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

General: Based on observation, the surveyor discovered a liquid substance on the toilet seat located in the restroom used by school aged children. During interview, staff-in-charge reported she would ensure that staff knows that toilet seats need to be cleaned.

Open Not marked corrected in the state record

Category: physical safety. 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. One (1) staff’s (DOH: 07/10/23) file did not contain an evaluation. 2. One (1) staff’s (DOH: 06/16/23) file did not contain an evaluation. Staff-in-charge stated that the staff person usually works at Tiny Treasures II and that she may have an evaluation at that location. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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 ECE-TRIS, the surveyor found the following: 1. One (1) staff (DOH: 03/19/15) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 07/01/23- 06/30/24. 2. One (1) staff (DOH: 06/16/23) completed thirteen and one-half (13 ½) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 06/16/23-06/16/24. This staff also completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period of 06/17/24-06/30/24. 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 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: recordkeeping. 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: 01/25/2023) did not complete the required six (6) hours of cabinet-approved orientation completed within their first three (3) months of employment in a child-care program. Staff reported that she would have the staff complete the training. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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: 1. There a thick layer of dust on the air intake vents located in the Preschool Classroom. 2. There was a thick layer of dust on the exhaust fan located in the Older Preschool Restroom. Staff reported that she would have the vents cleaned.

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 observed the following: 1. There were multiple brown spots located on the ceiling in the Old Preschool Classroom. 2. There were two (2) brown lines (approximately twelve (12) inches in length and less than one (1) inch wide) located on the ceiling in the Nursery. Staff reported that she would have the areas cleaned and repaired. 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 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on documentation, the surveyor found that only fifteen (15) children were signed-in on the attendance record for 06/27/22. During the surveyor's walk through, the surveyor observed seventeen (17) children to be present at the child-care center. Posted Documentation In Compliance Animals 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 from ECE-TRIS the surveyor found the following: 1. A staff (DOH: 03/19/15) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 0/3/23/16; therefore, the training was not completed within the last five years. 2. A staff (DOH: 03/19/15) obtained four (4) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/01/20 – 06/30/21. 3. The following staff (DOH: 12/01/21, 03/07/22) did not obtain the required six (6) hours of Orientation I & II within the first three (3) months of their hire date. 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 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor found a trash bag full of trash hanging on the fence outside on the Preschool playground; therefore, the playground was not free of litter and rubbish. Equipment 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 13. Toys and Furnishings.

General: Based on observation, the surveyor found the following: 1. A pink and purple picnic table on the School Age playground had a broken bench with one (1) protruding nail and a piece of wood that was splintered. Staff-in-charge stated that she had asked the owner to remove the picnic table the previous week. 2. On the Preschool playground, a red and yellow Little Tykes riding car had a broken roof and broken door. Staff-in-charge stated she would have this removed immediately. 3. On the Preschool playground, a red and blue Little Tykes riding car was broken and had a sharp jagged piece of plastic. Staff-in-charge stated she would have this removed immediately. 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 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 a child’s (DOE: 01/28/22) file contained an immunization certificate that was no longer current as of 05/30/22. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report

Open Not marked corrected in the state record

Category: health medication. 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. The following children’s files (DOE: 07/27/20, 06/14/22) did not contain the contact telephone numbers for the child’s preferred family physician or hospital. 2. A child's file (DOE: 01/28/22) did not contain authorization by the parent for the child-care center to seek emergency medical care for the child in the parent’s absence, or the name of each person who is designated in writing to pick-up the child. Written Documentation Not In Compliance

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.

Based on observation, the surveyor found the following: 1. There were holes in the diaper changing pad located in Nursery #2 Classroom. Staff reported that she would have the changing pad replaced. 2. There were holes in the diaper changing pad located in Nursery Classroom. Staff reported that she would have the changing pad replaced. 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 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 4. Premises Requirements.

General: Based on observation, the surveyor found a water bottle located underneath the chairs on the playground. Therefore, the playground was not free from litter. Staff reported that she would make sure the water bottle is picked up. Equipment 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 11. Toys and Furnishings.

General: Based on observation while on the playground, the surveyor found the following: 1. A pink and purple trike had a broken handle and the seat was missing. 2. A scooter had a broken handle. 3. There was a crack on the yellow structure on the big kid's playground. Therefore, the structure was not in good repair. 4. The steering wheel was broken off of a black and gray Little Tikes car. During interview, staff stated that she would have all broken toys removed from the playground and have the yellow structure repaired. Transportation Not Applicable 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

Open / not marked corrected.

