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

General: Based on observation, the surveyor found that the sink in the Toddler Classroom did not have running water; therefore, the sink was not equipped with hot or cold water. The surveyor was unable to check the temperature of the water to determine if the water was between the required minimum temperature of ninety (90) degrees Fahrenheit and a maximum of 120 degrees Fahrenheit. T The surveyor observed the children to wash their hands in the restroom that adjoins the classroom prior to lunch. During interview with staff-in-charge, she stated that she would call maintenance to have them come to the child-care center to fix the sink. Hygienic Practices In Compliance 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 1 of 2 Inspection Report 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 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 10. Director Requirements and Responsibilities.

General: Based on review of documentation, the surveyor found the following: 1. A staff's (DOH: 01/16/2020) file did not contain a staff evaluation. 2. A staff's (DOH: 12/03/1985) file contained a staff evaluation dated 2/10/2021; therefore, the staff evaluation was not conducted yearly. 3. A staff's (DOH: 05/14/2014 file did not contain a staff evaluation. Staff reported that she would have the staff evaluations completed. 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, the surveyor discovered a staff's (DOH: 01/16/2020) file contained a negative tuberculin (TB) skin test dated for 11/17/2019; therefore, the TB verification was no longer current. The surveyor was unable to verify if the staff person was free of active tuberculosis. Staff reported that she would have the staff bring in an updated negative TB skin test. 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 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on review of documentation and ECE- TRIS, the surveyor found that a staff (DOH:02/20/2017) completed the one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma (PAHT) on 02/08/2017; therefore, PAHT training was not completed once every five (5) years. Staff reported that she would have the staff member complete her training. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered in the restroom off from the nursery that the toilet seats were loose; therefore, the toilet seats were not in good repair. Staff reported that she would have the toilet seats fixed. Hygienic Practices In Compliance First Aid/Medication In Compliance 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 Not Applicable Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the child-care centers liability insurance documentation on file expired as of 08/01/16. During interview, staff-in- charge stated that the liability insurance was current; however, she was unable to locate the documentation. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report

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 of the Crib Room, the surveyor found the following: 1. Two (2) totes stacked with a black bag placed on top of them, two (2) boxes of paper stacked, and a charging cable located beside a crib. 2. Two (2) black camera bags and a black crate placed on the floor beside a crib. 3. A small white refrigerator placed on top of a small brown cabinet. 4. Two (2) boxes, a gray item with the cord exposed, and a clear plastic bag with what appeared to be clothes placed inside it placed on the floor beside a crib. 5. Several items that appeared to be toys stacked inside a crib. 6. A box, white bag, and other items stacked on top of a white three drawer cabinet located beside a crib. 7. Three (3) boxes of blinds placed on the floor beside a shelf. 8. One (1) tall rug leaning against a wall beside a tall gray cabinet and near a crib. 9. Two (2) tall rugs wrapped in plastic leaned against the wall in the corner of the room. The surveyor observed the Crib Room to be adjacent to the lunch area in the Infant Classroom that the children use to eat meals. The door to the Crib Room was observed to be open; therefore, the items inside the Crib Room were observed to be accessible to the children. During interview, staff-in-charge stated that the children do not currently use the Crib Room and that staff only use the Crib Room when children are carried into the room to have their diaper changed. 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, the surveyor found that a staff’s (DOH: 02/02/09) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis. During interview, staff-in-charge stated that the staff person should have a TB skin test; however, she was unable to locate the documentation. 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 3. General Requirements.

