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

General: Based on review of documentation and ECE-TRIS, one (1) staff member (DOH: 08/11/11) has not renewed the Pediatric Abusive Head Trauma (PAHT) training. The training was last completed on 04/09/19. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor found one (1) water-stained ceiling tile in the three-year-old classroom. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Kitchen Requirements 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 one (1) unlabeled bottle in the refrigerator located in the infant classroom. Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the document on the proper methods for handwashing was not posted in the infant classroom. The staff member could not locate the document. The staff member in charge printed the document and posted it above the hand-washing sink during the inspection. Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. The hall bathroom that was a light peach color contained a ceiling tile grid that was not secured properly and it was hanging down above the hand washing sink. This bathroom was located in the hall near the Three-Year-Old 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 4. Premises Requirements.

General: Based on observation, this regulatory requirement was not met. The Two-Year-Old Room contained a patch on the wall behind the half door that was uneven (not smooth) and a small hole was observed in the patched area. This appeared to be where the door knob had hit the wall. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report

Open Not marked corrected in the state record

Category: 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, this regulatory requirement was not met. The cold water in the hand washing sink in the boy's hall bathroom was not working.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. The boy's hall bathroom contained urine in the toilet. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records 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, this regulatory requirement was not met. A child enrolled on 3/13/2023, did not have a physician's name and phone number, or a preferred hospital on file. These areas were left blank on the enrollment form. 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 2:280 · 922 KAR 2:280. Section 5. Checks of Other States.

General: Based on review of documentation, this regulatory requirement was not met. A staff member hired on 3/10/2021, did not have evidence or the results of an out-of-state background check from Ohio. The staff member previously lived in Ohio from 2000 to 2020. The facility would need a child abuse and neglect check and a sexual offender registry check from Ohio for this staff member. This staff member was observed working alone in the Infant Room with four children during the renewal survey. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance 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 and review of documentation, this regulatory requirement was not met. A staff member was observed working alone in the Infant Room with four children during the renewal survey. The staff member was hired on 3/10/2021, and did not have evidence or the results of an out-of-state background check from Ohio. The staff member previously lived in Ohio from 2000 to 2020. The facility would need a child abuse and neglect check and a sexual offender registry check from Ohio for this staff member. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 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, this regulatory requirement was not met. A substitute staff member that was hired on 8/11/2011, did not have current TB documentation on file. The TB skin test on file was dated 8/05/2020, and is valid for two years.

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 review of documentation, this regulatory requirement was not met. A staff member hired on 1/10/2023, did not have written evidence of First Aid and CPR training. The ECE-TRIS system was reviewed confirmed these findings. Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. The Infant Room did not have a variety of creative materials that included dramatic play, block building, stacking, or books that the children could manipulate. A few teethers and rattles were observed on the floor of the Infant Room as well as a few story books for older children on the bottom shelf of storage unit that was located outside of the children's play area. Premises 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, the following was found: 1.) Several coats were protruding from children’s individual cubbies and touching one another in the two-year-old, three-year-old, and four-year-old rooms; this method of storage promotes the spread of germs and bacteria. 2.) In the infant room one outlet was uncovered and the plastic outlet cover was found on the floor. 3.) Two pacifiers used by the children in care had a beaded chain attached to them. This poses a choking hazard for the children in care. Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, two staff members (hire dates: 3/26/2015 and 8/8/2011) did not have a current TB test or statement from a health professional on file. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, three staff members (hire dates: 3/1/2021, 6/19/2020, and 12/10/2021) did not have evidence of completing CPR/First Aid training on file at the facility. A review of ECE-TRIS records supports the information found during the survey.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the following was found: 1.) Two staff members (hire dates: 3/1/2021 and 12/10/2021), did not complete the required Orientation. These staff members have been employed for more than three months. 2.) Two staff members (hire dates: 6/19/2020 and 3/1/2021) did not complete the required PAHT training. These staff members have been employed for more than one year. 3.) A staff member hired on 1/30/2017, completed PAHT training on 1/25/2017; however, did not renew the training due 1/25/2022. 4.) Six staff members (hire dates: 3/1/2021, 6/19/2020, 8/8/2011, 1/30/2014, 8/8/2011, and 3/26/2015) did not have evidence of completing 15 hours of annual early care and education training. A review of ECE-TRIS records supports the information found during the survey. 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.) There was chipped and peeled paint, and holes in the walls in the two-year-old, infant, and four-year-old rooms. 2.) A strip of the carpet was torn in the three-year-old room. 3.) The floor was dirty in the infant room in front of the trash can. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Kitchen Requirements In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, in the infant room fridge there was a bottle of Hawaiian Punch labeled with a child's name. The staff member explained that parent brought this for her 11-month-old child to drink. Drinks served at the centers shall not have added sugar therefore, Hawaiian Punch cannot be served to any child in care. Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, it was found that a child enrolled at the center on 3/18/2022, did not have a current immunization certificate on file at the facility. 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 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation, this regulatory requirement was not met. During a tour of the facility at 8:55AM, the surveyor noted that the staff person working in the two-year-old classroom was wearing her face mask under her chin. When the staff person looked up and saw the surveyor standing in the classroom doorway, she pulled her mask up over her mouth and nose. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, this regulatory requirement was not met. During a tour of the preschool classroom, the surveyor observed a section of the door frame (approximately three feet long) that was separating from the wall on the exterior door. This created a gap with jagged deteriorating edges. 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

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, this regulatory requirement was not met. During a tour of the facility, the surveyor found that there were no paper towels at the sink in the girls' bathroom closest to the school-age classroom. 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, this regulatory requirement was not met. Two bottles in the infant/toddler room refrigerator were not labeled with a child's name. Furthermore, one of these bottles did not contain a lid.

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, a crib located in the One-Year-Old Room had a sheet that did not fit tightly over the mattress.

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 diaper-changing table in the One-Year-Old Room faces the wall. At the time of the survey as the staff person was observed changing a diaper, a male child opened the door to the classroom. One of the surveyors in the room shut the door to keep the child from leaving the room. The staff member could not adequately supervise the children due to placement of the diaper-changing table. Staffing Requirements In Compliance General Administration 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 interview, while in the One-Year-Old Room, a one-year-old child was observed with socks on her hands. The elastic band of the sock had been secured to the child's wrist with clear packaging tape. The staff stated the child suffers from Eczema and her parent asked that the socks be placed on her hands to keep the child from scratching the area on the back of her hands. The staff person stated she had placed the packaging tape around the child's wrist at the request of the parent to keep the child from removing the socks. The staff person in charge indicated at the time of the survey she was not aware of this and was sure the parent would not request that the socks be taped to the child's wrists. Director Requirements In Compliance Employee Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 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, interview and review of documentation, the following was found: 1) In the Two-Year-Old Room: a) The posted planned program of activities had an art activity listed that required paper plates and finger paint. The staff person stated that the activity could not be completed because she did not have the paper plates and ran out of finger paint. b) The children did not have access to books. Several board books were observed on a high shelf. There was nothing mentioned on the daily lesson plan or schedule that included activities for stories and books. The staff person stated she reads a book to the children each day before naptime and after snack; however, the children are not given the opportunity to look at books independently. c) Empty puzzle boards were observed stored in a fabric books shelf. The pieces to the puzzles were loose in the pockets of the shelf. d) A play kitchen set and a puppet theater were observed in the room; however, the children did not have access to dishes, puppets or other items to be used with these pieces of equipment. 2) In the Three-Year-Old Room: a) It was found there is a child enrolled who does not speak English. The staff person indicated the Spanish version of ABC Mouse is provided for the child and is viewed on a small tablet. There were no other activities documented to meet the needs of this child in its native language. b) A dollhouse and a barn were observed but there were no dolls, furniture or animals accessible to the children. Containers with these items were observed in a corner of the room that had been blocked off with other pieces of equipment. 3) In the One-Year-Old room, a staff member was observed using a pointer while pointed to letters, numbers, colors and words posted on the wall. The staff person indicated that she does this activity daily with the children. It should be noted that the children were all seated in low highchairs and one child was seated in a bouncer/rocker type chair. The age of the children in the room was one- to two-years-old. It was also stated that this is done for approximately twenty-five to thirty minutes each day. The children were then required to remain seated while one child was given a wooden color sorting activity while the other children sat and waited for their turn. This is not developmentally appropriate for children of this age.

