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

General: Based on review of documentation, the following was found: 1.) A staff member hired 7/25/2022, did not have a current TB test or statement from a health professional on file. 2.) A staff member hired on 2/27/2023, did not obtain a TB test or statement from a health professional until 4/15/2023. 3.) A staff member hired on 4/10/2023, did not obtain a TB test or statement from a health professional until 4/14/2023. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, this regulatory requirement was not met. Documentation reviewed included daily sign-in/sign-out sheets documenting the time of arrival and time of departure of children on 9/8/2021, staff schedules, staff clock in and out time as well as documentation noting the transition of children from room to room. The surveyor found that on 9/8/2021 between 7:30 a.m. and 7:50 a.m., there was one staff person with ten children ages five months to seventeen months old. The staff to child ratio with the age of the youngest child being five months old was over by five children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report General Administration In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. The Preschool 2 Room contained a dusty vent over the toilet in the bathroom, and a dusty vent in the ceiling of the classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Hygienic Practices 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation and interview, this regulatory requirement was not met. The 2 Year-Old Room contained a pull down plastic diaper changing table without a pad. The staff member in the room indicated that she does not have a pad for the diaper changing table. First Aid/Medication In Compliance Outdoor Play Area In Compliance 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, this regulatory requirement was not met. The Toddler 2 Room contained tape residue on a shelving unit that contained community helpers.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Toys and Furnishings.

General: Based on observation, this regulatory requirement was not met. The metal fence that divides the front playground from the area where the buggies were stored was rusted. The surface of the metal fence was completely rusted. Transportation Not Applicable Kitchen Requirements In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Drink Requirements for All Child-Care Centers.

General: Based on observation, this regulatory requirement was not met. A child in the Infant 2 Room was served peaches and cottage cheese directly on a high chair tray. The food was not served on an intermediate surface. Tableware for the children shall include plates or bowls. Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Posted 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 8. General.

General: Based on observation and review of documentation, this regulatory requirement was not met. The Young Toddler Room, the Infant 2 Room, and the 2 Year-Old Room did not have the ages of the children posted with the staff-to-child ratio. The ratios listed the class ratio numbers and maximum group size, but not the ages of the children. Animals 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, the surveyor found the wall-mounted diaper changing table did not include a non-absorbent pad. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Food Service 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, the surveyor found the small refrigerator located in the infant classroom did not contain an indicating thermometer. Therefore, the surveyor could not determine the temperature. Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable Emergency Regulation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 14. Statement of Deficiency and Corrective Action Plans.

A PLAN OF CORRECTION WAS DUE ON 09/30/2019 AND AS OF 10/21/2019, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, it was found that the toilet paper was being stored on the back of the toilet tank in the hall bathroom. This is not a proper method of storage. It should be noted that the hall bathroom is not used by children and is for staff only. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, it was found that two (2) staff did not complete the required fifteen hours of cabinet approved training. The hire dates for these staff are 07/16/2018 and 05/14/2015. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the following was found: 1.) In the kitchen area of the preschool building, there are drawers that were not in good repair. These drawers were not able to be closed all the way and were not fully functioning. 2.) In the preschool building, there was a vent in between the classroom area and the kitchen that was not secured properly in the floor and was coming up from the floor. 3.) In the hall bathroom, there were numerous drawers that were missing the knobs to open the drawer. It should be noted that the children do not use the hall bathroom and it is only for staff. Hygienic Practices In Compliance First Aid/Medication In Compliance 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, it was found that there was not adequate ground cover on the larger playground at the facility. As a result of this, the plastic ground cover was exposed creating a tripping hazard for the children. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, it was found that there was not a thermometer in the infant room refrigerator; therefore the temperature could not be determined. Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, and interview, this regulatory requirement was not met. Upon arrival (1:18PM) the surveyor toured the facility with the staff person in charge and observed one (1) staff person caring for eleven (11) children in the two (2) - three (3) year old classroom. Since the youngest child in the group was identified as a two (2) year old, the minimum staff to child ratio would need to be one (1) staff person for ten (10) children. A review of Division of Regulated Child Care files found that this regulatory violation was previously issued as a result of inspections conducted on 4/4/19 and 3/27/19. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. A complaint investigation was conducted at the facility on 4/4/19. The front door to building # 1 remains locked. The surveyor knocked on the door at approximatley 12:25 p.m. and a staff peson opened the door and allowed the surveyor entry into the facility. The staff person returned to an area located on the other side of a half wall with plexi-glass from the top of the wall to the ceiling. This area is located to the right of the door. The surveyor followed the staff person into the area where there were eight (8) children ages one to two (1-2) years old. There was an additional staff person in the area. When the other staff person left the area to answer the door, this left the classroom out of ratio. The staff to child ratio with the age of the youngest child being one-year-old is one (1) staff for six (6) children. This put the staff to child ratio over by two (2) children while the staff person answered the door. Although there are half walls separating the area from the entryway, the walls are still very tall and a separate space. A review of DRCC files found that this regulatory violation had been found during a follow-up visit conducted on 3/27/18. Director Requirements In Compliance Premises 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 4. Premises Requirements.