General: Based on observation, the surveyor found the following: 1. A broom and dust pan placed near the tables the children use to eat meals in the Infant Classroom. 2. A rubbermaid sweeper and vacuum placed beside a crib in the Crib Room. 3. A staff's purse placed inside a crib in the Crib Room. 4. A container of 3M Diff Solutions placed on a white shelf beside a crib in the Crib Room. 5. A white cabinet that contained paint supplies in the bottom drawer in the Crib Room. The drawer was observed to not have a safety lock. 6. A door on a tall gray cabinet that was observed to be half open with paint supplies and other materials stored on the shelves inside the cabinet in the Crib Room. During interview, staff-in-charge stated that Crib Room has not been used by the children and is only used when staff take children for a diaper change. The surveyor observed the diaper changing table inside the Crib Room. 7. A closet door that would not latch properly in the Toddler Classroom. The surveyor observed the closet door to be easily pushed open and to contain the following items: a gray container placed on the floor with Microban, Comet cleaner, Spectracide, a hand cultivator garden tool, and other cleaning supplies placed inside the container, a vacuum and rubbermaid sweeper, filing cabinets and shelves with items stores on them, a box of cold/flu medicine placed on a bottom shelf, and a box of Ibuprofen tablets placed on a bottom shelf. The items were observed to be accessible to the children. During interview, staff-in-charge stated that the key broke off into the door handle and they will have the door handle replaced as soon as possible. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. An ABC square rug that contained stains in the Wallins Classroom; therefore, the rug was not kept clean. 2. A blue rocker that contained stains in the Crib Room; therefore, the rocker was not kept clean. 3. The sink located in the Wallins Classroom was observed to be leaking from a white pipe underneath; therefore, the sink was not kept in good repair. The surveyor observed water to come from the white pipe while the water was turned on and a blue towel placed underneath the sink.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found three (3) ceiling tiles that contained brown circular stains in the boys' restroom in the Cawood Classroom; therefore, the ceiling was not in good repair.

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 surveyor found the following: 1. The toilet seat moved easily and was not tightly secured to the toilet in the girls’ and boys’ restrooms located in the Wallins Classroom. 2. The toilet seat moved easily and was not tightly secured to the toilet in the boys’ restroom located in the Cawood Classroom. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found two (2) water bottles placed on the ground by the swing set on the playground. Therefore, the outdoor play area was not kept free of litter. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation of the playground, the surveyor found the following: 1. A small silver metal pole that was sticking out through the fence beside the fenced in unit. The pole was observed to be accessible to the children. 2. A tall metal pole placed in the ground with a feeder placed on top of it. The surveyor observed the pole to come out of the ground easily when pulling on the pole. 3. Four (4) tall shepherds hooks placed in the ground on the playground. 4. A small wooden stick/pole that was broken on the end and exposing split ends located by the swing set. 5. A black border that borders a climbing structure was broke in one (1) area exposing the silver metal stake. 6. A black border that borders the swing set was broke in one (1) area exposing the silver metal stake. 7. Several red wasps swarming the mulch around a plastic climbing structure. During interview, a maintenance worker on the playground stated that the wasps have a nest on the building and carry the mulch to the nest. The surveyor did not observe a nest on the building. During interview, staff-in-charge stated that she was not aware of a nest on the building and would have maintenance remove the nest. Equipment In Compliance Transportation In Compliance 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: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A child’s (DOE: 09/24/29) file did not contain a contact telephone number for the child’s preferred hospital. 2. A child’s (DOE: 09/03/19) file did not contain a contact telephone number for the child’s preferred hospital. 3. A child’s (DOE: 10/18/17) file did not contain a contact telephone number for the child’s preferred hospital. 4. A child’s (DOE: 08/19/19) file did not contain a contact telephone number for the child’s preferred hospital. 5. A child’s (DOE: 08/19/19) file did not contain a contact telephone number for the child’s preferred hospital. 6. A child’s (DOE: 08/13/20) file did not contain a contact telephone number for the child’s preferred hospital or family physician. 7. A child’s (DOE: 09/03/19) file did not contain a contact telephone number for the child’s preferred hospital. 8. A child’s (DOE: 08/01/20) file did not contain a contact telephone number for the child’s preferred hospital. 9. A child’s (DOE: 03/16/20) file did not contain a contact telephone number for the child’s preferred hospital. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found no documentation of earthquake and tornado drills conducted during the second quarter of 2021. During interview, staff-in-charge stated that the tornado and earthquake drills were completed; however, she was unable to locate the documentation. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found tears on the corner of the vinyl covering of the diaper changing pad located in the classroom for the toddler children. During interview, staff stated that they were unaware of the tears. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Food Service In Compliance Children's Records 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 9. Records.

General: Based on review of documentation, the surveyor found that a child’s (DOE: 12/3/19) file contained an immunization certificate; however, the certificate did not document the expiration date. During interview, staff stated that she was unaware the certificate was missing the expiration date. Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable Emergency Regulation In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, during a tour of the playground, the surveyor found only one (1) staff person on the playground watching the children. Six (6) children were out of the line of sight of the teacher. An additional staff person came outside while the surveyor completed the tour. Therefore, the child care center staff was not in compliance with proper supervision. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on observation, when the surveyor toured the playground, only one staff person was with fifteen (15) children on the playground exceeding the staff-to-child ratio by 3 children. Therefore, the child care center staff to child ratio and maximum group size was not in compliance. General Administration In Compliance Director Requirements In Compliance Employee 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 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: ratio. Open / not marked corrected.

