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

General: Based on review of documentation, the surveyor found the following: 1. A staff’s (DOH: 10/25/11) file contained documentation of a TB skin test dated 07/15/20; therefore, the staff’s file did not contain documentation of a current TB skin test or a statement from a health professional stating that the staff was free from active tuberculosis. During interview, staff-in-charge stated that the staff person did not have an up-to-date TB skin test. Staff-in-charge stated that she called to schedule a TB skin test on the day of the surveyor’s visit. 2. A staff’s (DOH: 07/29/21) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis. Through interview with staff-in-charge, the surveyor learned that the staff person had an up-to-date TB skin test; however, the documentation was not available for review on the day of the surveyor’s visit. 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

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. A staff (DOH: 07/29/21) obtained zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/29/21 – 07/29/22. The staff person obtained zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/30/22 – 06/30/23. 2. A staff (DOH: 11/02/21) obtained zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 11/03/22 – 06/30/23. 3. A staff (DOH: 01/16/23) obtained six (6) hours of cabinet-approved orientation training on 05/12/23; therefore, the training was not completed within the first three (3) months of employment. 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 6. Sleeping and Napping Requirements.

General: Based on observation in the Infant Classroom, the surveyor found a gray crib sheet inside a crib that contained excess fabric; therefore, the crib sheet was not tight fitting. During interview, staff-in-charge stated that she had put the crib sheet on the crib mattress on the day of the surveyor’s visit. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. One (1) brown purse and one (1) purple purse hanging from a wall hook on a wall located by the exit door that leads to the playground. The two (2) purses were observed to be accessible to the children. Through interview with staff, the surveyor learned that the two (2) purses belonged to staff. 2. A blue container placed on top of a cubby shelf that was located near the restroom and contained Lysol that read, "Keep Out of the Reach of Children," on the label and a spray bottle that had "bleach" written on it. The surveyor observed children to have to walk by the cubby shelf to go to the restroom. The items mentioned were observed to be accessible to the children. 3. The surveyor observed two (2) cabinet doors on the sink cabinet located beside the restroom to easily open. The surveyor observed the child safety latches to be loose and to not latch properly. The following items were observed inside the cabinet: One (1) gallon of Re-Juv-Nal, Ecolab Glass Cleaner, two (2) Alcohol Antiseptic Topical Solutions, Zep Glass Cleaner, and Great Value Pet Carpet and Upholstery Cleaner. The items mentioned read, "Keep Out of the Reach of Children," on the labels and were observed to be accessible to the children. The surveyor observed the staff-in-charge to tighten the safety latches on the day of the surveyor's visit in order for the latches to latch properly.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A ledge located in front of the window in the Preschool Classroom that contained peeling yellow paint; therefore, the paint on the ledge was not smooth or in good repair. 2. A ledge located in front of the window in the Toddler Classroom that contained peeling green paint; therefore, the paint on the ledge was not smooth or in good repair. Hygienic Practices In Compliance First Aid/Medication In Compliance 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: 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 two (2) S-Hooks located in the wood underneath the deck on the playground. One (1) of the hooks was observed to be broken off on the tip. During interview, staff-in-charge stated that the S-Hooks were used to hold a swing and that she would remove the hooks. 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 a blue child sized couch in the Toddler Classroom that was ripped/torn on the front part of the couch; therefore, the couch was not kept in good repair. Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. No documentation for fire drills conducted during the months of January, February, April, May, and June of 2023. 2. No documentation for a earthquake, tornado, or lockdown drill conducted during the second quarter of 2023. Through interview with staff-in-charge, the surveyor learned that the drills had been conducted; however, the drills had not been documented. Posted Documentation In Compliance Animals 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 15. Animals.

General: Based on observation, the surveyor found a guinea pig located inside a cage in the Preschool Classroom. When reviewing children's files, the surveyor found four (4) children's files that did not contain written parental consent allowing the children to be in the presence of the animal. Through interview with staff-in-charge, the surveyor learned that the documentation was not available for review on the day of the surveyor's visit. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4

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.

