroom contained numerous dark spots and stains. Furthermore, the two (2) bottle warmers sitting on top of the mat contained a brown, crusty substance inside of them.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, the facility failed to meet this regulatory requirement. A review of the summer and fall break documentation found that the times that children got on and off the vehicles during field trips had not been documented.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on Observation, the facility failed to meet this regulatory requirement. A tour of the infant classroom found one (1) uncovered bottle in the classroom refrigerator.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the emergency preparedness plan on file had not been updated since 2013.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the facility failed to meet this regulatory requirement. A review of the 3/13/15 attendance records during the visit found: 1. Six (6) children were present in the infant classroom; however, only four (4) of them had an arrival time documented. 2. Ten (10) children were present in the toddler classroom; however, only five (5) of them had an arrival time documented. 3. Fourteen (14) children were present in the preschool classroom; however, only nine (9) of them had an arrival time documented.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, three (3) staff did not have evidence of a current staff professional development plan on file in the facility.

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 Review of Documentation, the facility failed to meet this regulatory requirement. A cover letter from the DRCC office that stated an inspection was conducted and included instructions on how to submit a plan of correction was posted; however, the inspection report from the 4/10/14 relicensure survey was not posted. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 25 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 13. Animals.

General: Based on Observation, the preschool room contained a pet fish. The facility did not have written parental consent for the children to be in the presence of fish.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the staff did not have current professional development plans on file. This was an issue for all the staff.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, there was no evidence of completed drills as the binder containing the documentation was not available for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, there was no evidence of completed drills as the binder containing the documentation was not available for review.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Review of Documentation, there were five (5) children's files that did not include a valid immunization certificate.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Review of Documentation, the staff had not recieved the required child development training for the current training year. This was an issue for all staff. 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 Review of Documentation, there was no evidence of completed drills as the binder containing the documentation was not available for review.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Review of Documentation, there was no evidence of completed drills as the binder containing the documentation was not available for review. Posted Documentation

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the daily activity plans in the infant room and the one (1) year old room were not posted.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the surveyor found that five (5) staff were hired 8/6/2012. The five (5) staff had criminal records checks on file that were completed approximately ten (10) months or more prior to hire. The criminal records checks on file were dated: 2/28/11, 6/23/11, 10/13/11, 10/24/11, and 11/22/11. The staff person in charge indicated that the staff had submitted applications with the public school system in 2011 and that the public school system had the criminal records checks processed once their application was received. Based on record review, the five (5) staff held other jobs in other locations when their criminal records checks were processed by the public school system. The surveyor could not verify if the staff had committed any recent violations against children due to the background checks being processed so far in advance prior to their hire dates.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the surveyor found that one (1) staff person (hire date: 8/13/08) had TB skin documentation on file that was no longer valid as of 11/17/12.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the surveyor found that one (1) staff (hire date: 4/18/12) did not complete the required orientation training within ninety (90) days of hire. The documentation on file was dated 8/1/12. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty one (21) years old; (b) Complete the background checks as described in 922 KAR 2:110; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, the surveyor observed three (3) ceiling tiles located in classroom 171 that were stained with brown water rings.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, the surveyor found that the refrigerator in classroom 168 did not have an indicating thermometer. The refrigerator contained the children's bottles.

Open Not marked corrected in the state record

Open / not marked corrected.