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

General: Based on interview, the surveyor learned that four (4) staff had knowledge of a staff's alleged inappropriate behavior toward a child. A witness to the incident reported the concern to the staff-in-charge on that day. The witness reported that a two-year-old child was having a temper tantrum. A staff person allegedly picked up the child and slammed him in a time out chair. The child got out of the time-out chair onto the floor. The staff person picked up the child and again slammed him in the time out chair. The staff-in-charge confirmed having received the report. She also confirmed that while she interviewed the staff person, she did not report the allegation to the childcare center's management or the cabinet. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on review of documentation, the surveyor found that the childcare center director did not ensure that staff implemented the Classroom Discipline Policy. The policy states, “children will not be subject to harsh or physical discipline; including abusive language (loud, profane, threatening, or frightening) by staff or any other person on the premises”.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on interview, the surveyor found that a preschool-age child was having a behavioral outburst. The classroom teacher wrapped her legs around the child’s legs to restrict his movement. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 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 interview, the surveyor found that a staff person uses a loud and inappropriate tone with the children. The staff interviewed identified that the teacher’s tone scares the children, is hateful and is too stern.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found that the Infant/Toddler playground did not have any shaded area. Staff in charge reported that the shade canopy had came down under the weight of the snow. Staff also stated that the building does not provide any shade to the playground during the children's scheduled outside playtime. 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 An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a volunteer's (DOH: 11/7/16) file did not contain a completed criminal records check or a completed central registry check. In an interview with the Facilities Transportation Manager, the surveyor learned that the criminal background checks were not submitted until 11/9/16 and were therefore submitted untimely. In an interview with the staff-in-charge, the surveyor learned that the volunteer has not been left alone with children at any time. The surveyor was also informed that the volunteer would not be around children until the criminal records checks have been received. Transportation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, one (1) staff file presented for review (DOH: 3/23/12) did not contain record of an annual evaluation for 2015. Staff in charge had difficulty locating the file and explained that the staff in question had not been working at this center location long and while she had misplaced some of the staff's file documentation the annual evaluation would be on file at the main office.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, one (1) staff file presented for review (DOH: 3/23/12) did not contain record of the criminal records check or child abuse neglect check. Upon interview staff in charge explained that the staff in question had not been working at that particular location very long and while she has misplaced the staff's file the background checks would be on file at their main office.

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 file presented for review for a staff person (date of hire: 4/7/2012) did not contain a current statement from a health professional that the individual is free from active tuberculosis or a copy of negative tuberculin results. The most recent copy of negative tuberculin results in the file presented was dated 3/23/2012.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infant: Based on observation, an infant was wearing a bib while sleeping in a crib. 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 1) Toxic cleaning supplies, poisons, and insecticides In Compliance 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff In Compliance 197 - Premises Requirements 922 KAR 2:120 - Section 4 Premises Requirements. (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with a land-line telephone accessible to a room used by a child. 1) Suitable In Compliance 2) Clean In Compliance 3) Good repair In Compliance 4) Land-line phone accessible In Compliance 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 11 of 38 Web site: http://chfs.ky.gov/ Inspection Report 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 1) Windows In Compliance 2) Doors In Compliance 3) Stoves In Compliance 4) Heaters In Compliance 5) Furnaces In Compliance 6) Pipes In Compliance 7) Stairs In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 4 (18)

General: Based on observation, the landscaping fabic underneath the swings and at the exit of one (1) slide was exposed causing a tripping hazard.

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

General: Based on review of documentation, the following was found: 1. The file presented for review for a child (DOE - 6/12/12) contained an immunization record that did not include: a. the name of the parent or guardian of the child; b. the address of the child; c. certification that the child is current for immunizations until a specified date, including a statement that the ceritificate shall not be valid after the specified date; d. the signature and the date of the signature of a physican; an advanced practice registered nurse; a physician's assistant; a pharmacist; local heath department administration; or a registered nurse designee of a physician, local health department administratior, or other licensed health care facility as required in 902 KAR 2:060 Section 4 (c) (1) - (8)(f). 2. The file presented for review for a child (DOE- 7/30/12) contained an immunization certificate that was no longer current as of 1/30/13.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.