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

General: Based review of documentation presented, the surveyor found a staff's (DOH: 08/25/20) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. Staff stated during interview that a copy of the staff's proof of education was not available for review at the time of the survey.

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 of the file presented, the surveyor found a staff's (DOH: 09/07/09) file contained negative tuberculin verification dated 05/24/18 which was no longer current. Staff stated during interview that they could not provide current documentation at the time of the survey. 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 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

Open / not marked corrected.

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

General: Based on review of documentation presented, the surveyor found the following: 1. The most recent immunization certificate presented for surveyor review for one (1) child (DOE: 07/29/19) was no longer current after 11/15/20. 2. The most recent immunization certificate presented for surveyor review for one (1) child (DOE: 10/12/20) was no longer current after 10/29/20.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation presented, the surveyor found one (1) child’s file (DOE: 07/29/19) did not contain information to enable a person in charge to identify or contact the preferred hospital. Staff stated during interview that they would have the parent fill out the information as soon as possible. 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 presented, the surveyor found the following: 1. There was no verification of fire drills for the months of September – November 2020. Staff stated that the drills were completed; however, the documentation was not available for review. 2. There was no verification of tornado or earthquake drills for the months of April – November 2020. Staff stated during interview that the drills were completed; however, the documentation was not available for review at the time of the survey. Posted Documentation In Compliance Animals In Compliance Emergency Regulation 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 4. Premises Requirements.

General: Based on observation during a tour of the Two-Year-Old Room, the surveyor found that one (1) staff person was providing care for six (6) two-year-old children. Review of the center’s diagram found that the classroom measures for a capacity for only five (5) children. One (1) child exceeded the classroom capacity.

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 and review of documentation, the surveyor found that staff did not implement the childcare center’s programs and policies; 1. The childcare center’s policy requires that, “All staff and employees will be wearing name tags this will give all visitors the feeling of comfort know what your name and title is”. Through observation, the surveyor found that none of the staff was wearing nametags. 2. The childcare center’s Program/Orientation policy requires that, “It is expected that all employees will be knowledgeable in the childcare rules and regulations and will be expected to continue all hours of required continued training as required by state”. Review of documentation and ECE-TRIS found that the following four (4) staff were noncompliant with required training: (DOH: 5/1/19), (DOH: 7/11/18), (DOH: 7/11/18) and (DOH: 6/1/14).

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on observation during a tour of the childcare center, the surveyor found the following: 1. Numerous, shoebox size, clear plastic containers were stacked in a storage area located in the Preschool Room. Wooden blocks were stored in two of the plastic containers and stacked on top of the other containers. The surveyor found that the containers easily tipped and presented a safety risk to the children. 2. A child in the Infant Room was sucking on a pacifier with a stuffed animal attachment. The stuffed animal presents a risk of impeding the child’s breath. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report 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 no verification that a staff (DOH: 5/31/19) has obtained of a High School Diploma, GED or Commonwealth Child Care Credential.

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 the following: 1. No verification was found that a staff (DOH: 5/1/19) has completed six (6) hours of cabinet-approved orientation training. 2. No verification was found that a staff (DOH: 7/11/18) has completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training. 3. Verification of only eight (8) hours of cabinet-approved early care and education annual training was found for a staff (DOH: 7/11/18) for the review period of 7/11/18 through 7/10/19. 4. Verification of only one and one-half (1 ½) hours of cabinet-approved early care and education annual training was found for a staff (DOH: 6/1/14) for the review period of 6/1/18 through 5/31/19. Programming 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 2. Child Care Services.

General: Based on observation during a tour of the Preschool Room, the surveyor found that a staff person was providing care for ten (10) children whose ages ranged from four- years-old to eight-years-old. Review of the daily planned program found no age-appropriate activities for the school-age children. 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 during a tour of the childcare center, the surveyor found spiders and webs in the windowsill located in the classroom for the older preschool-age children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation during a tour of the childcare center, the surveyor found no hand drying blower or single use disposable hand drying material in the restroom used by the school-age children. Hygienic Practices Not In Compliance