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, interview and review of documentation, at approximately 9:55 a.m., three children in the One-Year-Old Room were observed sitting in low high chairs while one child was observed sitting in a bouncer/rocker-type chair while the staff person pointed to letters, numbers, colors and words on the wall. At approximately 10:26 a.m., the children were observed still sitting in the same place they were seated at 9:55 a.m. At this time, the children were watching a video on a small tablet that had been placed on the floor. The staff person then turned off the video and handed one of the children a wooden color sorting board with pegs. The rest of the children were not given any activity and remained seated. One child sitting beside the child with the toy reached out for it, but was told by the staff person to wait their turn. At 10:36 a.m., the children remained seated. In addition, there were three high chairs in the room but four children present. The staff person stated that the child who did not have a high chair, would not be served lunch until one of the other children finished eating. The children in the room were required to sit and wait for prolonged periods during activities, and while waiting for another activity to start. The children were confined to their seats and could only be removed with the help of an adult. The children in the room at the time were one- to two-years-old. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 6 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, interview and review of documentation, during a tour of the facility the following was found: 1) In the Preschool Room, a T.V. was observed on the wall. The staff person in the room indicated that the children watch T.V. for approximately thirty minutes each day before lunch. 2) In the Two-Year-Old Room, a tablet was observed plugged into the wall. The staff person stated she uses the tablet to allow the children to watch ABC Mouse. She also stated she uses the Spanish version of ABC Mouse for a child who does not understand English. 3) In the One-Year-Old Room, the children were observed sitting in low high chairs while they watched a program on a small tablet. It should be noted that the daily schedule and the posted lesson plan in each of these classrooms did not have television viewing or the use of other electronic devices listed as part of their programming for the day. 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 following was found: 1) A can of Surface Disinfectant spray was found on a low shelf beside the toilet in the gray bathroom. The label on the can indicates to keep out of the reach of children. This bathroom is used by the children, making the can of disinfectant accessible to the children. 2) A staff person's purse had been placed on top of the cots in the Three-Year-Old Room. The purse was within reach of the 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, the following was found: 1) In the Preschool Room a portion of the baseboard was missing by the door leading into the kitchen. 2) There were numerous areas of chipping and peeling paint on the walls in the classrooms, hallway and bathrooms. 3) Areas of dirt and grime were observed on the walls in the classrooms, bathrooms and the hallway. 4) Water stained ceiling tiles were observed in the hallway near the bathrooms. 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 3. General Requirements.

General: Based on observation, a staff person in the One-Year-Old room changed and child's diaper and did not have the child wash their hands afterwards. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 6 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a staff person in the One-Year-Old Room changed a child's diaper and did not wash her hands afterwards.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, a staff person changed a child's diaper and did not sanitize the diaper-changing mat afterward. A diaper-changing mat located in the Infant Room in the back was discolored and stained. First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, interview and review of documentation, a child in the One-Year-Old room was observed with socks on her hands. Staff indicated the child suffers from Eczema and requires Aveeno Baby Eczema relief to be applied to the back of her hands. The staff person stated she has applied this to the child's hands and further stated that only verbal permission has been obtained. There was no documentation available to confirm the parent has requested this medication be applied to the child's hands. 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: ratio. 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 One-Year-Old Room, a tube of Desitin diaper ointment was found on an open shelf at the diaper changing station. The tube of ointment was within reach of the children. The label on the ointment indicates to keep out of the reach of children. Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, numerous smudges, dirt and grime were observed on the plexiglass ends of cribs located in the One-Year-Old Room. Transportation In Compliance 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, an uncovered bottle was observed on the floor in the One-Year-Old Room. Children's Records In Compliance Written Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 6 Inspection Report Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the proper methods for diapering and handwashing was not posted in the diapering area in the One-Year-Old Room. Animals In Compliance Emergency Regulation In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation and review of documentation, the surveyor found the child-care center is not providing a daily planned program for school-age children when they are not taking part in virtual learning. The documents presented for review were labeled “lesson plan”; however, the surveyor found these documents were daily schedules, not lesson plans. The surveyor found the following activities listed on the documents: free play, virtual learning, and T.V. time. The staff person in charge stated that the children have access to toys and worksheets. 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation, the surveyor entered the child-care center on 12/14/2020, at approximately 11:45 a.m., and observed children watching Miraculous Tales of Ladybug Cat Noir. The program has a rating of Y-7, which suggests that the program is designed for children age seven and above. It is important to note, the youngest child present was five years old. Furthermore, the surveyor found "T.V. time" listed on the school-age lesson plan two times, from 8:30 a.m. until 9:00 a.m., and again from 2:00 p.m. until 4:30 p.m. This exceeds the two hour individualized listening/ viewing time. Emergency Regulation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:405 · 922 KAR 2:405E. Emergency Regulation.

General: Based on review of documentation, the surveyor found a staff person hired on 11/18/2020, did not have a criminal records check on file. Further review found this staff person has lived in the state of Indiana within the past five years; therefore, would also require an out-of-state criminal records check, child abuse and neglect check, as well as the sexual offender check. It is important to note, the staff person was not observed working alone with children.

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 observation, interview and review of documentation, it was found that a staff person hired 4/12/18 transports children and usually has a monitor on board while transporting children from school. However, it was found that this staff person has transported on occasion, two children from Yates Elementary, without a monitor. A review of this staff person’s personnel file found that there was not a copy of a high school diploma, GED or other qualifying documentation on file. This staff person had supervisory control over the children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 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 review of documentation, it was found that the posted planned program of activities for the Four and Five Year Old Room and the children in the One-Year-Old Room were dated 7/15/2020 to 7/21/2020. This is the week prior to the survey. In addition, upon arrival at the facility on 7/29/2020 at approximately 8:55 a.m. the surveyor entered the facility and observed five children ages one to five years of age with two staff in the front room. The staff person who is normally in charge was not present at the time and did not arrive at the facility until sometime between 9:30 and 10:00 a.m. Interviews with staff found that the children had been combined for approximately 10 minutes. Staff interviews also found that they have been combining children in the mornings upon arrival and normally do not separate them until around 9:30 a.m. At approximately 9:00 a.m. one of the staff took two of the children who were ages one and two years old to another classroom leaving the remaining children with the other staff person. It should be noted that the classroom the children were in when the surveyor arrived is a school age classroom. The materials in the classroom do not meet the developmental needs of children who are one and two years old.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, upon arrival at the facility on 7/29/2020, the surveyor entered the facility and observed five children ages one to five years of age with two staff in the front room. Interviews with staff found that the children had been combined for approximately 10 minutes. Staff interviews also found that they have been combining children in the mornings upon arrival and normally do not separate them until around 9:30 a.m. At approximately 9:00 a.m. one of the staff took two of the children who were ages one and two years old to another classroom leaving the remaining children with the other staff person. 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, during a tour of the facility a can of Lysol Power foam bathroom cleaner and a can of N1-7 auto scent were found on a shelf by the toilet in the gray bathroom. The label on the cans contained a warning to keep out of the reach of children. These items were 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 4. Premises Requirements.

General: Based on observation, during a tour of the facility several areas where the paint had peeled away from the surface was found on the yellow wall located by the the One- Year-Old Room. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on interview with staff in the One-Year-Old Room, it was found that soap and water are used to clean the diaper changing table after each child is diapered. Staff then stated that bleach water is used to sanitize the surface during nap time. Staff stated this is done to keep from getting bleach spots on the children's clothing. The surface of the diaper changing table should be disinfected after each diaper change. Soap and water does not serve as a disinfectant.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on interview with staff in the One-Year-Old Room, it was found that toys that are mouthed by the children are placed in a container and later cleaned and sanitized. The staff person stated that when the toys are cleaned they placed in soapy water and washed with a paper towel. The toys are then placed in clean water and then allowed to air dry. This process does not meet the requirement for the proper cleaning and sanitizing of toys mouthed by children who are not toilet trained. First Aid/Medication Not In Compliance

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, it was found that first aid supplies presented for review at the time of the survey did not contain a CPR mouthpiece and gauze. Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, it was found that two of the nap mats in the One-Year-Old Room were split down the side exposing the foam inside. This does not allow for the mats to be properly sanitized. Transportation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Food Service/Food Program 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 Meal Requirements.