Based on review of documentation located in a child's file, the surveyor found that a child's (DOE:8/9/2021) immunization certificate was a photocopy. The “signature” date, “current for immunizations until” date and “dose 4” date on the photocopied immunization certificate had been covered with white out and the dates had been written in. The surveyor was unable to determine if the child’s immunization certificate was current. Furthermore, the document had been altered and/or falsified. Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, a staff’s (DOH:6/13/2022) personnel file did not contain documentation confirming that the employee was free of active tuberculosis or provide a copy of a negative tuberculin result. Staff-in-charge stated that she did not think the employee had a current certificate. Staff-in-charge stated that the employee was a substitute; however, she had not worked at the child-care center yet. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found upon review of ECE-TRIS that for the timeframe of 7/1/2020 thru 6/30/2021 that one (1) staff (DOH: 5/30/2014) had failed to complete any of the fifteen (15) required hours of cabinet-approved early care and education training. 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 discovered a discarded paper towel and a roll of paper towels on the ground between a table and the fence; therefore, the outdoor play area was not kept free from rubbish/litter. 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 Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A child's (DOE:8/9/2021) immunization certificate presented to the surveyor for review was a photocopy. The “signature” date, “current for immunizations until” date and “dose 4” date on the photocopied immunization certificate had been covered with white out and the dates had been written in. The surveyor was unable to determine if the child’s immunization certificate was current. 2. The file presented to the surveyor for a child (DOE: 6/16/2022) did not contain an immunization certificate. Therefore, the child-care center failed to maintain a current immunization certificate for the children. Written Documentation In Compliance Posted Documentation In Compliance Animals 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, the surveyor found a square rug that contained stains in the Toddler Classroom; therefore, the rug was not kept clean. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation and review of documentation, the surveyor found the following: 1. A staff’s (DOH: 01/18/21) file did not contain a completed Child Abuse/Neglect Background Check or Criminal Records Background Check. During interview, staff-in-charge stated that she was unsure if the background checks were back yet and was unable to locate the documentation. Staff-in-charge stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. Based on review of the Kentucky National Background Check Service, the staff person did not have a completed background check. 2. A staff’s (DOH: 05/07/21) file did not contain a completed Child Abuse/Neglect Background Check or Criminal Records Background Check. During interview, staff-in-charge stated the background checks were submitted; however, they have not received the completed background checks back yet. Staff-in-charge stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. Based on review of the Kentucky National Background Check Service, the staff person did not have a completed background check. 3. Boxes stacked at the entry door in front of a set of cubbies. Staff-in-charge stated that the boxes arrived yesterday and they contained tricycles. 4. Several cots standing upright and stacked against each other in a small hallway that leads to the playground. 5. Several cords dangling from a shelf on the wall and two (2) tall boards leaned against the wall behind a door in an office space where the exit door is located that leads to the playground. During interview, staff-in-charge confirmed that the children walk through the office space to access the exit door that leads to the playground. 6. A long piece of white wall trim with four (4) exposed nails in it placed by the exit door to the playground. 7. A weed eater and leaf blower placed on top of a set of racks beside the exit door to the playground. Director Requirements In Compliance 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 that a staff’s (DOH: 09/27/19) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis. During interview, staff-in-charge stated that the staff person has not had a COVID vaccination in the last four (4) weeks. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A broom and dust pan placed beside a bookshelf in the Preschool Classroom. 2. A broom and dust pan placed beside of a half wall leading to the exit door to the playground. 3. A broom placed on the deck by the exit door to the playground. 4. A large umbrella placed near the exit door that leads to the playground. 5. A staff’s purse placed on the floor near the exit door that leads to the playground. 6. A bottle of wite-out and stapler placed on a desk that is by the exit door to the playground. 7. A bag of potting mix placed under the deck steps on the playground. The items mentioned were observed to be accessible to the children.

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 a tear in the diaper changing pad and debri underneath the diaper changing pad on the diaper changing table in the Toddler Classroom; therefore, the diaper changing surface was not clean and free from tears. First Aid/Medication In Compliance 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: physical safety. Open / not marked corrected.

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

General: Based on observation of the playground, the surveyor found the following: 1. A swing seat with chains exposed and Little Tikes seat with the rope exposed placed on the deck on the playground. 2. A rise in the bottom step of the deck; therefore, the height of the bottom step created a tripping/falling hazard for the children. 3. Four (4) large boxes with one (1) of the boxes standing upright placed under the deck steps. 4. Four (4) large boxes stacked on top of each other placed beside the deck steps. During interview, staff-in-charge stated that the boxes contained a new border for the playground. 5. Wooden boards bordering the playground that were observed to be decayed and knocked over; therefore, creating a tripping hazard for the children. 6. Several rusty metal stakes placed in the ground beside the wooden boards bordering the playground that were exposed. 7. Two (2) large nails exposed in the wooden boards bordering the playground. 8. A green metal toy with what appeared to be steering wheels attached to it that contained rust. 9. Two (2) white umbrella poles stuck in the fence on the playground. 10. Six oblong containers attached by a rope and placed on the playground. 11. A loose white umbrella pole in the center of a child sized picnic table. 12. Several rusty metal stakes placed beside of the fence by the bottom step of the deck on the playground.

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 that the protective surface around two (2) climbing structures with slides was depleted and did not have an adequate fall zone on the playground. Equipment Not In Compliance

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 surveyor found one (1) white fitted sheet and one (1) green fitted sheet that contained stains. The sheets were placed in cribs inside the Infant Classroom. Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 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: 1/28/19) file contained an immunization certificate that was no longer current as of 10/22/20. 2. A child’s (DOE: 10/28/20) file contained an immunization certificate that was no longer current as of 2/16/21.

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. A child’s (DOE: 1/28/19) file did not contain a contact telephone number for the child’s preferred hospital. 2. A child’s (DOE: 10/28/20) file did not contain a contact telephone number for the child’s preferred hospital. 3. A child’s (DOE: 06/08/21) file did not contain a contact telephone number for the child’s preferred family physician. 4. A child’s (DOE: 11/02/20) file did not contain the preferred physician name or contact telephone number. 5. A child’s (DOE: 01/18/21) file did not contain a contact telephone number for the child’s preferred hospital. 6. A child’s (DOE: 05/16/18) file did not contain the preferred hospital name or contact telephone number. 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 3. General Requirements.

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

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: (1.) Fire drills were not conducted or documented for the following months in 2020: July, August, September, October, November, and December. (2.) A fire drill for January 2021 was not conducted or documented. (3.) The quarterly earthquake drills were not conducted or documented from July 2020 through December 2020. (4.) The quarterly tornado drills were not conducted or documented from July 2020 through December 2020. Staff confirmed through interview that the drills were not conducted due to safety concerns regarding COVID. 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 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on observation, a staff member (DOH: 7/8/19) was observed working alone in the Infant Classroom with two (2) five-month-old children. Review of the Kentucky National Background Check portal revealed no background check had been submitted on behalf of the staff member. Upon interview, the director stated that she assumes the employee has a background check in KARES since she is employed with the school system. The director stated that she has been trying to obtain the employee's background check from the school; therefore, the new employee had not submitted her finger prints again for purposes of a background check. Thus, the center failed to provide verification of a completed background check or that fingerprints had been submitted for a background check prior to the staff member being employed and left unsupervised with children. Supervision 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 surveyor observed a child from the preschool classroom leave his group and wander around and play unsupervised for approximately five (5) minutes while the other preschool age children and staff member were in the back washing their hands after they returned from the playground. When interviewing the director, she stated that the child’s sister was in the infant room and the child liked to go check on her. Additionally, an employee left two (2) infant children unsupervised to open the door to allow the surveyor to enter; shortly thereafter she left the children alone a second time to open the door for the director. The infant children were not visible from the door. Upon review of the employee handbook, the policy states that children are not to be left alone for any reason. Therefore, in both instances the children were not being adequately supervised. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on observation upon arrival to the childcare center, the surveyor found one (1) staff member was providing care for seven (7) children, ranging in age from twenty-two (22) months to five (5) years old. Based upon the age of the youngest child, the staff-to-child ratio was exceeded by one (1) child. General Administration In Compliance Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor was not presented with a personnel file for a staff member (DOH: 7/8/19) who was observed working alone in the Nursery Classroom. Upon interview the director stated that she had been trying to get some of the paperwork (Background check & TB results) from the school system where the new employee is also employed and that a file had not yet been created. Therefore, the center failed to maintain a current personnel file for the new staff member.