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 observation during a tour of the Infant Room, the surveyor found that the trashcan was overflowing with soiled disposable diapers.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on interview with a staff in the Infant Room, the surveyor learned that the mouth contact toys are sanitized as follows: Wash in soapy water, wipe with a paper towel, spray with Lysol, air-dry, spray with bleach water and air-dry. Based on this method, the mouth contact toys are not properly sanitized. 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 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 the following: 1. No verification of immunization was found for a child (DOE: 8/24/15). Interview with staff found that an immunization record was not available for review. 2. No verification of immunization was found for a child (DOE: 7/8/11). Interview with staff found that an immunization record was not available for review. 3. The immunization certificate in a child’s (DOE: 1/23/17) file was no longer current as of 6/30/19. Interview with staff found that a current immunization record was not available for review. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation contained in ten (10) children’s files, the surveyor found the following: 1. The enrollment information for a child (DOE: 8/24/15) did not contain information to enable a person in charge to identify or contact the preferred hospital. 2. The enrollment information for a child (DOE: 3/12/18) did not contain information to enable a person in charge to contact the preferred hospital. 3. The enrollment information for a child (DOE: 8/24/15) did not contain information to enable a person in charge to contact the family physician. 4. The enrollment information for a child (DOE: 3/12/18) did not contain information to enable a person in charge to contact the family physician. 5. The enrollment information for a child (DOE: 3/1/19) did not contain information to enable a person in charge to identify or contact the family physician. 6. Two (2) children’s (DOE: 8/24/15 and 4/8/19) files did not contain information to enable a person in charge to identify or contact the family physician or preferred hospital. 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 11. Staff Requirements.

General: Based on review of documentation, the surveyor found the following: (1.) Staff's (DOH: 2/23/18) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. (2.) Staff's (DOH: 4/2/18) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. During interview, the director confirmed the documentation had not been obtained for the staff's file. 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

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 staff (DOH: 9/7/09) obtained six (6) of the required fifteen (15) hours of cabinet - approved early care and education training. During interview, the staff confirmed that fifteen (15) training hours had not been completed for the year. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area 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 found the following: (1.) A large climbing structure with two (2) slides had an inadequate amount of mulch as a protective surface. (2.) A small Little Tikes climbing structure with a slide did not have a protective surface. During interview, the director was aware of the issue stating the center has a plan in place to get new mulch for the playground. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Children's 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, the surveyor found the following: (1.) A child's (DOE: 5/22/18) file did not contain a preferred physician or a preferred hospital's telephone numbers. (2.) A child's (DOE: 6/27/17) file did not contain a preferred physician or a preferred hospital's telephone numbers. (3.) A child's (DOE: 4/3/18) file did not contain a preferred physician or a preferred hospital's telephone numbers. (4.) A child's (DOE: 3/8/18) file did not contain a preferred hospital's telephone number. 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 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation, review of ECE-TRIS, and interview, a staff file (DOH: 3/19/15) presented for review did not contain documentation of having completed fifteen (15) hours of annual training for 3/19/16 - 3/18/17. Review of ECE-TRIS revealed that the staff member had only completed eleven and a half (11.5) hours of annual training. The Director reported that the staff member had not completed all the required annual training hours. 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 and interview, the surveyor found that there were cob webs on the ceiling around the emergency exit sign in the Infant/Toddler Room. Staff reported that the center is cleaned and cob webs removed on a daily basis but they always reappear. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation and interview, the toilet in the restroom off of the Pre-school Room had a brown substance inside the bottom of the toilet bowl. Staff reported that the toilet and restroom are cleaned on a daily basis. Hygienic Practices Not In Compliance

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 observation and interview, the diaper changing mat in the Pre-school Room was found to have multiple small tears exposing the foam filling and preventing it from being properly sanitized. Staff stated that they did not have an extra changing mat and they were unsure of how long the tears had been there. 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 and interview, the surveyor found that the first aid kit did not contain medical tape as required. The Director relayed that the medical tape could have been used the previous week when a child had an accident.

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 observation and interview, the surveyor found that a tube of Desitin Diaper Cream and a bottle of sunscreen in the Infant/Toddler Room were stored on an upper shelf of an unlocked closet in the inside an unlocked storage container. Staff reported that all other medications are stored in a locked cabinet in the kitchen. The Desitin and sunscreen were out of reach of the children but were not locked up. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Outdoor Play Area 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 4. Premises Requirements.

General: Based on observation and interview, the surveyor found that the playground was not safe from forseeable hazards. There was an approximate six (6) inch gap between the ground and the bottom of the chain link fence where the fence had been bent or pulled up. Upon interview, staff were not aware of the damaged fence. Equipment In Compliance Transportation Not Applicable 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 8. Kitchen Requirements.