General: Based on observation and interview, during a tour of the kitchen a partially used gallon of What's Up brand artificially flavored orange drink was observed in the refrigerator. An interview with the staff person in charge found that the drink was served for snack along with cookies and Mott's fruit snacks on 7/21/2020. It should be noted that the drink does not contain 100% fruit juice. Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on a review of children's files, there were six children's files that did not contain a current immunization certificate. One of the children's immunization record did not have a date noted as to how long the record was current. It should be noted that the children have been enrolled more than 30 days.

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, it was found that five children's enrollment information did not include the name of a physician and contact number. Three children's enrollment information did not contain a preferred hospital. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, interview and review of documentation, it was found that the last documented earthquake and tornado drills was 3/10/18. Earthquake and tornado drills are required to be conducted quarterly. It was also found that fire drills noting the date, time and children who participated could only be verified for the dates of 1/17/19 and11/22/19 for the year 2019. Further review of documentation found there was no documentation with the date, time and names of children who participated in a fire drill for January 2020 and February 2020. Fire drills are required to be conducted monthly and have documentation verifying the date, time and children who participated in the drill. During an interview with the staff person in charge it was indicated that the required documents must have been thrown away by a person who had come in to clean and paint while the facility was temporarily closed. Posted Documentation In Compliance Animals Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Emergency Regulation Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:400 · 922 KAR 2:400E. Emergency Regulation.

General: Based on observation, interview and review of documentation, the center was not in compliance with the emergency regulations regarding social distancing and screening and illness requirements: • On 7/29/2020 at approximately 8:55 a.m. the surveyor entered the facility and observed five children ages one to five years of age with two staff in the front room. Interviews with staff found that the children had been combined for approximately 10 minutes. Staff interviews also found that they have been combining children in the mornings upon arrival and normally do not separate them until around 9:30 a.m. At approximately 9:00 a.m. one of the staff took two of the children who were ages one and two years old to another classroom leaving the remaining children with the other staff person. • At approximately 9:05 a.m. a parent arrived at the door of the facility with a child. The staff person in the front room opened the door and let the parent and child inside the facility. The staff person took the temperature of the child but not the parent. The parent then took the child who was two-years-old to the classroom where the other two children had been taken. The parent went back out to his car and brought in another child. The staff person in the front room took the child's temperature but not the parent’s temperature. The parent once again took the child down the hall to the classroom with the younger children. At that time there were four children ages one to two years old and one staff person in the second classroom. • At approximately 9:10 a.m. a staff person arrived at the facility and the staff person in the front room took the staff person's temperature. This staff person clocked in put her belongings away and went to the second room and took two of the children from that room to the one-year-old room. A review of the facilities written policy regards to COVID19 indicates that a staff member will escort each child to their classroom. The policy also indicates that each parent will be required to wash their child's hands for 20 seconds before their child enters their classroom. • A male staff person was observed in various areas of the facility, including classrooms, throughout the survey. During the exit conference, the staff person in charge stated she thought it was okay to combine groups of children in the mornings and throughout the day.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, this regulatory requirement was not met. A child's enrollment paperwork contained an immunization certificate that was no longer current. The immunization certificate was dated 11/15/15. The child had been enrolled in excess of 30 days.

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 and review of documentation, the child-care center failed to provide children with a variety of activities and failed to have an adequate amount of materials/toys/equipment provided to the children to use on a daily basis. 1. The surveyor noted lesson plans posted in the infant classroom and two-year-old classroom; however, there were not enough materials and toys to implement activities listed on the lesson plans. 2. The surveyor entered the infant classroom at approximately 9:00 a.m. and observed five (5) children present ages nine-to-thirteen (9-13) months. Four (4) children were standing in their cribs while the fifth child was trying to open the lid of a trash can that was next to the hand-washing sink. The staff person stated the children were in cribs because she was changing diapers. The surveyor noted a few large Legos, one (1) baby doll, and two (2) books as the only items available to the children. 3. Equally important, one (1) female toddler was still standing in her crib at approximately 9:26 a.m. This child moved to the one-year-old #2 classroom at 9:28 a.m. The child was in a crib for almost thirty minutes without any activity offered to her. The staff person stated the child’s mother did not want her on the floor. 4. The surveyor found a very limited amount of toys available to the children in care in the two-year-old classroom. In the corner of the classroom, the surveyor noted several baby dolls, pretend housekeeping materials, a container of large Legos, and a container of musical instruments. However, these materials/toys were not available to the children because the area was blocked off with shelving units. The surveyor also noted that there were no books on the bookshelf. The classroom was a large open space with no defined areas. The surveyor noted a few children walking around the room and crying. 5. Additionally, a review of the daily schedule posted in the preschool classroom found that children have a limited amount of time to participate in free choice activities. The only free choice play on the schedule listed as “Developmental Learning Centers” was from 9:30 a.m. until 10:00 a.m. This limits the children to only thirty minutes of free choice activity in the classroom. 6. Furthermore, the preschool staff did not follow the daily schedule during the renewal inspection. Nineteen (19) children ages three-to-five (3-5) went outside and played with sidewalk chalk and hula-hoops from 9:15 a.m. until 10:30 a.m. Per the daily schedule, children were supposed to be participating in learning centers and then “cartoon time.” An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 10 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 proper methods of diapering were not posted in the infant classroom. Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based review of documentation, two (2) of the drivers files contained driving records that were no longer current. A staff / driver that was hired on 8/08/11 had a driving record on file that was requested on 5/16/17. A driver hired on 8/08/11 had a driving record on file that was requested on 4/16/17. 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 review of documentation, the surveyor reviewed the daily schedule posted in the preschool classroom and found "Cartoon Time" listed from 10:00 a.m. to 10:30 a.m., 4:50 p.m. to 5:00 p.m., and again from 7:30 p.m. until 8:30 p.m. The surveyor could not determine what type of cartoons the children watch each day and if it is utilized as an educational tool. This was not documented on the classroom lesson plan. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on interview and review of documentation, a substitute staff member hired on 8/02/11 did not have a National background check on file. The staff member had a completed CA/N and criminal records checks on file that were dated 8/04/11. The staff in charge indicated that she had not yet submitted the National background check for this substitute staff member. The staff member was not scheduled to work alone with the children. Supervision In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 10 Inspection Report Staffing Requirements 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 items accessible to the children in care: 1. A staff person's purse was on the floor and accessible to the children present in the infant classroom. There were five (5) children present ages nine (9) months to thirteen (13) months. 2. A can of warm pumpkin spice Odor Eliminator and a bottle of Discover Hospital Deodorant were located within reach in a restroom used by children.

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 child-care center failed to maintain staff-to-child ratios according to the regulations. The surveyors entered the child-care center at approximately 9:00 a.m. and found the following: 1. The two-year-old classroom had thirteen (13) children ages two-to-three (2-3) years old and one (1) staff person. Therefore, the classroom was over ratio by three (3) children. The staff person indicated that he had not been over ratio for too long. At approximately 9:10 a.m., a staff person removed three (3) children from the classroom in order to remedy the situation. 2. The infant classroom had five (5) children present ages nine (9) months to thirteen (13) months with one (1) staff person; however, at approximately 9:13 a.m. a sixth child was observed in the classroom. At approximately 9:16 a.m., the child was removed from the infant classroom and placed in the one-year-old classroom. It is important to note that this regulatory violation was cited during inspections conducted on 7/30/18, 9/26/18, and 11/7/18. General Administration In Compliance Director Requirements 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 10. Director Requirements and Responsibilities.

General: Based on observation, the child-care center failed to meet this regulation as follows: 1. There was an uncovered outlet in the infant classroom within reach of the children present. The five (5) children present were nine (9) months to thirteen (13) months old. 2. There was an uncovered outlet located next to the hand-washing sink in the one-year-old classroom #2. At the time of the observation; three(3) toddlers were present. 3. A long cord to a lamp located in the preschool classroom was found hanging over a shelf and in the children's play space. An uncovered outlet was observed under the lamp cord. 4. An outlet face plate located in the preschool room above the cots was not secured to the wall. The plate was turned sideways. 5. A radio cord was hanging over a shelf and within the children's play space in the school-age classroom. An uncovered outlet was observed under the radio cord. 6. A toddler was observed drinking from a sippy cup as he walked around the room in the one-year-old #2 classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 10 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, two (2) staff did not have proof of education on file. These staff were hired on 10/01/18 and 4/25/19.