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 was not presented with documentation of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential for a staff member (DOH: 7/8/19). Therefore, the center failed to obtain the required verification of a high school diploma, GED, or Commonwealth Child Care Credential, at the time of employment. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that the label on the liquid hand soap located on the bathroom sink stated "Keep Out of Reach of Children"; thus, the liquid hand soap was accessible to the children. During interview, the Director stated she was not aware that it said that on the label and will put the soap out of reach.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that the heat/air intake vent had a buildup of dust. Therefore, the center was not in compliance with keeping the area clean and in good repair.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, of the playground area, the surveyor found a small container approximately six (6) inches by twelve (12) inches and approximately four (4) inches deep full of water, with what appeared to be mosquito larvae swimming inside. The surveyor also observed a stack of plastic drinking cups filled with water, dirt and dead bugs. Upon interview, the director stated that the children play with those cups. The surveyor also observed a covered water toy filled with dirty water and some type of bug swimming inside. Therefore, the children have access to play with unfiltered, non-disinfected containers. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found a drawstring garbage bag half-full of paper towels and tissues hanging on the playground fence. Upon interview, the director stated that was where they put those items when the children were on the playground playing.

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 tall grass and weeds in the playground area; thus, the playground was not well maintained. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report 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, multiple dirty dishes & disposable spoons were observed in the sink; thus, the kitchen was not kept clean.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on observation, the surveyor found two (2) unlabeled bottles in the kitchen refrigerator. Upon interview, the director stated that she knew who each belonged to, but was aware that they should be labeled. Therefore, the center failed to ensure that the bottles were individually labeled. 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 that the most recent immunization certificate presented for review for one (1) child (DOE: 08/09/17) was no longer current as of 11/03/18. In addition, the most recent immunization certificate presented for review for one (1) child (DOE: 08/14/17) was no longer current as of 07/02/19. The most recent immunization certificate presented for review for one (1) child (DOE: 02/04/19) was no longer current as of 07/06/19. Therefore, the surveyor could not verify that the children’s immunizations were current. Written 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 9. Records.

General: Based on review of documentation, the surveyor was not presented with updated annual professional development plans for two (2) staff members (DOH: 10/25/2011) and (DOH: 5/30/14). The last professional development plan on file for each employee was for the 2017 - 2018 year. Therefore, a written plan for child-care staff professional development has not been maintained. 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 and ECE-TRIS, the surveyor found the following: 1. The surveyor found that a staff (DOH: 04/26/15) had obtained only five (5) hours of cabinet-approved early care and education annual training. 2. The surveyor found that a staff (DOH: 05/30/14) had obtained only ten (10) hours of cabinet-approved early care and education annual training. 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 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 the playground had not been maintained as it contained tall grass and weeds. The Director stated that the playground is mowed every two (2) weeks; however, it had not been mowed on schedule recently due to rain and storms. 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

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation contained in a child’s (DOE: 02/08/18) file, the surveyor found that the immunization certificate was no longer current as of 02/21/18. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation during a tour of the Preschool Room, the surveyor found that two (2) staff were providing care for seven (7) children whose ages ranged from two to nine-years-old. During observation of the classroom, the surveyor found that the planned daily program was not posted. Through interview with the Director, the surveyor learned that the daily planned program was being updated and was not available for review. Premises In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found five (5) children in a classroom that measures for a total capacity of four (4) children. Additional staff arrived within twenty (20) minutes of the surveyor's visit taking the total capacity of the infant classroom from five (5) children to two (2) children. Equipment 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 during the surveyor's visit, four (4) children were eating in the dining area. The children were in the dining area alone and were not being supervised by staff. In an interview with a staff member (DOH: 5/30/14), the surveyor was informed that the staff member had only left the children unsupervised for twenty (20) seconds in order to get baby wipes from the infant room. However, the surveyor observed the children to be left unsupervised for two (2) minutes. Staffing Requirements In Compliance Programming In Compliance Equipment In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on review of documentation, a child's (DOE: 8/9/17) file did not contain an immunization certificate. The child has been enrolled at the center for more than thirty (30) days. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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 during the surveyor's visit on 9/13/17, there was a total of six (6) children present; 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation during the surveyor's visit, a staff member (DOH: 5/30/14) was standing in the pre-school room with two (2) infant/toddler children and the door to the baby room was closed. After approximately four (4) minutes, the staff member went into the baby room and at that time it was discovered that a child (DOE: 6/15/17) was asleep inside the room. Based on interview, staff stated the child had been asleep in the classroom by himself with the door shut for a couple of minutes. Based on interview with the director, she acknowledged that the child was asleep in the room by himself with the door shut and stated that it was the only way he can sleep. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Staffing Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on review of documentation, a re-licensure visit conducted on 7/7/17 found that the child care center had not maintained the minimum staff-to-child ratio on that date. As a result, the ongoing compliance on the plan of correction stated "Director will ensure enough staff is available for each classroom each day". Based on observation of the pre- school room on 8/9/17 at 9:42am, the surveyor found a total of eleven (11) children and one (1) staff member present with the youngest being a one-year-old child. Based on interview, the director stated that the last child arrived approximately ten (10) minutes prior to the surveyor. The director further stated that an additional staff member was on the way to the center and should arrive at 10:00am; however, the staff member did not arrive to the pre-school classroom until 10:14am. Based on review of documentation, only eight (8) of the fourteen (14) children present were signed in and so the time of the last child's arrival could not be confirmed. Therefore, the minimum staff-to-child ratio was exceeded by five (5) children for a total of forty-two (42) minutes and the child care center failed to follow their plan of correction. Programming Not 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 6. Sleeping and Napping Requirements.