General: Based on observation and interview, the surveyor found that the thermometer in the refrigerator read forty-five (45) degrees fahrenheit; therefore, the temperature was not maintained at forty (40) degrees fahrenheit or lower. The Director reported that the refrigerator had been fixed in the past but may just need to be replaced. 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 and interview, the following was found: 1. A child's file (DOE: 4/24/17) presented for review did not contain the preferred hospital name or telephone number. 2. A child's file (DOE: 7/1/16) presented for review did not contain the preferred hospital name or telephone number. 3. A child's file (DOE: 3/13/17) presented for review did not contain the preferred physician name or telephone number. Upon interview, the Director was not aware that the preferred hospital information was missing from the files. The Directer stated that the family was in the process of locating a family physician covered by their insurance as they had just relocated to the area from out of state. Written Documentation 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 and interview, it was found that there were no earthquake or tornado drills documented for October - December 2016. Upon interview, the Director stated that they might have not completed the earthquake or tornado drill for that quarter. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 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 and interview, it was found that there were no earthquake or tornado drills conducted for October - December 2016. Upon interview, the Director stated that they might have not completed the earthquake or tornado drill for that quarter. Posted Documentation In Compliance Animals 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, there was one (1) staff member and five (5) children present inside the child care center on 9-19-16 at 1:41pm. The surveyor entered the child care center from the front door and did not observe any adults and/or children upon entry. After approximately ten (10) seconds, a staff member became visible as they were walking out of the pre-school room towards the infant room. Based on interview, staff stated they were the only adult present and they had stepped across the hallway to retrieve the cordless telephone. Further observation revealed the five (5) children ages one (1) to four (4) were asleep in the infant room with the door closed. Therefore, the staff was unable to adequately supervise the children for at least one (1) minute. Staffing Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on review of documentation of staff files, one (1) staff's (DOH: 3-19-15) child abuse and neglect (CA/N) background check indicated that they had resided in the state of Georgia within the last five (5) years; however, the file did not contain an out-of-state background check as required. Based on interview, the director stated that an out-of-state background check was never submitted for this staff as they only lived in Georgia for a few months. The director further stated the staff received mail in Georgia but they were never a citizen of that state and never had a Georgia driver's license. 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 2:110 · 922 KAR 2:110. Section 3. Records.

General: Based on review of documentation of children's files, the following was found: 1) One (1) child's (DOE: 3-7-16) immunization certificate was only current until 7-30-16. 2) One (1) child's (DOE: 4-17-12) immunization certificate was only current until 3-1-16. 3) One (1) child's (DOE: 7-1-14) immunization certificate was only current until 7-7-15. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, there were a total of five (5) children present during the surveyor’s visit on 9-19-16; however, based on review of documentation, there were only four (4) children signed in on the attendance sheets.

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, the verification of a staff persons (DOH: 11/9/15) educational requirement was not contained in the file.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the freezer read at a temperature of four (4) degrees Fahrenheit. Frozen foods are required to be kept at a temperature of zero (0) degrees Fahrenheit or below.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation, an immunization certificate for a child (DOE: 9/29/15) was not contained in the file.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation of a staff persons (DOH: 11/9/15) file, the surveyor found that the staff person's criminal records check was not completed on or before the hire date. In an interview with the director, the surveyor was informed that the staff person was originally hired as a groundskeeper only but has since been hired as a substitute. The director stated the staff person has not substituted since his hire date.

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 outdoor play area was not maintained in a clean condition as trash (i.e., empty bubble containers, plastic, used paper towels, foil) were on the grounds.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation of the Toddler room, a broken, wooden child's chair was located in the room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the temperature of the refrigerator was measured at forty-eight (48) degrees Fahrenheit; therefore, exceeding the requirement that perishable, nonfrozen food be stored at a temperature of forty (40) degrees Fahrenheit or below. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 20 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 8. Kitchen Requirements.

General: Based on observation, the temperature of the freezer was measured at seventeen (17) degrees Fahrenheit; therefore, exceeding the requirement that frozen food be stored at a temperature of zero (0) degrees Fahrenheit or below.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation, an employee's (DOH 06/01/14) criminal records check was not submitted until 06/04/14; therefore, the request was not submitted timely according to KRS 199.896 (20). During an interview with the director, she stated that this employee was initially hired as a cook and was not left alone in supervision of children.

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, only one (1) staff person had completed CPR training from a Cabinet for Health and Family Services approved training organization. Three (3) other staff had completed CPR training from National CPR Foundation which is not listed on the Division of Child Care approved list. During an interview with the director in which the staff schedule was verbally outlined, it was confirmed that qualified CPR coverage was not available at the center daily from 1:30PM - 3:30PM.