General: Based on observation, this regulatory requirement was not met. During an inspection of the kitchen, dried food and dirt particles were observed on the wall by the trashcan. A review of DRCC files found that this regulatory violation was found during a relicensure survey conducted on 8/23/18. Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During an inspection of the kitchen at the time of the complaint investigation, the following was found: 1) The handles were missing on two (2) drawers in the cabinet by the sink. 2) Dirt, grime and dried food were found on the surface of the cabinet doors under the sink. 3) The first layer of glass on the stove front was missing, leaving the stove in disrepair. 4) The handle on the stove door was hanging loose and was not secured to the stove door leaving the stove in disrepair. A review of DRCC files found that this regulatory violation was found during a relicensure survey conducted on 8/23/18. It should be noted that handles were missing on the drawers, the glass from the stove was missing and there was dirt, grime and dried food on the cabinet fronts. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, this regulatory requirement was not met. Upon arrival (2:15PM), the surveyor entered building #2 and observed one (1) staff person caring for a group of thirteen (13) children (three (3) year olds) in the preschool classroom. Since the youngest child in the group was a three (3) year old, the minimum staff to child ratio would need to be one (1) staff person for twelve (12) children. The facility exceeded the staff/child ratio by one (1) child. The staff person working in the classroom stated that a second teacher was assigned to the group; however, she "ran across the street for something". An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, and interview, this regulatory requirement was not met. An unannounced visit was made to the facility on 2/12/19 at 8:26AM. The surveyor entered building #2 (Preschool and Pre-K Classrooms) and observed two (2) staff caring for eleven (11) children (three (3) – four (4) year olds) in the preschool classroom. The surveyor proceeded down the hall and observed a staff person walk out of the children’s bathroom in the hallway and then enter the Pre-K Classroom. The surveyor followed the staff person (hire date: 3/24/06) into the Pre-K Classroom and found that no other adults were present in the room; therefore, the eight (8) children present in the room had been left without adult supervision. The staff person stated that she was in the hallway bathroom putting away a child’s sheet and blanket. The door to the bathroom is approximatley five (5) feet down the hallway from the Pre-K Classroom. The children in the Pre-K Classroom were not visible from the bathroom area. Staffing Requirements In Compliance Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on Review of Documentation, and the Training Records Information System (TRIS), this regulatory requirement was not met. Five (5) staff files (hire dates: 6/6/05, 2 on 7/28/08, 3/24/06, 5/3/14) contained Pediatric Abusive Head Trauma training class certificates that were dated 5/29/13, 11/15/13, 5/20/13, 2/26/13 and 3/19/13; therefore, this training was no longer valid. A review of Division of Regulated Child Care files found that this regulatory violation was previously issued as a result of a relicensure inspection conducted on 8/23/18 and these same five (5) staff were identified. The director had indicated on a plan of correction submitted 9/14/18 that she would keep a running log of all employees to ensure that the confusion does not happen again. Director further stated that she would also check TRIS monthly to ensure that all training hours were recorded. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Food Service 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 9. Food and Meal Requirements.