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, a staff member hired on 4/25/19 did not have a statement from a health professional that the individual is free of TB or a copy of a negative TB skin test on file. A staff/van driver hired on 8/08/11 had a TB skin test on file that was no longer current. This TB skin test was dated 2/07/17.

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 facility did not have anyone present with current CPR and first aid training from 6:00 AM until 9:10 AM on 4/25/19. The staff in charge had current CPR and first aid training, but she arrived at the facility at 9:10 AM.

Open Not marked corrected in the state record

Category: health medication. 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, nine (9) staff did not complete the fifteen (15) hours of cabinet-approved early care and education training and some staff needed to renew the pediatric abusive head trauma training as follows: 1. Substitute - hired on 8/02/11 - 0 hours completed 2. Staff hired on 10/10/12 - 0 hours completed 3. Staff hired on 1/30/14 - 5 hours completed 4. Staff and van driver hired on 8/08/11 - 1 hour completed and PAHT was expired 5. Staff hired on 4/06/16 - 4 hours completed 6. Staff hired on 8/08/11 - 4 hours completed & PAHT was expired 7. Staff hired on 3/26/15 - 11 hours completed & PAHT was expired 8. Staff hired on 11/30/17 - 5 hours completed & no evidence of completing PAHT 9. Staff hired on 8/08/11 - 1 hour completed An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 10 Inspection Report

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 child-care center failed to be clean and in good repair as follows: 1. The ceiling return vent located in the two (2) year old classroom was embedded with an excessive amount of dust. 2. The floor in the school-age classroom was scuffed and dirty. 3. The walls in each restroom were dirty, scuffed, and streaked. 4. The caulking behind a hand-washing sink located in a restroom was peeling and flaking. 5. There was an excessive amount of peeled paint/tape residue on the walls in the one-year-old #1 classroom. 6. A wall in the school-age classroom next to the office was scuffed and dirty. 7. The restroom doors were scuffed and dirty. 8. A cabinet door of the hand-washing sink unit located in the one-year-old #2 classroom was buckled at the bottom from what appeared to be water damage. There were small pieces of wood in front of the unit on the carpet. In addition, brown colored water stains were observed inside the cabinet and the hot and cold water lines were accessible because there was no safety lock on the door to keep toddlers from opening it. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 10 Inspection Report

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. One (1) overhead light fixture located in the two (2) year old classroom was not working. 2. One (1) cracked overhead light fixture cover was located in the one (1) year old #1 classroom. 3. One (1) overhead light fixture located in the corner of the preschool classroom was not working and as a result, the area was dimly lit.

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 review of documentation, the child-care center was found over capacity in the two-year-old classroom and pre-school classroom. The surveyors entered the two-year-old classroom at approximately 9:00 a.m. and observed thirteen (13) children ages two-to-three (2-3) years old. The two-year-old classroom has a square footage of accommodating only twelve (12) children. A review of the child-care center’s diagram found the classroom was measured for a capacity of twelve (12) during the change of location inspection conducted on 3/26/18. It is important to note the classroom was over capacity for approximately ten (10) minutes. At approximately 9:10 a.m., three (3) children were moved from this classroom and placed in the preschool classroom. At approximately 10:32 a.m., nineteen (19) children ages three-to-five (3-5) years old came inside from the outdoor play area and entered the preschool classroom. The preschool classroom has a square footage of accommodating only fourteen (14) children. A review of the child-care center’s diagram found this classroom was given a capacity of only fourteen (14) children during the change of location inspection conducted on 3/2/18. The preschool classroom was still over capacity at 11:32 a.m. when the surveyors exited the child-care center.

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 noted the following: 1. There was a bulging and ripped ceiling tile located in the one-year-old #1 classroom. It is important to note this classroom was not in use at the time of the renewal inspection. 2. One stained and bulging ceiling tile was found in the restroom located down the hall from the two-year-old classroom. 3. The ceiling tiles located in the hallway were stained brown from old water residue. 4. A ceiling tile located in the girls’ restroom was not secured to the tile frame.

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 toilet located in the boys' restroom contained urine and a large stain was noted behind the toilet. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 6 of 10 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on review of documentation, the director did not present for review the pre-trip inspections of the vehicles for April 8th through the April 25th.

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 a couple of tears in the diaper changing pads located in the infant classroom and the one-year-old classroom. 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 4. Premises Requirements.

General: Based on observation, the child-care center failed to have an adequate amount of materials/toys/equipment available to the children. The surveyor noted a few large Legos, one (1) baby doll, and two (2) books as the only items available to the children present in the infant classroom. The surveyor noted a few toys and materials in the two-year-old classroom but children did not have access to them because the area of the room was blocked by shelving units.

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 noted stains and loose dirt particles on crib sheets in five (5) cribs located in the infant classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child-care center failed to store bedding in a sanitary manner. The surveyor observed nine (9) nap mats covered with sheets stored on top of cubbies located in the school-age classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found an excessive amount of tape reside on the shelving units located in the school-age classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found all three (3) vehicles (2006 Ford, 2000 Dodge Ram, and 2007 Ford) used to transport children were in need of vacuuming. Each vehicle had an excessive amount of debris and dirt particles. The director stated the 2006 Ford was in need of repairs and had not been used since January 2019. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 7 of 10 Inspection Report Transportation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on observation, the surveyor found that there was no first aid kit on the 2006 Ford fifteen (15) passenger van. The director stated the van was in need of repairs and had not been used to transport children since January 2019.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on review of documentation, the surveyor found the 2006 Ford was last inspected on 5/19/17 and the 2007 Ford was last inspected on 3/22/18.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on review of documentation, the children's transportation record documentation presented for review only listed the children's first names. Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on observation, the surveyor found that there was no temperature measuring device in the refrigerator located in the two (2) year old classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 8 of 10 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following food contact surfaces unclean: 1. The refrigerator located in the two-to-three (2-3) year old classroom contained spills and loose food particles. 2. A cream colored substance was observed underneath the crisper drawer 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, the surveyor found one Playtex brand bottle in the refrigerator located in the infant classroom that was 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 during the renewal inspection conducted on 4/25/19, the surveyor found a partially full gallon of milk that had an expiration date of 4/20/19 in the refrigerator located in the two (2) year old classroom.

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 and interview, the surveyor noted cans of formula labeled with children’s names in the infant classroom. Interviews with staff found parents provide formula and nursery water but both are not premeasured.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation, the facility did not have a posted breakfast menu, lunch menu, or a snack menu. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 9 of 10 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, five (5) children's files did not contain current immunization certificates. All five (5) children had been enrolled in excess of thirty (30) days. Written Documentation In Compliance Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Observation, the surveyor entered the infant room and found six (6) children ages nine to eleven months old (9-11) with one (1) staff person. The staff to child ratio for infants is one (1) staff person for five (5) children. An observation of the two-year-old room found sixteen (16) children ages one to two (1-2) years old with two (2) staff persons. The staff to child ratio with the age of the youngest child being one-year-old is one (1) staff person for six (6) children. The group size with the age of the youngest child being one- year-old is twelve (12). This room was out of ratio and groups size at the time of the survey. Based on interview with the staff person in charge it was found that a staff person left the facility at 9:30 a.m. due to an emergency. The staff person on charge also indicated that when the surveyor arrived she had just left the kitchen to get her glasses out of the office. It was not determined as to how long these classrooms were out of ratio and group size. While the surveyor was present one (1) of the staff in the two-year-old room brought two (2) one-year-old children from the room and took them into another empty infant room. Equipment 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 2. Child Care Services.

General: Based on observation at the time of the visit, fifteen (15) children ages three to four (3-4) years old were observed napping in a classroom. There was only one (1) staff person present in the classroom. Let it be noted that this regulatory violation was found during a complaint investigation conducted on 7/30/18. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Equipment 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 at the time of the visit conducted on 9/26/18, ten (10) children ages five (5) months to one-year-old were observed in the infant room. There were six (6) cribs in the room with a child sleeping in each of them. There were two (2) infants sleeping in bouncey seats and two (2) children sitting on the floor playing. There were not enough cribs to accomodate the children in the room at the time.