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, an employee (DOH 09/07/09) file contained only fourteen (14) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the sink in the Older Preschool room used for handwashinig was not equipped with liquid soap.

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 observation of the Infant room, multiple small tears were visible in the diaper changing pad; therefore, hindering the pad from being properly sanitized.

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, the following was found: 1) A child's (DOE 12/02/13) record presented for review contained an immunization certifcate dated 10/20/14 which was no longer current. 2) A child's (DOE 05/22/12) record presented for review contained an immunization certificate dated 12/31/14 which was no longer current. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation of the child care center's policies and procedures, a policy read: "All staff and employees will be wearing name tags this will give all visitors the feeling of comfort to know what your name and title is." None of the employees were observed wearing name tags as required by the center's policy.

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 child care center did not have a written staff schedule as required by regulations. During an interview with the director, she verbally outlined the staff schedule. 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

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, an employee's (DOH 09/07/09) record presented for review contained a professional development plan dated 04/08/13; therefore, the professional development plan was not maintained up-to-date as required by regulations.

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 in the Preschool room, the posted daily lesson plan of activities was dated 05/18/15-05/22/15; therefore, the posted plans were not maintained up-to-date as required by regulations.

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 observation, the proper methods of handwashing were not posted by sink in the Infants' room. 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

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the light in the restroom for the preschool children did not have a cover, was not protected or shielded and did not have a shatter proof bulb.

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 paint on the wall by and around the sink in the school age children's classroom was faded and worn.

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 mats on both changing tables had multiple tears making them unable to be properly cleaned and sanitized.

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 did not observe the changing table being cleaned or sanitized prior to the diaper change that was observed.

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 interview, the formula for an infant's bottle had not been prepared by the parent.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, the regulations that the provider had on file were printed in April 2013 which are not the most current.

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, the file presented for review for a staff person (DOH: 11/1/12) did not contain documentation of an evaluation.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the following was found: 1. In the school age classroom, the lesson plan that was posted on the wall was dated for 06/17/13 - 06/21/13 and titled "On a cruise". There was no evidence that this lesson plan was being followed. 2. The lesson plan in the preschool classroom was not dated but was titled "Family" and the children were doing an activity for Mother's Day.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on review of documentation, a current personnel file for each staff had not been maintained as follows: 1. The file presented for a staff person (DOH: 04/19/14) did not contain documentation of a high school diploma, GED or commonwealth child care credential as required. 2. The file presented for review for a staff person (DOH: 09/01/09) contained evidence of only twelve and one-half (12 1/2) hours of cabinet approved early care and education training for the training year 09/01/2012 - 09/01/2013. A review of the ECE-TRIS record found record of only nine and one-half (9 1/2)hours of training for this same time period. However, the staff person presented a certificate of three (3) additional hours that were not recorded in ECE-TRIS. 3. The file presented for review for a staff person (DOH: 03/19/13) contained evidence of only six (6) hours of training for the training year 03/19/13 - 03/19/14. A review of the ECE- TRIS record also found evidence of six (6) hours of training for the same time period. 4. The file presented for review for a staff person (DOH: 09/01/09) contained documentation of a TB skin test/assessment that was no longer current as of 09/22/13. 5. The file presented for review for a staff person (DOH: 11/01/12) contained documentation of a TB skin test/assessment that was no longer current as of 11/30/13.

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 a staff person (DOH: 04/19/14) did not contain documentation of a high school diploma, GED or commonwealth child care credential as required.

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. The file presented for review for a staff person (DOH: 09/01/09) contained documentation of a TB skin test/assessment that was no longer current as of 09/22/13. 2. The file presented for review for a staff person (DOH: 11/01/12) contained documentation of a TB skin test/assessment that was no longer current as of 11/30/13.

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 interview, it was learned that the center does not have two (2) qualified substitutes.

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 the center's only substitute (DOH: 4/19/14) did not contain documentation of a high school diploma, GED or Commonwealth Child Care Credential as required. Therefore, the staff person designated as substitute does not meet the requirements of a qualified substitute.