General: Based on Observation, this regulatory requirement was not met. At approximately 8:25AM the surveyor pulled into the facility parking lot and observed a staff person exit building #1, walk across the road, and enter building #2. The staff person was observed carrying multiple food items. One of the items was a large open tray of pancakes. There were no provisions to protect the food from contamination.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that there was not a complete copy of the current regulations available for staff.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, in the bathroom located in the two-year-old room in building # 1 a plunger was observed sitting beside the toilet. The plunger was accessible to the children. In the bathroom in the hallway located in building # 2 a toilet plunger was observed sitting by the toilet. 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, and ECE-TRIS record it was found that a staff person hired as a substitute on 6/28/15 only had evidence of having completed six (6) hours or annual training.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, and ECE-TRIS records there were five (5) staff whose pediatric abusive head trauma training had not been renewed. There was one (1) staff person with a hire date of 7/28/08 who only had evidence of having completed twelve (12) hours of annual training. An additional staff person hired 5/14/15 only had evidence of completing six (6) hours of annual training. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, During a tour of building # 1 there was an accumulation of dirt and grime along the basboards in the blue one-year-old room. In the same building in the one-year-old room located beside the bathroom in the hallway there was an accumulation of dirt and dust particles along the baseboards. There were also numerous scuff marks and dirt on the walls and along the baseboards. During a tour of building # 2 numerous scuffs and marks were observed on the walls in the dramaitc play area, book area and block area in the three-year-old room. Tape residue was observed on the wall in the listening area in the four-year-old room. The baseboards in the bathroom located in four-year-old room had an accumulation of dirt and dust particles. Hygienic Practices 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on Observation, the changing mat used in the two-year-old room had a small tear. The tear does not allow for the mat to be adequately sanitized. First Aid/Medication In Compliance 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, along the fence line on the large and small playgrounds there were numerous weeds and vines growing along the fence. On the large playground there were areas of tall grass. On the large playground at the end of the curved slide attached to the climbing structure the black plastic ground cover under the mulch was visible. The plastic covering was bunched in one (1) area. This was in the path of where the children get off of the slide thus making it hazardous. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, in the two-year-old room there was a white shelf that had an accumulation of dirt and grime. In the blue one-year-old room located in building # 1 a large tan pillow was observed in the book area had several areas that were soiled and stained. In the four-year-old room located in buildng # 2 there was a large tan pillow in a corner that had areas that were soiled and stained.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, on the large playground there was a plastic Little Tykes kitchen set that had numerous areas of embedded dirt and grime. There were also areas of the kitchen set that were covered in what appeared to be green moss. A plastic table and chair and doll bed located in the same area as the kitchen set had an accumulation of dirt and grime embedded on the surface. On the small playground there were various riding toys, and a kitchen set that had embedded dirt and grime on the surface. In the kitchen there were two (2) drawers that were missing handles. The glass front to the stove was gone and had been placed against the wall in front of the stove. Dried food particles were observed on the front of the refrigerator in the kitchen. Dried food particles were also observed on the front of the cabinets in the kitchen. Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

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, a drawer located by the stove in the kitchen contained serving utensils. There was an accumulation of crumbs and food particles in the drawer. Dried food and crumbs were observed inside the door and on the shelves of the refrigerator in the kitchen.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on Observation, on the bottom shelf of a cabinet located beside the stove in the kitchen in building # 1 a mouse trap was observed. The trap was observed sitting near a bottle of Great Value 100% grape juice. Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

Based on interview, the Fayette County Health Department closed the facility's kitchen from March 27, 2018 through April 2, 2018 due to presence of mouse droppings. Staff interview found that there was no indication the mouse was in any other part of the building.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, a staff person hired on 5/22/17 had the results of a criminal records check on file that was dated 5/31/17; however, there was no documentation on file to verify if the criminal records check was requested prior to hire or on the day of hire. The director stated that she did not keep the documentation but did request the background check on the day the individual was hired.

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, a staff person identified as a substitute hired on 6/28/15 had TB skin documentation on file that was no longer valid as of 1/16/17. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

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 noted that there was a strong urine odor coming from the restroom. Additionally, the surveyor noted that there was some dirt and grime around the base of the toilet and some stains within and on the outside of the toilet bowl. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance 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 11. Toys and Furnishings.