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, upon arrival at the facility at approximately 1:13 p.m. on 7/30/18 the surveyor was let inside the facility by a male staff person. This same staff person remaind in the front room as the surveyor came inside the building. This staff person had a bag of garbage in his hands. The surveyor proceeded to conduct a tour of the facility. When the surveyor entered the infant room at approximately 1:16 p.m. there was one (1) staff person with six (6) infants ages three to eleven (3-11) months. Shortly after the surveyor had entered the infant room the male staff person seen at the front of the building came in the room. He indicated he was supposed to be in the room with the other staff person but had to change the trash in the room becasue of the smell of soiled diapers. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Director Requirements In Compliance 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 2. Child Care Services.

General: Based on Observation, upon entry into the facility on 7/30/18 a group of eight (8) school age children ages nine and ten (9 &10) years old were watching a movie called Dr. Suess' How the Grinch Stole Christmas. Let it be noted that this version of the movie is rated PG. The surveyor was unable to locate a posted planned program of activities in the room. The surveyor asked the staff person if there was a planned program of activities and the staff person stated she had not yet completed a lesson plan for the week.

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, upon entry into the facility on 7/30/18 a group of eight (8) school age children ages nine and ten (9 &10) years old were watching a movie called Dr. Suess' How the Grinch Stole Christmas. Let it be noted that this version of the movie is rated PG. The surveyor was unable to locate a posted planned program of activities in the room. The surveyor asked the staff person if there was a planned program of activities and the staff person stated she had not yet completed a lesson plan for the week. Therefore it could not be determined that the movie the children were watching was used for educational purposes and this movie is rated PG suggesting parental guidance when watching this movie..

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, upon entry into the facility on 7/30/18 a group of eight (8) school age children ages nine and ten (9 &10) years old were watching a movie called Dr. Suess' How the Grinch Stole Christmas. Let it be noted that this version of the movie is rated PG. The surveyor was unable to locate a posted planned program of activities in the room. The surveyor asked the staff person if there was a planned program of activities and the staff person stated she had not yet completed a lesson plan for the week. Therefore it could not be determined that the movie the children were watching was used for educational purposes and this movie is rated PG suggesting parental guidance when watching this movie..

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, this regulatory requirement was not met. The surveyor toured the outdoor play area during the visit and observed one (1) staff and thirteen (13) school age children using the space. One (1) child was observed pushing a plastic toy truck on the concrete. The other twelve (12) children were observed sitting on the concrete playing on their personal cellphones. This activity was not part of the children's planned program of activities and was not being used as an educational tool.

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 and interview, this regulatory requirement was not met. During a tour of the infant classroom at 10:25AM the surveyor observed three (3) infants asleep in cribs with large fluffy blankets. The staff person in charge stated, "I have written permission from the parents, so I thought this was okay". An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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 and interview, this regulatory requirement was not met. The surveyor toured the outdoor play area during the visit and observed one (1) staff and thirteen (13) school age children using the space. One (1) child was observed pushing a plastic toy truck on the concrete. The other twelve (12) children were observed sitting on the concrete playing on their personal cellphones. The plastic toy car that one (1) child was observed playing with was the only piece of equipment on the playground. The staff person in charge pointed to a shelf in the school age classroom during the visit and stated, "Here's the toys for them to take outside". The surveyor observed two (2) hula-hoops (one (1) was broken) and five (5) or six (6) plastic toy trucks on the shelf; no additional materials available.

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, upon arrival at the facility, the only two (2) staff on the playground were sitting next to the fence on one side of the playground. A tour of the playground found that there was an area around the corner of part of the building that could not be seen from where the two (2) staff were sitting. The children on the playground were ages three (3) years to School-age. Staffing Requirements In Compliance 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 Interview, on 5/10/18, a school-age child was signed in the facility at 3:00 p.m. by the van monitor. The children were then taken outside to the playground. The child's mother arrived to pick up the child at 3:30 p.m. but was told by the two (2) staff on the playground that her child was not there yet. The child's mother waited for the facility's van to return after their second van run only to find that her child was not on the van. The van arrived at the facility from the second van run at 3:46 p.m. One of the staff then got up and walked around that side of part of the building and found the child playing in a group of other children. The two (2) staff on the playground stated that niether saw the child come out to the playground at 3:00 p.m. The two (2) staff were not aware that the child was present on the playground for forty-six (46) minutes.

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, this regulatory requirement was not met. Upon arrival (8:55AM), the facility’s entrance door was locked. The surveyor knocked on the front door a few times and the staff person working in the two (2) year old classroom came to the front door to open it. The staff person then went to the preschool classroom doorway in an attempt to locate the staff person in charge. The staff person in charge was observed exiting the kitchen area. The surveyor followed the staff person that opened the door down the hallway and into the two (2) year old classroom. A tour of the classroom revealed that nine (9) children had been left without adult supervision while the staff person left the room to open the door for the surveyor. All of the children were observed awake and playing in the classroom. It is important to note that the two (2) year old classroom is not visible from the front door or the preschool doorway. Staffing Requirements In Compliance General Administration 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, it was found that the file for an employee hired on 4-1-16 contained evidence of a TB skin test being completed on 11-14-15. This date is not within the two-year timeframe required by the regulation. The file for an employee hired on 4-12-18 did not contain evidence of a TB skin test or screening being completed. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the files for a driver hired on 4-12-18 and a van monitor hired on 11-30-17 did not contain evidence of current certification in first aid and cardiopulmonary resuscitation (CPR). The owners stated that the two (2) employees have transported children together on at least one (1) occasion in the last two (2) weeks.

Open Not marked corrected in the state record

Category: health medication. 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 1) the ECE-TRIS record and file for an employee hired on 8-8-11 contained evidence of zero (0) hours of training being completed during the last full training year; 2) the ECE-TRIS record and file for an employee hired on 8-8-11 contained evidence of the Pediatric Abusive Head Trauma training (PAHT) being completed on 1-29-13, which is not within the five-year timeframe required by the regulation; 3) the ECE-TRIS record and file for an employee hired on 3-21-13 contained evidence of only seven and a half hours of training being completed during the last full training year; 4) the ECE-TRIS record and file for an employee hired on 10-10-12 contained evidence of only seven and a half hours of training being completed during the last full training year; 5) the ECE-TRIS record and file for an employee hired on 1-30-14 contained evidence of only ten (10) hours of training being completed during the last full training year; 6) the ECE-TRIS record and file for an employee hired on 3-17-15 contained evidence of only one and a half hours of training being completed during the last full training year; 7) the ECE-TRIS record and file for a second employee hired on 8-8-11 contained evidence of only six (6) hours of training being completed during the last full training year; 8) the ECE-TRIS record and file for a second employee hired on 8-8-11 contained evidence of the PAHT training being completed on 3-7-13, which is not within the five-year timeframe required by the regulation; 9) the ECE-TRIS record and file for an employee hired on 4-1- 16 contained evidence of only four (4) hours of training being completed during the last full training year; 10) the ECE-TRIS record and file for a third employee hired on 8-8-11 contained evidence of only four (4) hours of training being completed during the last full training year; 11) the ECE-TRIS record and file for an employee hired on 3-26-15 contained evidence of only four (4) hours of training being completed during the last full training year; 12) the ECE-TRIS record and file for an employee hired on 2-3-17 contained evidence of only six (6) hours of additional training being completed during the first full year of employment; 13) the ECE-TRIS record and file for an employee hired on 2-3-17 did not contain evidence of the PAHT training being completed during the first year of employment; 14) the file for an employee hired on 11-30-17 did not contain evidence of the six-hour cabinet- approved orientation training being completed. A review of ECE-TRIS found that this employee has not yet been entered into the system.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the file for a driver hired on 4-12-18 did not contain evidence of a Kentucky driving history record being requested or completed. The owners stated that the employee has transported children since his hire date. 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 6. Sleeping and Napping Requirements.