General: Based on observation of the baby room, the sleeping and napping requirements were not met, i.e., a child (DOE: 6-15-17) was sleeping inside of a pack n play with a play mat that included hanging toys. Equipment Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation of the baby room, a child (DOE: 6/15/17) was sleeping in a pack n play. Based on interview, staff stated the child had been asleep for a couple of minutes.

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 interview, an individual non-tiered crib that meets safety guidelines was not provided for the number of children in attendance on the day of the visit, i.e., on 8/9/17, there were two (2) infants present at the child care center; however, based on interview, the director stated that the child care center currently has one (1) crib and one (1) pack n play that is used for the children in this classroom. The director further stated they are in the process of obtaining additional cribs. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report 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 observation, there were a total of fourteen (14) children present during the surveyor’s visit on 8/9/17; however, based on review of documentation, there were only eight (8) children signed in on the attendance sheets.

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, review of documentation, and interview, the surveyor found that there was one (1) staff person working alone in the preschool classroom while supervising seven (7) children between four-months-old and nine-years-old. Staff reported that she had been the only staff member working at the center that morning. Staff stated that the youngest two (2) children were four-months-old (DOE: 6/15/17) and one-year-old (DOE: 4/20/17). Review of the sign in and out sheet for 7/7/17 revealed that the four-month- old child was signed in at 8:10 a.m., the fifth (5th) child to arrive at the center and the one-year-old child was signed in at 8:35 a.m., the sixth (6th) child to arrive at the center. The Director arrived at the center at approximately 9:45 a.m.; therefore, the center was over staff-to-child ratio for a period of approximately one (1) hour and ten (10) minutes. Upon interview, the Director reported that she is usually at the center in the mornings; however, she had a meeting to attend on the morning of 7/7/17. General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 6 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation and interview, one (1) employee file (DOH: 5/30/14) did not contain an up-to-date annual performance evaluation. The last annual performance evaluation completed was dated May 2016. Upon interview, the Director confirmed that an updated annual performance evaluation had not been completed.

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 observation and interview, the surveyor found that one (1) electrical outlet next to the radio in the preschool classroom was missing a protective covering. The Director stated that the radio is usually plugged into the outlet. 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 6. License Issuance.

General: Based on review of documentation, and interview, the surveyor found that one (1) employee file (DOH: 2/3/17) contained a criminal records check (CRC) that was submitted on 2/10/17; therefore, the CRC was not submitted timely, on or before the employee's date of hire. Upon interview, the Director acknowledged that she was aware that the CRC was not submitted timely but stated that the employee did not work with the children at all until the results had been returned.

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 surveyor found that a swing was hanging from the bottom of the deck on the playground. There was not a protective surface under the swing. The Director acknowledged she was aware that there was not a protective surface under the swing. Equipment Not 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 and interview, the surveyor found that one (1) employee file (DOH: 10/25/11) contained documentation of a negative turberculin skin test dated for 8/6/14; therefore, a tuberculin skin test was not completed every two (2) years as required. Upon interview, the Director stated that she thought that the employee's tuberculin skin test had been completed and filed; however, she did not locate the documentation at time of the survey. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 6 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 and interview, the surveyor found the following: 1. The lesson plan posted in the preschool classroom was dated 8/29/16 - 9/2/16. 2. The lesson plan posted in the nursery classroom was dated 8/29/16 - 9/2/16. 3. The lesson plan posted in the toddler classroom was dated 8/29/16 - 9/2/16. The Director and staff reported that the lesson plans are re-used. The Director also stated that she is in the process of updating all of the lesson plans.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, review of documentation, and interview, the surveyor found that there was one (1) staff person working alone in the preschool classroom supervising seven (7) children between four-months-old and nine-years-old. Staff stated that the youngest two (2) children were four-months-old (DOE: 6/15/17) and one-year-old (DOE: 4/20/17). Review of the sign in and out sheet for 7/7/17 revealed that the four-month-old child was signed in at 8:10 a.m. At approximately 9:45 a.m., the director arrived at the center and the infant child was taken to the nursery. Therefore, the infant was combined with older children for a period of approximately one (1) hour and thirty-five (35) minutes. Upon interview, the Director reported that she is usually at the center in the mornings; however, she had a meeting to attend on the morning of 7/7/17. 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation and interview, the surveyor found that the child care center restroom was not equipped with a hand-drying blower or single use disposable hand drying material. The Director reported that the center had just ran out of paper towels and that she had paper towels ordered which were due to arrive on 7/7/17.

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 surveyor found that the toilet had not been flushed and it appeared to contain urine. The Director reported that staff attempt to check the restroom after each time it is used; however, due to the staff member being alone that morning she may not have had the opportunity to do so. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 6 Inspection Report Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found that the playground had not been maintained as it contained tall grass and weeds. The Director related that the playground is moved every two (2) weeks; however, it had not been mowed on schedule recently due to rain and storms.