General: Based on Observation, the surveyor observed an excessive amount of dirt, food, and paper particles on area rugs located in the toddler and two-year-old classrooms. The staff stated that the rugs are vacuumed every day. Transportation Not Applicable Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, and ECE -TRIS records a substitute with a hire date of 6/8/15 only had evidence of having completed four (4) hours of cabinet- approved early care and education training. In addition this staff person has not one and one-half (1 1/2) hours of pediatric abusive head trauma training. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 7 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, and ECE - TRIS records it was found that one (1) staff person with a hire date of 5/11/15 only had evidence of having completed 7.5 hours of training for the staff person's annual training year. During an interview with a staff person in charge it was indicated that this staff person in currently working on a Child Development Associate credential (CDA). The staff person in charge indicated that the documentation is in the staff person's CDA notebook but the staff person was off for the day and the notebook is not kept at the facility. 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, during a tour of the infant room the carpet located in the area where the sink and changing table are located had an accumulation of crumbs and dirt particles. An interview with the staff person in charge found that this is the area where the children eat. However, while the surveyor was in the classroom an infant was observed crawling on the carpet. During a tour of the two's (2's) room the wall where the art area is located had several holes the size of a nail head as well as numerous areas with scuffs and chipping and peeling paint.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that on 9/24/15 a parent filled out a medication administration form to administer Motrin to their infant. The parent requested that the medication be administered at 8:00 a.m. and 2:00 p.m. as needed. Further review of the document found that a staff person administered the Motrin at 10:15 a.m. This was not the time specified by the parent.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, during a tour of the infant/toddler playground a portable shade structure was observed. There was a black and white nylon string located at the top of each pole taht was used to secure the gray cover to the metal poles inserted into the ground. On one (1) of the these corners the string had come loose and was dangling from the top of the structure down to the ground. This made the string loose and accessible to the children.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, during a tour of the infant room there were four (4) vinyl nap mats stored on a shelf above the sink. The mats had worn and torn edges. An interview with the staff person in the room found that the mats are used daily for children who are transistioning from a crib to a nap mat. Additional vinyl nap mats were observed stored in a small closet in the hallway. These mats also had edges that were worn and torn. An interview with staff found that the mats are used for naptime for children located in the two (2) year old room located beside the office.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, during a tour of the two (2) year old room located across from the infant room a white shelf in the book area there was a white shelf. There were large areas where the plastic covering had peeled away from the wood.

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, during a tour of the kitchen crumbs and dried milk were observed on the lower shelf in the refrigerator located in the kitchen.

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, during a tour of the kitchen there was an accumulation of dried food on the cabinet doors and drawers used to store food and utensils.

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, there was one (1) child whose enrollment information did not include a preferred hospital. An interview with the staff person in charge found that the enrollment from was an older form.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, one (1) staff file (hire date: 4/28/14) contained results of a negative T.B. test that is no longer current. The test was dated 8/5/13 which exceeds the two (2) year time frame.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the following was found: 1. One (1) staff file (hire date: 5/11/15) did not contain evidence of the six (6) hours of cabinet-approved training being completed within the first three (3) months of employment. 2. One (1) staff file (hire date: 7/16/12) did not contain evidence of the pediatric abusive head trauma training class being completed within the required time frame. 3. One (1) staff file (hire date: 7/14/08) did not contain the required fifteen (15) hours of 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. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, this regulatory requirement was not met. An inspection in the kitchen found that the interior surface areas of the microwave contained food crumbs and spills.

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, two (2) children (enrollment dates: 2/28/14 and 11/14/12) had an immunization certificate on file that was no longer current as of 8/9/15 and 2/23/15.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Review of Documentation and interview, this regulatory requirement was not met. A review of records found that the facility did not have evidence of a job description for the director and the assistant director. The director stated that she was not aware of this regulatory requirement.

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 Interview, it was found that there was not a copy of the regulations available for staff.

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, there was no documentation avaialable for review to verify staff meetings had been conducted during 2013.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, there was one (1) staff person hired 7/14/08 whose last T.B. skin test was completed on 5/18/12. This exceeds the two (2) year time frame.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, there was one (1) staff person with a hire date of 7/16/12 who only had evidence of having completed six (6) hours of training for the 2012-2013 traininig year. There were two (2) additional staff with hire dates of 6/6/05 and 5/1/08 who only had evidence of having completed 1.5 hours of training for the 2012-2013 training year.