General: Based on Observation and interview, this regulatory requirement was not met. During a tour of the infant classroom at 9:05AM the surveyor observed three (3) infants asleep in cribs with large fluffy blankets. Two (2) of the children were identified as four (4) month old twins. They were observed sleeping in separate cribs on top of a fluffy blanket and covered up with a second fluffy/loose blanket. The third child was identified as an eleven (11) month old. This infant was observed asleep in a crib with a fluffy loose blanket covering the child from head to toe. The surveyor toured the infant classroom a second time at 9:30AM and observed the same three (3) infants sleeping this way. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 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 4. Premises Requirements.

General: Based on Observation, this regulatory requirement was not met. The surveyors arrived at 8:55AM and observed the exterior door propped open in the preschool classroom. The door did not contain a screen. Hygienic Practices In Compliance First Aid/Medication Not In Compliance

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, this regulatory requirement was not met. The first aid kit was found to be sitting on a shelf under the CD player in the school age classroom. This made the first aid kit accessible to the children. Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

Based on observation and interview, this regulatory requirement was not met. An inspection of the facility outdoor play area found that it did not contain any equipment. The area consists of a concrete surface and chain link fencing around it. The surveyor asked the staff person in charge during the visit what toys and equipment are used when the children go out side to play. The staff person in charge responded by stating, "They just go out for a few minutes to run around; we have some outdoor equipment, but it's inside a temporary storage unit in the parking lot".

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 and interview, this regulatory requirement was not met. An inspection of the Ford 2007 fifteen (15) passenger van found numerous dirt particals and small pieces of trash (candy wrappers, paper plate and styrofoam cup), lying on the floor. The staff person in charge stated during interview that the van is used daily to transport children. Transportation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report 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, this regulatory requirement was not met. An inspection of the refrigerator in the infant classroom found one (1) infant bottle that was not labeled with a child's name and was not covered. 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, this regulatory requirement was not met. Four (4) children (enrollment dates: 12/4/17, 9/25/17, 7/20/17 and 7/21/17) had no immunization record on file and two (2) children (enrollment dates: 8/9/17 and 10/9/15) had immunization certificates that were no longer current as of 6/13/16 and 8/14/17.

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, this regulatory requirement was not met. The following was found: 1. Two (2) of the children’s files/enrollment documentation did not contain information for the family’s preferred hospital. 2. One (1) child's file did not contain information regarding the child’s general health status & medical history including, but not limited to allergies and activity restrictions. 3. One (1) child’s file/enrollment paperwork did not have physician contact information. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation and observation, this regulatory requirement was not met. The surveyors entered the facility at 8:55AM and observed thirty (30) children present; however, only fifteen (15) children had an arrival time documented. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Posted Documentation 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 8. General.

General: Based on Review of Documentation, this regulatory requirement was not met. The two (2) year old classroom had a schedule of daily activities posted that was dated April 23 – 27, 2018; therefore, it was no longer current. Animals 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, it was found that there were eight (8) large glass windows making up two (2) sides of the Two Year Old classroom. The windows went from the ceiling to a window sill approximately two (2) feet from the floor. The facility did not have documentation indicating that the windows were shatterproof, nor were the windows inaccessible to the 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, it was found that there were multiple ceiling tiles throughout the facility that were stained due to past water damage. Some of the tiles had a thin layer of white paint over the stains to disguise rather than repair the issue. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on Observation, it was found that the changing pad in the Infant classroom was torn in the middle, exposing the foam. 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 the chain link fence around the outdoor playground was not adequately anchored to the concrete foundation. The bottom of the fence was very loose and easily pushed out, creating entrapment and elopement hazards. In addition, the fence post on the right side of the playground did not go all the way to the building, leaving a gap of approximately four (4) to five (5) inches. Food Service In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, there were six (6) infants with one (1) staff person in the infant classroom. General Administration In Compliance Director Requirements 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

Category: ratio. Open / not marked corrected.

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

General: Based on Review of Documentation, there were three (3) children's files that did not contain immunzation certificates. Based on the children's enrollment forms, they were enrolled on 7/24/17, 2/17/17, and 10/22/15.

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, interview, and record review, upon arrival to the facility there were eighteen (18) children in the front preschool room ranging in age from one to three (1-3) years-old. When the staff were interviewed about the ages of the children they stated the youngest child was two (2) years-old. After the surveyor reviewed some of the children's records it was found that the youngest child in the group was one (1) year-old. The facility was out of group size in this classroom with the youngest child being one (1) year-old. The group size shall not exceed twelve (12) children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 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 Observation and interview, the teachers in the upstairs front preschool room and the teacher in the three to four (3-4) year-old room in the basement were not aware of some of the children's names in their care. The surveyor asked the teachers for the names and ages of specific children in the front preschool room (upstairs) and they were unsure, so the director had to intervene and tell the staff the children's names. The staff stated that the children in the front preschool room were two to three (2-3) years-old and after a review of the children's files some of the children were one (1) year-olds. The staff in the three to four (3-4) year-old room in the basement was unsure of a child's name and the other children in the class spoke up and told the teacher the child's name. Children's Records 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 Interview, it was found that the building did not have adequate heat as required. The building has multiple units which control separate areas of the facility. However, one unit was not working, making that area of the building extremely cold with temperatures in the (40) forties. All other aspects of the building were in compliance and well heated. 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 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on Review of Documentation, it was determined that during the intital licensure the area of the facility used for a classroom for ages 3-5 was measured and approved for (20) twenty children. Upon the site visit completed there were (24) twenty-four children counted in the classroom which is only approved for (20) twenty children based on the square footage of the room.

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, it was found that (4) four classrooms did not met the minimum temperature requirements for a facility. The temperature must be between sixty-five (65) to seventy-five (75) degrees during winder months. However, the temperature showed to be in the (40) forties in all four (4) rooms. These rooms include an infant (44 degrees), toddler (45 degrees), two year old room (42 degrees) and secondary entry space (46 degrees). This was confirmed by a temprature gun which was used on the internal walls of each room. Children had been moved from these areas into adequately heated rooms. However, these rooms are part of the licensed space.

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, during a tour of the facility on 11/17/17 the infant room was out of ratio. There were seven (7) infants present with one (1) staff supervising them. Based on interview the infants ranged in age from eight (8) months-old up to ten (10) months-old. The staff member in the infant room stated that she had been out of ratio for about twenty (20) minutes while the other staff member went on her break. The staff in charge was in the kitchen upon the surveyor's arrival and said that she would go in the infant room to cover the rest of the staff member's break. 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, on 10/11/17 at approximately 11:30 AM there were eighteen (18) children in the front preschool room with one (1) staff supervising the children. The children ranged in age from three to four (3-4) years-old. At approximately 11:40 AM a second staff arrived and went into the preschool room with the other staff member to correct the ratio issue. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report General Administration 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 6. Reports.

General: Based on Interview and record review, the facility failed to notify the cabinet within twenty-four (24) hours from the time of a vehicular accident that occurred when the child care center was transporting a child. On 9/15/17 one (1) of the daycare vans was in an accident at approximately 5:30 PM. The daycare van contained a four (4) year-old child. The child was being transported to his home. Based on interviews the child was not harmed. The facility faxed over a written statement on 10/04/17 in regards to the accident. This was not within twenty-four (24) hours of the vehicular accident. Transportation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

Based on interview and record review, on 9/15/17 a four (4) year-old child was transported to his home by the director of the daycare in her personal vehicle. An attempt to deliver the four (4) year-old to his home was made by the facility van, and according to the van driver, no one was home. The four (4) year-old child was brought back to the daycare and then taken home by the director in her personal vehicle. The director's personal vehicle was not an approved vehicle to transport children.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on Observation, the one (1) year-old class contained seven (7) children and one (1) staff member supervising the group. Based on interview with the staff she had been alone supervising the seven (7) children for about twenty (20) minutes. During the complaint investigation the director corrected the ratio issue in the one (1) year-old classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 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 Interview, a three (3) year-old child was placed on a school bus by a daycare staff member around 11:56 AM on 9/11/17 with urine soaked pants. Based on interview the child had an accident while waiting on the school bus to pick him up. The daycare staff member was aware that the child had an accident and notified the bus driver. Based on interview the child was on the bus for approximately twenty (20) mintues with urine soaked pants. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview, a three (3) year-old child was placed on a school bus by a daycare staff member around 11:56 AM on 9/11/17 with urine soaked pants. Based on interview the child had an accident while waiting on the school bus to pick him up. The daycare staff member was aware that the child had an accident and notified the bus driver. Based on interview the bus driver allowed the child to ride the bus to school. Based on interview the child was on the bus for approximately twenty (20) mintues with urine soaked pants. A child shall be helped with personal care and cleanliness based upon their developmental skills. Based on interviews this three (3) year-old child is non-verbal and would need help with toileting. 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, a child enrolled on 3/13/17 did not have a physician's name or phone number listed on their enrollment form. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a three (3) year-old child that attends the child care facility leaves the facility around 11:56 AM each day to get on a school bus to go to Northern Elementary for preschool. The same child comes back to the child care facility by a school bus around 3:27 PM each day. The daily attendance records for this child do not reflect the child leaving (at approximately 11:56 AM) or returning to the facility (at approximately 3:27 PM). The attendance records show the child arriving at the facility in the morning and being signed in and then leaving in the evening and being signed out at the end of the day. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3

