922 KAR 2:280 · 922 KAR 2:280. Section 11. Status of Employment.

Based on review of documentation of the child-care center's KARES report, the surveyor found a staff member (DOH: 05/03/22) was showing separated on the child-care center's roster. The staff member was working at the child-care center on the day of the surveyor's visit. Supervision 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 the following: 1. A child’s (DOE: 07/26/21) file contained an immunization certificate that was no longer current as of 04/23/25. 2. A child’s (DOE: 01/14/25) file contained an immunization certificate that was no longer current as of 04/24/25.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS, the surveyor learned that a staff member (DOH: 09/18/2023) did not obtain training on first aid and cardiopulmonary resuscitation (CPR).

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 in the staff member's personnel files and ECE-TRIS, the surveyor found the following: 1. A staff member (DOH: 10/01/2018) completed the one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training (PAHT) on 01/21/2019; therefore, the training was not completed once every five (5) years. 2. A staff member (DOH: 10/24/2022) did not complete the one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training (PAHT). An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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 4. Premises Requirements.

General: Based on observation, the surveyor discovered the following: Three-Year-Old Restroom: 1. There was a layer of dust on the ceiling tiles. 2. There was a layer of dust on the wall. School Age Classroom: 1. There was a layer of dust on three (3) air vents. Three-Year-Old Classroom: 1. The emergency light was hanging down from the light socket. Two-Year-Old Classroom: 1. There was a layer of dust on the air conditioner. Staff-in-charge reported that she would have the areas cleaned and repaired.

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 discovered the following: Four-Year-Old Restroom: 1. There was a brown substance on the ceiling tile. Four-Year-Old Classroom: 1. There was a brown substance on eight (8) ceiling tiles. Three-Year-Old Classroom: 1. There was a brown substance on three (3) ceiling tiles. Three-Year-Old Restroom: 1. There was a brown substance on three (3) ceiling tiles. Crawler Classroom: 1. There was a brown substance on three (3) ceiling tiles. Over-Flow School Age Classroom: 1. There was a brown substance on four (4) ceiling tiles. Staff-in-charge reported the roof was recently repaired and she was advised to not change the ceiling tiles in the building until after rain to ensure the roof was no longer leaking. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals 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

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain state regulations. During a tour of the Two-Year-Old room during naptime, it was found multiple children sleeping on cots that were touching. Therefore, without the required twelve (12) inch spacing between each individual cot.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain state regulations in regards to programming. Observation of the Infants' Room found one (1) infant asleep in a crib with a pacifier that had a clip attached. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the child care center failed to maintain state regulations in regards to the premises. Observation of the School Age room found a section of the ceiling that was dripping water through the ceiling tile into a bowl that had been placed on the floor. An interview with staff-in-charge found there is a leaking pipe in the ceiling causing the water to drip. 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 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

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, 16 staff (all with 2018, 2019, and 2020 hire dates) did not have a current annual professional development plan on file at the facility. 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 9. Records.

General: Based on review of documentation, this regulatory requirement was not met. During a tour of the preschool classroom, the surveyor found a form labeled "Classroom Allergies" posted on the front of a storage cabinet. The form listed the name of a child and the child's food allergy. This information was available to all visitors; therefore, was not kept confidential. 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 observation, this regulatory requirement was not met. During a tour of the younger two-year-old classroom, the surveyor observed two toilet plungers positioned beside a toilet in the children's bathroom area. This manner of storage is not sanitary and promotes the spread of germs. Employee Records In Compliance Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During a tour of the older and younger two-year-old classrooms, the surveyor observed an excessive build up of dirt and grime on the floor in the threshold between the two rooms. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During a tour of the facility, the surveyor observed one stained ceiling tile in the office and four stained ceiling tiles in the Pre-K Classroom. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During a tour of the school-age classroom at approximately 9:50 AM, the surveyor inspected the refrigeration unit used to store milk and observed a cup of milk sitting inside a milk crate. There were no provisions to protect the milk from contamination. Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation and interview, this regulatory requirement was not met. The emergency preparedness plan on file had not been updated since 12/4/19. The staff person in charge stated that she had been working on the plan and indicated that she would be submitting it soon. Posted Documentation In Compliance Animals In Compliance Emergency Regulation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, this regulatory requirement was not met. During a tour of the facility, the surveyor noted the following: 1. The staff person in charge was wearing a face shield throughout the entire survey; however, was not wearing a face mask. 2. When the surveyor entered the facility kitchen, the staff person was not wearing a face covering of any kind. As soon as the surveyor entered the kitchen area, the staff person reached for a face shield and wore it while the surveyor was in the kitchen; however, was not wearing a face mask. The staff person removed the face shield as soon as the surveyor exited the kitchen area. These situations were discussed with the staff person in charge during the visit. The staff person in charge stated that she thought it was acceptable for her to only wear a face shield because she occasionally covers breaks in the infant/toddler classrooms. The staff person in charge stated that the kitchen staff person has a medical condition which causes her to have difficulty breathing while wearing a mask; therefore, she does not wear one. The staff person in charge further stated that a health department representative witnessed the staff person not wearing a face covering on a recent visit to the facility and told the staff person that it was acceptable. The staff person in charge did not have a medical waiver on file for the staff person and did not have documentation of approval from the health department. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation in the 11-month-old room's medication box, a diaper medication was not labeled with a child's name. Outdoor Play Area In Compliance Equipment 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 11. Toys and Furnishings.