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 and interview, the surveyor found a rocking chair with a broken arm that was located in the nursery. The arm had been broken completely off of the chair leaving some splintered wood where the arm had connected to the seat. The Director stated that she was aware of the broken arm on the rocking chair. Transportation Not Applicable Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, and interview, the following were found: 1. A child's file (DOE: 6/15/17) presented for review contained an immunization certificate that was no longer current as of 6/27/17. There was documentation in the file, from the child's physician, documenting that the child has an appointment to have the immunizations updated on 08/10/17. The Director stated that the child's guardian scheduled the appointment as soon as she requested an updated copy of the immunization certificate for the child's file. 2. A child's file (DOE: 4/20/17) presented for review did not contain an immunization certificate. The Director reported that the immunization certificate has been requested. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 6 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 and interview, the surveyor found that one (1) child's file (DOE: 5/31/16) did not contain the preferred physician's name or contact information. Upon interview, the Director was not aware that the information was missing. 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 5. Evacuation Plan.

General: Based on review of documentation and interview, the surveyor found that the emergency preparedness plan was not signed and updated by 12/31/16. Upon interview, the Director reported that no changes had been made to the plan; however, she had failed to sign and date it the day that she reviewed it.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor was not presented with an organizational chart/chain of command. Upon interview, the Director stated that she had taken the organizational chart/chain of command documentation down from the wall recently to have it updated; however, she did not locate the documentation for the surveyor to review at time of the survey.

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 surveyor was not presented with a written record of practiced fire drills conducted in May or June of 2017. Upon interview, the director stated that the drills may not have been practiced those months. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 6 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 3. General Requirements.

General: Based on review of documentation and interview, the surveyor found that there was not written record of a monthly fire drill being conducted in May or June of 2017. Upon interview, the director stated that the drills may not have been conducted those months. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the information contained in two (2) substitute staff (DOH: 05/03/14 and 04/26/15) files do not meet regulatory requirements for qualification based on the following: annual performance evaluations, annual plans for professional development, annual training and negative tuberculin result.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the information contained in two (2) substitute staff (DOH: 05/03/14 and 04/26/15) files do not meet regulatory requirements for qualification based on the following: annual performance evaluations, annual plans for professional development, annual training and negative tuberculin result.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found the following: 1. Nineteen (19) index cards containing information for the Summer Reading Program that identified the child’s name, address, telephone number and school attended had been left on top of the cubbies located near the entry door. The children’s information was accessible to others. 2. Payment ledgers, with attached child care subsidy benefit information, were stacked on top of the children’s cubbies located near the entry door. The children’s information was accessible to others.

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, the surveyor found that two (2) staff (DOH: 05/03/14 and 04/26/15) files did not contain an annual written performance evaluation.

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 observation during a tour of the child care center, the surveyor found the following: 1. A portion of the dining area/school-age area is being used for storage. The area housed a flag attached to pole that was approximately four and a half (4 ½) feet long, crates of books, plastic bins and plastic bags of supplies, a computer and monitor, a large wooden board with a painted-on mural and large blue mat. Shelves, world globes, a box and a trophy had been stacked on top of other supplies creating a safety risk to the children. 2. A large wooden board was propped-up in the Staff Room. Through interview with staff, the surveyor learned that the children pass through this area to access the playground. The propped board created a safety risk to the 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, the surveyor found that a staff’s (DOH: 05/03/14) file contained a copy of a negative tuberculin result that was no longer current as of 04/14/16.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a child’s (DOE: 05/19/14) file did not contain an immunization certificate.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS, the surveyor found that a staff’s (DOH: 05/03/14) file contained only eight (8) hours of cabinet-approved early care and education annual training. 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 27 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on review of documentation, the surveyor found that one (1) staff person was providing care for nine (9) children whose ages ranged from two to eight-years-old. Through interview with the staff person, the surveyor learned that five (5) of the children were over five-years-of-age. The daily planned program indicated that the lessons were developed for children whose ages ranged from two to five-year-old; therefore, the activities were not individualized and developmentally appropriate for all of the children in the class.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that Palmolive Dishwashing Detergent had been stored in an unlocked cabinet located under the sink near the food prep area. The dish detergent label indicated that it should be kept out of the reach of children.

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 child care center, the surveyor found that five (5) large trash bags filled with garbage were stored in the “Staff Room” that is adjacent to the School-age Room. Through interview with staff, the surveyor learned that the children pass through this room to access the playground. The room had a rank odor of garbage.

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 that the waste can was full and that trash had spilled onto the floor in the restroom that is used by the children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 27 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found that the toilet seat was not securely attached to the toilet bowl located in the restroom that is used by the children. Hygienic Practices

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 during a tour of the Toddler Room, the surveyor learned that a brush is not used to reach into crevices of mouth contact toys and that the toys are submerged in a sanitizing solution for only one (1) minute. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 15 of 27 Web site: http://chfs.ky.gov/ Inspection Report First Aid/Medication

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, the surveyor found that the First-Aid Kit contained a non-working flashlight. Through interview with staff, the surveyor learned that a second flashlight was not available.

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 during a tour of the kitchen, the surveyor found that two (2) bottles of a child’s medication (Clonidine HCL) had been stored in the refrigerator. The kitchen door was not locked and the medication was not in a separate and locked place. Outdoor Play Area

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 during a tour of the playground, the surveyor found that a an electric cord had been left on the deck that exits to the playground and ball goal net was draped over the fence. Both items were within reach of 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 4. Premises Requirements.

General: Based on observation during a tour of the playground the surveyor found that three (3) tyke-size slides and a swing had no protective surface.

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 surveyor found approximately one (1) inch of ice on the food and interior sides and bottom of the freezer. Through interview with staff, the surveyor learned that the refrigerator was not working properly.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on observation, the surveyor found that two (2) bottles of milk had been stored in the refrigerator. The two (2) bottles of milk were not labeled.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that a staff person took a bottle of milk from the refrigerator and gave it to a one-year-old child. Through interview, the surveyor learned that the staff person did not know the fat content of the milk being served; therefore, regulatory compliance could not be determined.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that a box of powdered milk and a bag of potatoes had been placed on the kitchen floor. The food items had not been placed in nonabsorbent labeled containers and stored a minimum of six (6) inches off of the floor.