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. The file presented for review for a staff person (DOH: 09/01/09) contained evidence of only twelve and one-half (12 1/2) hours of cabinet approved early care and education training for the training year 09/01/2012 - 09/01/2013. A review of the ECE-TRIS record found documentation of only nine and one-half (9 1/2) hours of training for this same time period. However, the staff person provided a certificate of an addition three (3) hours of training that was not recorded in ECE-TRIS. 2. The file presented for review for a staff person (DOH: 03/19/13) contained evidence of only six (6) hours of training for the training year 03/19/13 - 03/19/14. A review of the ECE - TRIS record also found six (6) hours of training for the same time period. 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. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 8 of 26 Web site: http://chfs.ky.gov/ Inspection Report Programming

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 following was found: 1. The file presented for review for a child (DOE: 2/26/14) did not contain documentation of the child's immunizations. 2. The file for another child (DOE: 2/26/14) did not contain documentation of the child's immunizations.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, none of the ten (10) children's files reviewed contained documentation of the preferred hospital or the telephone number of the preferred hospital. 1080 - Documentation for Off Premise Trip Not Applicable 922 KAR 2:110. Section 3. Records. (1) A child-care center shall maintain: (b) A written record for each child: 3. To contain: g. A permission form for each trip off the premises signed by the child’s parent in accordance with 922 KAR 2:120, Section 12; Written Documentation

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 surveyor found that one (1) Exersaucer in the Nursery had a sticky liquid substance spilled on the tray of the toy.

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 interview, one (1) child care center staff member failed to scrub with a brush toys and other items that are considered mouth contact surfaces by a child not toilet trained and one (1) child care center staff member failed to wash toys and other items with warm soapy waterthat are considered mouth contact surfaces by a child not toilet trained. First Aid/Medication

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, one (1) climbing structure in the Infant and Toddler outside play area and one (1) climbing structure in the School Age and Preschool outside play area did not contain a protective surface equal to the fall zone of the equipment.

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, one (1) toddler in the Nursery accessed an open door and walked out of the classroom; therefore, the child was out of the supervising staff's scope of vision. There were two (2) staff present in the Nursery at the time of the incident and neither staff initially noticed the child had walked out of the classroom.

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 review of documentation, the child care center director failed to document staff meetings in writing. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 5 of 26 Web site: http://chfs.ky.gov/ Inspection Report

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, the child care center director failed to complete an annual performance evaluation for one (1) staff member (DOH: 2-14-12).

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, the child care center failed to provide documentation for submitting a timely child abuse and neglect check and criminal records check for one (1) employee (DOH: 11-1-12), pursuant to KRS 199.896(19) and 922 KAR 1:470. The child abuse and neglect check was not submitted within five (5) days and the criminal records check was not submitted on or before the date of hire.

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 observation, the child care center failed to equip two (2) sinks with a hand-drying blower or a single use disposable hand drying material and also failed to equip one (1) sink with liquid soap.

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 observation, the surveyor found debris in the floor of one (1) restroom. Hygienic Practices

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 child care center failed to maintain a current immunization certificate for one child (DOE: 4-17-12) in care within thirty (30) days of the child’s enrollment. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to obtain the name of each person who is designated in writing to pick-up one (1) child that currently attends the child care center. 1080 - Documentation for Off Premise Trip Not Applicable 922 KAR 2:110. Section 3. Records. (1) A child-care center shall maintain: (b) A written record for each child: 3. To contain: g. A permission form for each trip off the premises signed by the child’s parent in accordance with 922 KAR 2:120, Section 12; Written Documentation

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 review of documentation, the child care center failed to obtain written parental consent from all children's parents/guardians in the Two and Three Year Old Classroom for five (5) caterpillars.

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 interview, the following was found: (1) On 4/12/13, a staff member pulled a nine-year-old child out of a cubby in which he was seated because the child had kicked his sister, was argumentative with staff, and refused to get out of the cubby. (2) On 4/12/13, a staff member held a nine-year-old child on at least two (2) separate occasions for an estimated twelve to thirteen (12-13) minutes because the child reportedly tried to exit the center. A second staff member then held the child on two (2) separate occasions during this incident for an estimated twelve to thirteen (12-13) minutes. Each staff member wrapped their arms around the child's arms and chest so that the child could not move. The child had several scratches on his chest and back due to being held by the staff members on 4/12/13. Equipment

Open Not marked corrected in the state record

Open / not marked corrected.