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, during a tour of the two (2) year old room and the Early Head Start room located in the back of building # 1 there was a large amount of tape residue and areas where the paint had been peeled off of the surface on the ceiling.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, the wall behind the sink in the bathroom located in the two (2) year old room had an accumulation of dirt and grime.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, during a tour of the bathroom located in the hallway in building # 2 it was found that there was no soap or paper towels accessible for 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 changing table in the front Early Head Start room in building # 1 had a pad that could be placed on the changing table. However, at the time of the survey a staff member was observed changing a child but the padded mat was not used. The child was placed on the plastic surface. During a tour of the two (2) year old room it was found that there was not a padded surface on the pull down changing table in the bathroom. The changing table is used for 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 7. First Aid and Medicine.

General: Based on Observation, there was no medical tape available for first aid if needed.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Observation, during a tour of building # 2 there were numerous nap mats that had torn corners with exposed foam.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the faucet at the sink in the two (2) year old room had an accumulation of dirt and grime. There was a torn flower pillow in the book area in the Early Head Start room located at the front of building # 1 as well as two (2) stained and soiled white pillows. In building # 2 there was a broken toy cash register in the three (3) to four (4) year old room.

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, out of ten (10) children's files reviewed there was one (1) child enrolled who did not have permission for emergency medical care, the name and number of the child's physican, a preferred hospital and information regarding the child's medical history. In addition there was one (1) child enrolled 2/18/13 who did not have the name and number of the child's physician.

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 Interview, it was found that the children in building # 2 do not have a playground located at their building. The staff must take the children across the street to building # 1 to play on the playground located behind the building. There were two (2) children who did not have written permission to leave building # 2 and go to building # 1 to play on the playground. Written Documentation

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 Review of Documentation, there was no documentation available and presented for review at the time of the survey to verify the facility has a written policy that specifies that staff will implement what was taught at the orientation training.

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, it was found that the file for an employee hired on 7-18-13 contained the results of a criminal records check that was submitted on 7-25 -13. This date is not within the timeframe required by the regulation.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the file for an employee hired on 2-19-13 contained evidence of the six (6) hour cabinet-approved orientation training being completed on 7-10-13. This date is not within the timeframe required by the regulation. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty one (21) years old; (b) Complete the background checks as described in 922 KAR 2:110; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, it was found that the sink in the hall bathroom of Building #2 was clogged.

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, it was found that the wall and the floor on the right side of the kitchen was splattered and littered with food particles and debris.

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, it was found that there were multiple dried spills and debris in the freezer and on the shelves and door of the refrigerator. The front of the refrigerator and freezer was found to be smeared with accumulated grime and grease. The drawer to the oven was found to contain food particles and debris. The interior surfaces of the cupboards, which contained dishes to be used by the children, were found to contain debris and be slick with accumulated grime. The cooking utensil drawers were found to contain food particles, dirty spoons and a measuring cup with what appeared to be a blob of grease on it. 955 - Single Service Item Not Applicable 922 KAR 2:120. Section 8. Kitchen Requirements. (8) A single-service item shall be: (a) Stored; (b) Handled and dispensed in a sanitary manner; and (c) Used only once.

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, it was found that one (1) child's file out of ten (10) files reviewed did not contain the parent's preferred hospital.

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, it was found that one (1) child had an immunization certificate that was no longer current. The immunization certificate was dated 8/1/12. The child had been enrolled in excess of thirty (30) days.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Interview, it was determined that a two (2) year old child hurt his leg at approximately 12:00pm and was unable to walk on the leg and the child's grandparent was not notified until approximately 3:30pm after the child woke up from his nap. First Aid/Medication 248 - Nonprescription medication protocol 922 KAR 2:120 - Section 7 (5) Nonprescription medication: (a) May be given to a child only with the written daily request of the: 1. Parent; or 2. Person exercising custodial control of the child; and (b) Shall be administered according to the instructions on the label. 1) Written daily request Not In Compliance Findings: General: Based on Interview, it was determined that a two (2) year old child received Ibuprofin without having a written permission to admister medication form signed by a parent or guardian.

Open Not marked corrected in the state record

Open / not marked corrected.