General: Based on observation, the following was found: 1. In the three-year-old room, there were toy babies that were deeply soiled. The shelf in the three-year-old room had an area covered in sticky black residue. 2. In the three- to five-year-old room, there was a shelf with areas of covered residue. In addition, there was a makeup toy that was covered in dirt. The floor by the sink had an excessive amount of dirt build up. 3. In the three-month to one-year room, there was a play kitchen that had sticky tape with residue on it and a blue seat with sticky residue on the surface. 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

Open / not marked corrected.

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

General: Based on interview and review of documentation, the child-care center failed to ensure the health, safety, and comfort of a child in care. The director reported an incident involving a three-year-old child and a staff person to the Division of Regulated Child Care on 1/18/19. A review of the report found a three-year-old child was washing her hands for an extended period and had refused to leave the area after repeatedly being asked to by a staff person. The staff person picked up the child by her upper arms in order to move her away from the handwashing sink and place her in "time-out." Interviews with staff conducted on 1/23/19 found that they observed the child "digging and wringing" in her arm and crying. Staff indicated they thought the child was crying due to being in "time-out" and thought she was just having an emotional day. The child went to the doctor the next day and diagnosed with having a strained muscle in her left forearm. In an interview with the staff person in question it was found that on 1/17/ 19 she told the child several times to stop playing in the water and when she refused, she picked up the child underneath her arms and carried her approximately three (3) feet across the room to the cubby area. Based on review of documentation, the surveyor found the first accident/ incident report written by the staff person reads as follows “…..refusing to listen to the teacher when I asked her to leave the sink area after washing her hands for an extended period of time, so I picked her up by her forearms. She dropped to the floor and I picked her back up by her forearms and carried her to the wall for time-out.” A second accident/ incident report amended by the staff person reads as follows “….refusing to listen to the teacher when I asked her leave the sink area after washing her hands for an extended period of time, so I picked her up by her upper arms to take her to time-out. She dropped to the floor and I picked her back up by her upper arms and carried her to the wall for time-out.” A review of medical documentation received on 2/7/19 found the child was examined at Harrodsburg Urgent Treatment Center the evening of 1/18/19. Per the report it was found the child’s medial, lateral, and anterior potion of her left elbow forearm were tender. It is important to note the director placed the staff person on suspended leave due to the incident. Employee Records In Compliance Children's Records In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During a tour of the younger one (1) year old classroom (Crawlers), the surveyor observed the staff person working in the room having to lift each child up and assist them to stand in an adult size chair so that children could wash their hands because the children could not reach the sink. This process is not safe because children were not able to balance unassisted on the soft surface of the chair. 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 9. Records.

General: Based on review of documentation and interview, this regulatory requirement was not met. The following was found: 1. A review of staff files during the inspection found two (2) staff that did not have the date of employment listed in their file. The staff person in charge reviewed internal documentation and then identified 11/12/18 and 12/17/18 as the hire dates. 2. One (1) staff person had a hire date of 10/1/18 documented in her file; however, the staff person in charge stated during interview that this information was not listed correctly. The staff person in charge identified 12/19/18 as the person's actual hire date. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the facility failed to provide opportunity for children to practice developmentally appropriate self-help procedures in respect to hand-washing. During a tour of the younger one (1) year old classroom (Crawlers), the surveyor observed the staff person working in the room having to lift each child up and assist them to stand in an adult size chair so that children could wash their hands because the children could not reach the sink. Furthermore, this process is not safe because children were not able to balance unassisted on the soft surface of the chair. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During a tour of the facility the surveyor observed an excessive accumulation of dust on ceiling exhaust fans in three (3) of the children's bathrooms (School age room, older two (2) year old room, and the playroom).

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 and interview, this regulatory requirement was not met. The following was found: 1. During a tour of the children's bathroom in the playroom area, the surveyor found that one of the ceiling tiles was missing. A large piece of pink insulation was exposed. 2. During a tour of the facility, the surveyor observed three (3) ceiling tiles with dark stains in the facility office. The staff person in charge stated that she was in process of getting these repairs done. Hygienic Practices In Compliance First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. The following was found: 1. During a tour of the three (3) year old classroom, the surveyor observed a tube of Desitin diaper cream positioned on top of a shelf with diapering supplies. This tube was not labeled with a child's name. 2. During a tour of the younger one (1) year old classroom (Crawlers), the surveyor observed a tube of A&D Ointment in a cabinet with various diapering supplies. This tube was not labeled with a child's name. Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 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 Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the following was found: 1. The older one (1) year old classroom (Walkers) had a schedule of daily activities posted that was dated December 24 - 28, 2018; therefore, it was no longer current. 2. Both two (2) year old classrooms had a schedule of daily activities posted that was dated 1/7/19 - 1/11/19; therefore, they were not current.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, this regulatory requirement was not met. The facility had proper methods for hand washing posted next to the diaper changing table in the younger two (2) year old classroom; however, they did not have diaper changing methods posted. The staff person working in the classroom stated, "Posted items were recently taken down so the room could be painted. We must have forgotten to hang that one back up." Animals Not Applicable

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.