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

2 Year-Old Room: Based on observation during a tour of the Two-Year-Old Room, the surveyor found that a child (DOE: 03/23/12) was wearing only a diaper and shoes. The surveyor observed that staff took the child outside to the playground where the temperature was approximately sixty-seven (67) degrees. Preschool Room: Based on observation during a tour of the Preschool Room, the surveyor found that an electrical outlet located on the wall by the classroom door was not covered. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 45 Web site: http://chfs.ky.gov/ Inspection Report 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 4) Land-line phone accessible 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. 2) Clean Not In Compliance Findings: 2 Year-Old Room: Based on observation during a tour of the Two-Year-Old Room, the surveyor found that the ceiling air vents were covered with a thick layer of dust. School-Age Room: Based on observation of the School-Age Room, the surveyor found that spider webs were on the electrical box, exit sign and corners in the classroom. l Year-Old Room: Based on observation during a tour of the One-Year-Old Room, the surveyor found dead bugs, dust and spiders webs in the window sill of the classroom. Infant Room: Based on observation during a tour of the Infant Room, the surveyor found the following: 1. The surveyor observed a thick layer of dust and dirt on the baseboards and in the corners of the floor in the classroom. 2. The surveyor observed a soft white substance that was located between the foam letters on the alphabet mat. The surveyor learned through interview with a staff that the substance was mashed potatoes that had spilled when the children were being served lunch. 3) Good repair Not In Compliance Findings: Preschool Room: Based on observation during a tour of the Preschool Room, the surveyor found that the covering over the cable outlet was loose which allowed the outlet to be accessible to children. Infant Room: Based on observation during a tour of the Infant Room, the surveyor found that the folding closet door was not properly fitted to the closet tracks; therefore, the closet door was not shutting properly. 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 45 Web site: http://chfs.ky.gov/ Inspection Report 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures 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 6) Lights good repair Not In Compliance Findings: Infant Room: Based on observation, the surveyor found that the glass of a light bulb had been broken leaving the metal receptacle in the light fixture that is located in the Infant Room. 7) Shielded/shatter proof bulbs Not In Compliance Findings: Infant Room: Based on observation during a tour of the Infant Room, the surveyor found that the overhead light bulbs were not covered. Through interview with a staff, the surveyor learned that the exposed light bulbs located in the overhead light fixture are not shatter proof. 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 2

2 Year-Old Room: Based on observation during a tour of the Two-Year-Old Room, the surveyor found that one (1) staff person was providing care to eight (8) children. The youngest child in the class was twenty-three (23) months of age. 163 - Defined Groups 922 KAR 2:120 - Section 2 (2) (a) In a Type I center, a group size shall: 1. Be separately maintained in a defined area unique to the group; and 2. Have specific staff assigned to, and responsible for, the group. 1) Separate/Defined Area In Compliance 2) Specific Staff In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 4

General: Based on observation and interview, the surveyor learned that the child care center had added an Infant and Toddler playground as well as modifying a wall to increase space in the Infant and Toddler Room. Through interview with a staff, the surveyor learned that neither the Department for Housing, Buildings and Construction, the State Fire Marshal's Office nor the cabinet had been notified prior to the construction of the playground and renovation of the classroom wall.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on review of documentation of all staff files, the surveyor found that the file for a staff (DOH: 09/07/09) did not contain a staff evaluation that was conducted within the last year of employment.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 3

General: Based on review of documentation of all staff files, the file for a staff (DOH: 09/07/09) did not contain a Professional Development Plan within the last year of employment. 107 - Maintenance of Background check/Out of State 922 KAR 2:110 - Section 3 (12) For the director, employee, volunteer, or any person with supervisory or disciplinary control over, or having direct contact with a child, results of the: (a) Criminal records check in accordance with KRS 17.165; (b) Child abuse and neglect check in accordance with 922 KAR 1:470; and (c) Background check from: 1. Previous state of residence, if the individual has been a resident outside of Kentucky in the previous five (5) years; or 2. Current state of residence, if other than Kentucky; 1) Criminal Records Check In Compliance 2) Child Abuse/Neglect Check In Compliance 3) Previous State of Residence In Compliance 4) Current State other than KY In Compliance

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 of all staff files, four (4) staff files (DOH: 04/26/12, 05/08/12, 01/02/12, and 04/13/12) did not contain documentation of a High School Diploma, GED or Commonwealth Child Care Credential.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 5

2 Year-Old Room: Based on observation during a tour of the Two-Year-Old Room, the surveyor found that a twenty-three month old child was being provided care with older children. Through interview with a staff, the surveyor learned that the twenty-three month old child had been in the combined age group for the entirety of the day. 282 - Toilet Training Not Applicable 922 KAR 2:120 - Section 10 (5) Toilet training shall be coordinated with the child's parent. Premises - Classroom