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, there was a child who was so tired he could not partipate in the classroom activities but he was not allowed to rest. The child was first obeserved sleeping while sitting in a chair and his head on the table at 9:10 AM. The stafff person in the room got him up and asked him to help clean up. He holds the staff's hand and walks around with her with his eyes closed. When she lets go of his hand he lays down on the floor and falls back to sleep. The staff sits him up but he does not open his eyes. When the staff person lets go of him he lays back down; this happens a few times. He is still struggling to stay awake at 9:28 AM. During the exit conference the director stated that the child doesn't get to sleep at home at night because his mother is being beat by her boyrfriend. Also, in the two-year-old room (the room near the infant room) the children's coats were hanging so that they were touching and an accordian style baby gate was being used in the window. The accordian style gate is a pinching hazard and cannot be used. In the infant room the staff makes bottles as they are needed to feed the infants. Each child has one bottle sent by the parents and it is reused throughout the day. The staff person stated she uses the sink in the classroom to wash the bottles. The proper washing technique was not followed. Employee 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, staff persons hired 3/21/13 and 1/25/12 did not have evidence of a professional development plan on file in the facility.

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 determined that a staff person hired 4/19/17 did not have evidence of proof of education on file in the facility.

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, there were six (6) children in the one-year-old room. This room has a capacity for only five (5) 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, the window in the cafeteria was open. There was a screen on the window but it did not fit or was not placed in the opening properly. There were gaps on each side of the screen. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 8 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, in the one-year-old room the sink and changing table were positioned so that the staff person cannot supervise the children while using them. The changing table and the sink are in a bathroom separate from the classroom. At 10:10 AM the staff person wiped a child's nose and went into the bathroom to wash her hands. She was in the bathroom for less than a minute. She then went back into the bathroom at 10:12 AM to change a diaper. While changing diaper she spoke to the children in the room but could not properly supervise them. She returned to the room at 10:14 AM but immediately went back into the bathroom to change another diaper. The staff person in charge stated the classroom staff was supposed to pull the changing table closer to the bathroom door but that would not completely remedy the supervision issue. Staffing Requirements In Compliance General Administration In Compliance Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation and interview, there was approximately twenty (20) minutes at the time of the survey that there was no staff who could carry out the director's duties in her absence. The surveyors arrived at the center at approximately 9:00 AM and the staff indicated that the director had just left. The staff files were locked and nobody present had a key. The director returned to the center at approximately 9:20 AM.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, staff person hired 3/21/13 did not have evidence of an annual evaluation on file in the facility. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 8 Inspection Report

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, a staff person hired 4/19/17 had listed an address in Georgia as a previous residence in the past five (5) years. There was no evidence of a background check from Georgia for the staff person on file in the facility.

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. Staff persons hired 8/8/11 and 3/21/13 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. 2. Staff person hired 3/26/15 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 10/6/16 and the current results were not obtained until 11/7/16. 3. Staff person hired 8/11/11 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 3/18/17 and the current results were not obtained until 4/10/17. 4. Staff person hired 8/8/11 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 4/4/16 and the current results were not obtained until 2/7/17. 5. Staff person hired 3/7/15 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 12/8/16 and the current results were not obtained until 2/1/17. 6. Staff person hired 1/25/12 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 3/18/17 and the current results were not obtained until 4/10/17. 7. Staff person hired 12/29/14 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 11/7/16 and the current results were not obtained until 1/23/17. 8. Staff person hired 8/8/11 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years. The previous T.B. results expired 5/15/15 and the current results were not obtained until 6/10/15. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 8 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, the following was found: 1. The van driver hired 8/8/11 and the monitor hired 4/19/17 did not have evidence of current First Aid/CPR certification on file. In an interview with the Director it was stated that the two staff are the only staff on the van when children are transported. 2. On 4/26/17 the van driver hired 12/8/16 and the monitor hired 3/21/13 were observed to be the only staff on the van while transporting children to the facility. Neither staff person had evidence of current First Aid/CPR certification on file.

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, the following was found: 1. Staff persons hired 8/11/11, 3/17/15, 3/21/13 and 10/10/12 did not have evidence of completing the Pediatric Abusive Head Trauma training within the first year of employment. A review of ECE-TRIS records supports the information found during the survey. 2. Nine (9) out of thirteen (13) staff persons employed for more that one (1) year did not have evidence of fifteen (15) hours of annual training on file for the last full year of employment. A review of ECE-TRIS records supports the information found during the survey.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that three (3) of the four (4) staff designated as van drivers did not have evidence of an annual driving record on file in the facility. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 8 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, in the two-year-old room (the room near the infant room) the teacher helped the children make a circle on the floor and gave them each a book at 9:32 AM. At 9:46 AM the children were expected to continue sitting still and looking at books individually. The staff repeatedly told the children to sit down and stop moving around.

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, in the two-year-old room (the room adjacent to the two-year-old-room) the children were watching Looney Toons on the television. The video was not part of the planned program of activity. 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, in the middle bathroom there was a disinfectant spray sitting on the toilet tank, accessible to children. Also, in this space there was a mop bucket filled with cleaner and water in the tub and accessible to 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, in the peach preschool bathroom there was an area of the wall that had been patched with dry wall mud but had not been painted. In the yellow preschool bathroom the paint on the window sill was chipping. The linoleum around the toilet in the middle bathroom was discolored. The staff person in charge stated there had been discussions of replacing the linoleum. In the one-year-old room the carpet seam between the classroom and the bathroom was raveled out and pulling up from the floor. In the infant room there was a brown substance on the wall in the gap between the sink vanity and the wall. In the cafeteria the walls were dirty with scuffs and food splatter. Also in the cafeteria the air vent in the floor did not sit properly so subfloor was exposed and it was dusty around the vent. In the pre k room there was an area around a wall vent that was patched but not yet painted and multiple areas of the wall with crayon marks. In the school age room there was a black substance on the low ceiling near the air vents.

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 sink faucet in the one-year-old bathroom had a build up grime in the cold water knob and on the caulk behind the sink.

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, there were two (2) bathrooms adjacent to the preschool room, a peach bathroom and a yellow bathroom. Both bathrooms were lacking paper towels at the sink. Also, the water was tested at the sinks in both bathrooms and the water temperature was eighty (80) degress Fahrenheit. The water temperature in the two-year-old room (the room near the infant room) was also too cool at eighty-five (85) degrees Fahrenheit. A calibrated thermometer was used to measure the water temperature.