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 contained in ten (10) children’s files, the surveyor found the following: 1. Seven (7) files did not contain information to enable a person in charge to contact the preferred hospital. 2. Ten (10) files did not contain authorization by the parent to enable the child care center to obtain emergency medical care for the child in the parent’s absence.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that two (2) staff files (DOH: 11/08/11 and 05/03/14) did not contain a written annual plan for professional development.

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 from 11:40 AM until 11:45 AM, one (1) staff person supervised seven (7) children ages one (1) year-old to ten (10) years-old while an employee went to the store to purchase milk for lunch meal service.

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 most current copy of regulations available for staff were dated 08/04/11; therefore, the regulations were not updated as revisions have since occurred.

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 following was found: 1) An employee (DOH 11/08/11) file presented for review contained an annual performance evaluation dated 08/07/13; therefore, the evaluation was not updated annually as required by regulations. 2) An employee (DOH 05/30/14) file presented for review did not contain an annual performance evaluation as required by regulations. 3) An employee (DOH 06/10/14) file presented for review did not contain an annual performance evaluation as required by regulations.

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, an employee's (DOH 06/10/14) criminal records check dated 01/22/15 which was not submitted timely according to KRS 199.896 (20). During an interview with the director, she stated that the employee was hired as an assistant and did not work 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, an employee (DOH 11/08/11) record presented for review contained negative tuberculin verification dated 10/06/11 which was no longer current.

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) An employee (DOH 05/30/14) record contained only one and a half (1 1/2) hours of cabinet-approved training as verified by ECE-TRIS and the file presented for review. 2) An employee (DOH 05/30/14) record presented for review did not contain evidence of the employee completing cabinet-approved orientation within ninety (90) days as required by regulations. During an interview with the director, she stated that the employee's orientation had been scheduled. 3) An employee (DOH 06/10/14) record presented for review did not contain evidence of the employee completing cabinet-approved orientation within ninety (90) days as required by regulations. During an interview with the director, she stated that the employee's orientation had been scheduled. 4) An employee (DOH 06/10/14) record presented for review did not contain evidence of the employee completing pediatric abusive head trauma training within one (1) year of hire as required by regulations. 5) An employee (DOH 06/10/14) record presented for review did not contain evidence of the employee completing any of the fifteen (15) hours of required annual training. Upon further review by the surveyor, ECE-TRIS did not list any training hours for the employee during this time. During an interview with the director, she was uncertain about how many training hours the employee had completed during the period of time in 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 4. Premises Requirements.

General: Based on observation, the outdoor play area was not well-maintained as grass was overgrown and weeds (approximately one to two (1-2) feet in height) were growing around the play equipment.

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 protective surfacing of mulch beneath the slides was worn away and was no longer adequate for safety purposes.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the Preschool daily schedule indicated that lunch was served at 11:30 AM-11:55 AM and later an afternoon snack was served at 3:00 PM-3:15 PM; therefore, food service exceeded the regulatory requirement that food be served every two to three (2-3) hours.

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, the following was found: 1) A child's (DOE 08/11/14) record presented for review contained an immunization certificate which did not have a valid date indicating that immunizations were current. 2) A child's (DOE 12/17/14) record presented for review contained an immunization certificate which was no longer current after 03/30/15. 3) A child's (DOE 09/02/14) record presented for review did not contain an immunization certificate. 4) A child's (DOE 05/30/14) record contained an immunization certificate which was no longer current after 05/01/15. 5) A child's (DOE 12/31/13) record contained an immunization certificate which was no longer current after 08/21/13. 6) A child's (DOE 11/09/11) record presented for review did not contain an immunization certificate.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation and observation, at 10:05 AM six (6) enrolled children were present at the child care center; however, only two (2) children were signed- in on the attendance form. Therefore, attendance documentation was not accurately maintained to reflect which children were present.

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) An employee (DOH 11/08/11) file presented for review contained a professional development plan dated 08/15/13 which was not updated annually as required as required by regulations. 2) An employee (DOH 11/08/11) file presented for review contained a professional development plan dated 08/07/13 which was not updated annually as required by regulations. 3) An employee (DOH 05/30/14) presented for review did not contain a professional development plan as required by regulations. 4) An employee (DOH 06/10/14) presented for review did not contain a professional development plan 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, the following was found: 1) The Infant room daily schedule indicated that the infants were fed breakfast at 8:30 AM-9:00 AM. No other snacks or meals were noted on the schedule. 2) The Preschool room daily schedule indicated that lunch was served at 11:30 AM-11:55 AM and afternoon snack was served at 3:00 PM-3:15 PM. Food service must occur every two to three (2-3) hours. 3) The Toddler room daily lesson plan of activities was dated 07/14/14- 07/18/14; therefore, the lesson plan was not updated weekly as required. 4) The School Age lesson plan of activities was dated 07/14/14-07/18/14; therefore, the lesson plan was not updated weekly as required.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to have a prepared menu for 7/17/14 and 7/18/14.

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 child care center's thermometer located in the freezer indicated that the temperature was eleven (11) degrees Fahrenheit; therefore, the frozen food was not kept at a temperature of zero (0) degrees or below on the date of the surveyors inspection.

Open Not marked corrected in the state record

Category: nutrition. 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: 11/8/11). 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 observation during a tour of the restroom, the surveyor found one (1) toilet plunger located on the floor accessible to the 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, the child care center failed to provide documentation of a high school diploma, GED or qualifying document from a comparable education entity, or Commonwealth Child Care Credential as described in 922 KAR 2:250 for one (1) staff (DOH: 5/30/14).