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 11

Infant Room: Based on interview with a staff, the surveyor learned that the mouth-contact toys are not scrubbed with a brush during the cleaning and sanitizing process. The procedure to clean mouth-contact toys is as follows: Wash mouth-contact toys in warm soapy water using a brush to reach inside crevices, rinse, submerge in a sanitizing solution for at least two (2) minutes and air dry. First Aid/Medication 244 - First aid supplies 922 KAR 2:120 - Section 7 (3) If a child becomes ill while at the center: (a) The child shall be placed in a supervised area isolated from the rest of the children; (b) The parent shall be contacted immediately; and (c) Arrangements shall be made to remove the child from the child-care center as soon as practicable. 1) Availability In Compliance 2) Storage In Compliance 3) Inventoried In Compliance 4) Sanitized, if reusable In Compliance 5) Maintained in sanitary manner In Compliance 6) Liquid soap In Compliance 7) Adhesive bandages In Compliance 8) Sterile gauze In Compliance 9) Medical tape In Compliance 10) Scissors In Compliance 11) Thermometer In Compliance 12) Flashlight In Compliance 13) Cold pack In Compliance 14) First aid book In Compliance 15) Disposibale gloves In Compliance 16) Cardiopulmonary resuscitation mouthpiece protector In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 7

Infant Room: Based on review of documentation and interview, the surveyor found that a child's (DOE: 04/14/12) medication, CPM/PSE DM Drops had expired on 03/12/12. Outdoor Play Area - Staffing Requirements 117 - Cooking/Cleaning Staffing 922 KAR 2:110 - Section 4 (1) (k) Assure that additional staff are available during cooking and cleaning hours, if necessary, to maintain staff-to-child ratios pursuant to 922 KAR 2:120; 1) Cooking In Compliance 2) Cleaning In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 25 of 45 Web site: http://chfs.ky.gov/ Inspection Report 135 - Adequate Adults/Qualified Staff 922 KAR 2:110 - Section 5 (10) The minimum number of adult workers in a child-care center shall be sufficient to ensure that: (a) Minimum staff-to-child ratios in accordance with 922 KAR 2:120 are followed; (b) Each staff person under eighteen (18) years of age and each student trainee are under the direct supervision of a qualified staff person who meets the requirements of this section; and (c) Unless providing care with a qualified staff person, a person under the age of eighteen (18) shall not be counted as staff for the staff-to-child ratio. 1) Ratio Compliance In Compliance 2) Under 18 directly supervised 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 4 (18)

General: Based on observation during a tour of the playground, the surveyor found that the wires that connect the fence to the posts had sharp edges that protruded inward toward the playground area. The sharp edged wires were accessible to the children.

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

Infant Room: Based on observation during a tour of the Infant Room, the surveyor found that two (2) cribs were spaced approximately six (6) inches apart.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 3

General: Based on review of documentation of ten (10) children's files, the surveyor found that a child's (DOE: 8/15/11) file contained an immunization certificate that was no longer current as of 3/15/12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 10

l Year-Old Room: Based on observation during a tour of the One-Year-Old Room, the surveyor found that the Diaper Changing Procedure was not posted at the diaper changing area. Animals 319 - Animal Requirements Not Applicable 922 KAR 2:120 - Section 13 (1) Animals shall be: (a) Supervised by an adult if in the presence of a child in care; and (b) Certified as properly vaccinated against rabies. 1) Supervised Not Applicable 2) Vaccinated Not Applicable 321 - Prohibited Animals Not Applicable 922 KAR 2:120 - Section 13 (3) Except if used as planned program activity in the control of an animal specialist, an animal that is considered undomesticated, wild, or exotic shall not be allowed at a child-care center. 1) Undomesticated Not Applicable 2) Wild Not Applicable 3) Exotic Not Applicable C.O. 13 - Corporation/ LLC/ Partnership 922 KAR 2:090 - Section 4 (3) If the applicant for licensure is a: (a) Corporation or a limited liability company, the application shall include a current certificate of existence or authorization from the Secretary of State; or (b) Partnership, the application shall include a written statement from each partner that the partnership is current and viable. 1) Corporation/LLC statement Not Inspected 2) Partnership statement Not Inspected

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 (1)

General: Based on interview, an infant child was bitten more than eight (8) times by two (2) other toddlers while she was sitting in an exerciser while the only staff person supervising the children was changing another child's diaper and unaware the child was being bitten.

Open Not marked corrected in the state record

Open / not marked corrected.