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 most recent negative TB skin test result presented for review for a staff member (DOH: 11/8/11) was dated 10/6/11 and was no longer current after 10/6/13. (2) The most recent negative TB skin test result presented for review for a staff member (DOH: 11/8/11) was dated 10/21/11 and was no longer current after 10/21/13. (3) The most recent negative TB skin test result presented for review for a staff member (DOH: 11/8/11) was dated 10/20/11 and was no longer current after 10/20/13.

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 one (1) sink with a hand-drying blower or single use disposable hand drying material.

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, the child care center's first aid supplies failed to contain disposable gloves.

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 during a tour of the outdoor play area, the surveyor found one (1) climbing and sliding structure that did not contain an adequate amount of protective surfacing as multiple patches of grass and areas of dirt were visible.

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 following was found: (1) Record of the earthquake drills presented for surveyor review for 1/16/14 and 4/11/14 failed to contain the names of the children that participated in the drills. (2) Record of the tornado drills presented for surveyor review for 1/16/14, 2/14/14, 3/18/14, 4/11/14, 5/5/14, and 6/10/14 failed to contain the names of the children that participated in the drills.

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, record of fire drills presented for surveyor review for 1/16/14, 2/14/14, 3/15/14, 4/11/14, 5/5/14, and 6/10/14 failed to contain the names of the children that participated in the drills.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the front door of the center was locked on 10/8/13 at approximately 3:00 p.m. The surveyor looked through the window and saw three (3) children sleeping on mats/cots on the floor. There was no staff person in the room with the children. The surveyor knocked on the door and a staff person came from behind a wall at the back of the center. Through interview with this staff person, it was learned that she had been preparing snack in the kitchen area and was gone from the classroom for a "few minutes". Staffing Requirements

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 observation and interview, the staff person in charge of supervising the children on 10/08/13 had prepared snack on this date at approximately 3:00 p.m., leaving three (3) children alone in the classroom sleeping. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 1 of 2 Web site: http://chfs.ky.gov/ Inspection Report Employee Records

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 interview, the staff person (DOH - 10/7/13) stated that she had not filled out any paperwork for a criminal records check or a child abuse and neglect (CAN) check and that she did not have a file for review. Interview with the owner on 10/09/13 revealed that this staff person's background checks had been submitted but not completed. This staff person was working alone with the children on 10/8/13 at approximately 3:00 p.m.

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, the staff person (DOH- 10/7/13) stated that she did not have a file for review. Interview with the owner via telephone on 10/9/13 revealed taht the saff person did not have a TB skin test or a statement from a physican that the individual was free from tuberculosis. The staff person was working alone with the children on 10/08/13.

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 surveyor learned that a personnel file for a staff (05/13/13) was not available for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor learned that a High School Diploma, GED or Commonwealth Child Care Credential for a staff (DOH: 5/1/13) was not available for review.

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 that the toilet seat was easily moved and not securely attached to the toilet bowl. Hygienic Practices

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, the surveyor found that medication was stored in a latched medicine cabinet rather than in a securely locked area. Outdoor Play Area

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 and interview, the surveyor learned that a staff's (DOH: 5/1/13) Criminal Records Check and Child Abuse or Neglect check were not available for review. The staff person was observed to be working alone with 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 observation, the surveyor found that on 08/06/13, only two (2) staff were present at the child care center. As a result, the one-year-old children were combined in the classroom with the two-year-old children.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor found that the children's full names and dates of birth were posted on the wall in the Toddler Room. 130 - Volunteer/Board Member Compliance Not Applicable 922 KAR 2:110. Section 2 General. (4) A volunteer or board member shall comply with the policies and procedures of the child-care center. 135 - Resident Interference Not Applicable 922 KAR 2:110. Section 2 General. (6) An activity of a person living in a child-care center that is a dwelling unit shall not interfere with the child-care center program.

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, the surveyor found that an annual written performance evaluation had not been completed for three (3) staff within the review period.

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 observation during a tour of the child care center, the surveyor found that two (2) blankets and two (2) sheets had been stored in the children's cubbies and were touching. This creates the potential for cross contamination. The surveyor observed that two (2) crib mattresses with yellow-colored circular stains and two (2) doorway gates were leaned against the wall in the School-age Room. The crib sheets and mattress covers were piled in the floor creating a risk for falls. The surveyor observed an uncovered electrical outlet located in the School-age Room.

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 and interview, the surveyor learned that a copy of a negative tuberculin result or a statement from a health professional that the individual is free of active tuberculosis for a staff (DOH: 5/1/13) was not available for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation of staff files, the surveyor found that the child care center has only one (1) qualified substitute staff person.

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 staff files, the surveyor found that the child care center has only one (1) qualified substitute staff person.

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 surveyor found that the Planned Program of Activities was not posted for the school-age children and it could not be determined that a Planned Program was being followed.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that an infant was combined in the Two Year Old Room with three (3) two-year-old children for longer than one (1) hour.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that a toddler child was combined in the Two Year Old Room with three (3) two-year-old children for longer than one (1) hour. 420 - Infant Sleep Position Not Applicable 922 KAR 2:120. Section 6. Sleeping and Napping Requirements. (1) An infant shall sleep or nap on the infant’s back unless the infant’s health professional signs a waiver that states the infant requires an alternate sleeping position.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found an empty blue plastic bag in the children's cubbies located by the entry door.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found a thick coating of dust on an air vent located in the ceiling of the Preschool Room and on an air vent located on the wall in the hallway outside of the School-age Room.

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 surveyor found that two (2) disassembled non-compliant cribs had been stored in a closet. Additionally, the surveyor observed that a crib was not provided for an infant child that was in attendance.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that pasteurized two percent (2%) milk rather than whole milk was served to the children ages thirteen months to twenty-four months that were in attendance at the child care center.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: The files for two (2) children (DOE: 12/5/11) contained immunization certificates that were no longer current as of 11/13/12. The file for a child (DOE: 6/18/12) contained an immunization certificate that was no longer current as of 5/17/13. The file for a child (DOE: 2/23/11) contained an immunization certificate that was no longer current as of 6/30/12. The file for a child (DOE: 12/23/11) contained an immunization certificate that was no longer current as of 2/1/13. The file for a child (DOE: 1/25/13) did not contain an immunization certificate.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the file for a child (DOE: 12/23/11 and 1/25/13) did not contain information identifying the family physicians or contact numbers. The file for a child (DOE: 1/25/13) did not contain emergency contact numbers. 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; An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 24 of 27 Web site: http://chfs.ky.gov/ Inspection Report Written Documentation

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview with the staff person in charge, the surveyor learned that the Emergency Preparedness Plan was not available for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that on 08/06/13, the arrival time for two (2) children had not been documented.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation and interview with the staff person in charge, the surveyor learned that a written annual plan for child care staff professional development was not available for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview with the staff person in charge, the surveyor learned that a written record of practiced earthquake and tornado drills conducted quarterly that detailed the date, time and children that participated was not available for review.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview with the staff person in charge, the surveyor learned that a written record of practiced fire drills conducted monthly that detail the date, time and children that participated was not available for review.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and interview with the staff person in charge, the surveyor learned that a record of fire drills that had been conducted monthly during the hours of operation was not available for review.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and interview with the staff person in charge, the surveyor learned that a record of earthquake and tornado drills that had been conducted quarterly during the hours of operation was not available for review. Posted Documentation

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that the daily schedule of activities was not posted in the School-age Room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Toddler Room: Based on observation, a toddler was left sitting in a high chair for approximately ten (10) minutes after he was finished eating. Preschool Room: Based on observation, the surveyor found the following: 1.)The bottoms of several children's feet were stained black and all of the children were barefoot. 2.) A damp rag used to clean with a bleach/water solution was located on top of a spray bottle containing a bleach water solution accessible to the children. 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 Not In Compliance Findings: Preschool Room: Based on observation, a spray bottle containing a bleach/water solution was located on a low shelf accessible to the children. 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. 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff In Compliance 197 - Premises Requirements 922 KAR 2:120 - Section 4 Premises Requirements. (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with a land-line telephone accessible to a room used by a child. 1) Suitable In Compliance 2) Clean In Compliance 3) Good repair In Compliance 4) Land-line phone accessible In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 42 Web site: http://chfs.ky.gov/ Inspection Report 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance 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 10

Nursery Room: Based on observation, a staff member did not wipe a child with a disposable wipe after diapering. 289 - Disinfect Diaper Surface Not Applicable 922 KAR 2:120 - Section 10 (12) Staff shall disinfect the diapering surface after each child is diapered. 290 - Disposable Gloves Not Applicable 922 KAR 2:120 - Section 10 (13) If staff wear disposable gloves, the gloves shall be changed and disposed after each child is diapered. 291 - Children's Individual Items 922 KAR 2:120 - Section 10 (14) Combs, towels or washcloths, brushes, and toothbrushes used by a child shall be: (a) Individually stored in separate containers; and (b) Plainly labeled with the child’s name. 1) Individually stored In Compliance 2) Labeled In Compliance 292 - Toothbrushes Not Applicable 922 KAR 2:120 - Section 10 (15) Toothbrushes shall be: (a) Individually identified; (b) Allowed to air dry; and (c) Protected from contamination. 1) Identified Not Applicable 2) Air Dry Not Applicable 3) Protected Not Applicable 293 - Toothpaste Procedure Not Applicable 922 KAR 2:120 - Section 10 (16) Toothpaste used by multiple children shall be dispensed onto an intermediate surface such as waxed paper to avoid cross contamination.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Nursery Room: Based on interview, the mouth contact toys are not being scrubbed with a brush. Preschool Room: Based on interview, the staff stated that she does not use a scrub brush to sanitize mouth contact toys. 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 22 of 42 Web site: http://chfs.ky.gov/ Inspection Report 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 2:110 · 922 KAR 2:110 - Section 3

General: Based on review of documentation, the record for a child (DOE: 11/7/11) did not contain a current immunization certicate. 99 - Documentation for Off Premise Trip Not Applicable 922 KAR 2:110 - Section 3 The following records shall be maintained at the child-care center for five (5) years: (4) Permission forms for each trip off the premises signed by the parent; Written Documentation 93 - Policies and Procedures 922 KAR 2:110 - Section 2 (5) Program policies and procedures shall: (a) Be in writing; and (b) Include: 1. Staff policies; 2. Job descriptions; 3. An organization chart; 4. Chain of command; and 5. Other procedures necessary to ensure implementation of: a. KRS 199.898, Rights for children in child-care programs and their parents, custodians, or guardians - posting and distribution requirements; b. 922 KAR 2:090, Child-care center licensure; c. 922 KAR 2:120, Child-care center health and safety standards; and d. This administrative regulation. 1) Writing In Compliance 2) Staff Policies In Compliance 3) Job Description In Compliance 4) Organization Chart In Compliance 5) Chain of Command In Compliance 6) Other Procedures-a) Rights for Children b)922 KAR 2:090 c) 922 KAR 2:110 d)922 KAR 2:120 In Compliance 100 - Daily Attendance Records 922 KAR 2:110 - Section 3 (5) Daily attendance records documenting the arrival and departure time of each child; 1) Arrival In Compliance 100 - Daily Attendance Records 922 KAR 2:110 - Section 3 (5) Daily attendance records documenting the arrival and departure time of each child; 2) Departure Not In Compliance Findings: General: Based on review of documentation, the departure time for one (1) child was not documented on 7/24/12 and the departure time was not documented for two (2) children on 7/25/12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.