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, in the peach preschool bathroom the toilet had urine in it and it had not been flushed. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, a child in the one-year-old room did not have his hands washed following a diaper change. Also, in the two-year-old room (the room adjacent to the preschool room) a child had an accidnet where his pants were wet with urine. He did not wash his hands after he was cleaned up. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 8 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, in the one-year-old room the staff changed a diaper and did not wash her hands after; she immediatley changed another diaper, She did change gloves between diaper changes. In the two-year-old room (the room adjacent to the preschool room) a child had a accident where he urinated and his pants were wet. The staff person changed his clothes but did not wash her hands after changing him or handling the wet clothes.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, the diaper changing mat in the yellow preschool bathroom had a build up of dirt/grime in the textured part of the mat. In the two-year-old room (the room near the infant room) the diaper changing mat was torn. Also, in the one-year-old room the diaper changing mat was torn. 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, on the big playground there was a piece of carpet near the picnic table. The carpet was somewhat covered with mulch but not covered enough to prevent it from being a tripping hazard. On the middle playground there were multiple plastic water bottles and various other debris. 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 preschool room the areas of the picture surface of the train table was peeled off, the pillows in the book area had dark spots/stains, and a pink doll stroller had a large brown spot/stain on the cloth seat. In the two-year-old room (the room near the infant room) several of the children's books had torn pages and missing covers and the pink polka-dot pillows had dark stains/spots. The center used two (2) vans to transport children, A 2006 Ford and a 2007 Ford. Both of these vans had trash and debris inside and the seats on both were torn and had the inner foam exposed. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 6 of 8 Inspection Report

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 Review of Documentation, the refrigerator and freezer in the cafeteria had food spills and crumbs on the inside and was sticky on the outside of the door. The refrigerators and freezers in the kitchen were also dirty with food spills and crumbs. Transportation 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, a copy of each child's personal information including name, address, phone number and names of people who could receive the child was not maintained on either of the center's vans.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, the 2006 Ford had a vehicle inspection dated 3/29/16. There was no inspection for this vehicle within the past year.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Observation, there was no first aid kit on the 2007 Ford. 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 Meal Requirements.

General: Based on Observation, and interview, the staff in the infant room prepared the infants' bottles. Two (2) diaper bags were observed to contain one (1) bottle and can of formula. The staff person stated she used the bottle, formula from the can, and tap water from the classroom sink to prepare each bottle. Children's Records 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 3. Records.

General: Based on Review of Documentation, five (5) out of the ten (10) children's file presented for review did not have a current immunization certificate on file in the facility. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 7 of 8 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, children enrolled 2/21/17, 8/10/15 and 2/21/17 did not have a physician’s name and contact information or information for a preferred hospital signed by the parent on file in the facility. 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.

Based on review of documentation there was no evidence of practiced earthquake drills. Posted 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 2. General.

Based on observation the Consumer Product Safety Program information was not posted. Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, there were fourteen (14) preschool children present with one (1) teacher. Per interview with the staff person, the youngest child was three (3) years old. Director Requirements 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

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. At the time of the visit (8:01AM) it was found that one (1) staff person was caring for a group of seventeen (17) children (age range: 3 - 13 years old) 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 five (5) children. The staff person in-charge was observed supervising a group of ten (10) children in the front lobby that were waiting to get on the van. A second staff person was observed working in the preschool classroom during a second walk thru at 8:09AM. The staff person stated that she had been working with the school age children in the basement and switched classroom once the school age children got on the van for school. 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 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

General: Based on Observation, it was found that at 6:20 p.m., a three-year-old child and a four-year-old child were sitting on the floor in the Preschool classroom wearing their coats and backpacks. The director told the surveyors that the children were scheduled to be picked up by their mother between 7:30 p.m. and 8:00 p.m. One of the children was overheard to say that he was hot. 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, it was found that the children in the Preschool classroom were watching "Shimmer and Shine" on television. The director stated that the children were watching television to pass the time until they were picked up. The television show was not being used as an educational tool. 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 2:120 · 922 KAR 2:120. Section 3. General Requirements.

General: Based on Review of Documentation, it was found that the children in the Preschool classroom were watching "Shimmer and Shine" on television. Television time is not noted on the daily schedule or the dated schedule of daily activities.

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, a monitoring visit was conducted on 2/3/17 and the following was found. The surveyor entered the two-year-old classroom at approximately 10:25 a.m. and observed a total of seven (7) children with one (1) staff person. The surveyor asked the staff person for the age of the youngest child present in the group. The staff person told the surveyor that all of the children were two (2) years old. The surveyor asked the staff person for the names of each child and then the surveyor checked the names of each child listed on the Provider Active Enrollments Report. The surveyor found that based on the names given that one child present in the group was a one-year-old. The staff person stated that she did not realize that the child was not two (2) years old. The surveyor asked how long she had been out of ratio. She replied, “Since 9:15 a.m.” During the exit interview with the Director it was revealed that the staff person in the two-year-old classroom had given the surveyor the wrong name of the one-year-old child. The Director confronted the staff person and told her the name of the one-year-old child present in her group. The staff person replied, “Oh, I didn’t know his last name.” The surveyor checked the Provider Active Enrollments Report again and found that the child the Director had now identified was twenty (20) months old. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 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 Observation and interview, the director failed to provide for the health, safety and comfort of each child in care. During the tour of the preschool room the surveyor asked the two staff persons in the room to identify a child seated at the table. Neither of the staff members could identify the child by name. One staff member asked the child's brother to provide the child's name. Further, during a tour of the two-year-old room the surveyors asked the staff member to identify a male child. The staff person provided a name and identified the child as a two-year-old. Upon further interview the director indicated that the staff person had provided the wrong name and identified the child as having a different last name. The director also identified the child as a two-year-old. After reviewing records it was found that the child was actually a one-year-old. 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 Review of Documentation, during the monitoring visit conducted on 2/3/17 the surveyors found that there were no daily planned activities (lesson plans) posted in the following classrooms: infant, toddler, and preschool. A lesson plan was posted in the two-year-old classroom; however, it was dated 1/16/17-1/20/17. The director stated that the staff know to post lesson plans because they had just had a training from Child Care Aware representatives last week.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the facility failed to ensure that a child not be required to sit for a prolonged period of time while waiting for an activity to start. During an unannounced inspection at the facility it was found that four (4) one-year-old children were required to sit at the table with no activity while waiting for lunch for more than fifteen (15) minutes. In an interview the staff person indicated that the children were seated at approximately 10:30 AM. At 10:40 AM two of the children were observed going to sleep while sitting in their chairs. The staff person was observed slapping the table and talking loudly to the children to try and keep them awake while waiting for their food. This continued as the children slouched and tried to put their heads down on the table to sleep. Lunch was delivered to the room at approximately 10:45. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, a monitoring visit was conducted on 2/3/17 and the following was found. The surveyor entered the two year old classroom at approximately 10:25 a.m. and observed a total of seven (7) children with one (1) staff person. The surveyor asked the staff person for the age of the youngest child present in the group. The staff person told the surveyor that all of the children were two (2) years old. The surveyor asked the staff person for the names of each child and then the surveyor checked the names of each child listed on the Provider Active Enrollments Report. The surveyor found that based on the names given that one child present in the group was a one-year-old. The staff person stated that she did not realize that the child was not two (2) years old. The surveyor asked how long she had been out of ratio. She replied, “Since 9:15 a.m.” During the exit interview with the Director it was revealed that the staff person in the two-year-old classroom had given the surveyor the wrong name of the one-year-old child. The Director confronted the staff person and told her the name of the one-year-old child present in her group. The staff person replied, “Oh, I didn’t know his last name.” The surveyor checked the Provider Active Enrollments Report again and found that the child the Director had now identified was twenty (20) months old.

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 and interview, the director failed to provide for the health, safety and comfort of each child. On 12/9/16 the director reported an incident that occurred earlier that afternoon (12/9/16) by faxing a written statement to the DRCC office. The director stated that the staff person (hire date: 5/9/16) working in the school age classroom in the basement came upstairs "cussing and fussing" because a ten-year-old male child had hit her in the eye. The director further stated that the staff person hit the child back as a result. Director stated that the child's parent was contacted to come to the facility, the police were called and the staff person was terminated as a result of the incident. It is important to note that on 12/12/16 the director stated during a phone interview that the staff person hit the ten-year-old male child in the shoulder as a result of him hitting her in the eye; however, a review of facility video footage of the incident revealed the following: At 4:08:08PM the ten-year-old male child and his younger brother were observed pushing an air hockey table around in the back corner of the classroom. The ten-year-old is then observed following his younger brother around the classroom. When the ten-year-old child walks beside the staff person she reached out with her left arm to stop him from walking by and grabbed his arm with her right hand. The child tried to pull away from the staff person and the two (2) of them got into a physical altercation. The staff person swung the child around on the other side of her, put him in a head-lock with both of her arms and then pulled him over to the other side of the room out of the view of the camera. Five (5) seconds later the child re-appeared on the video footage. The staff person re-appeared on the video footage at 4:09:16PM. She walked straight over to the same child, grabbed him around the neck and began punching him on the back of his neck and head area. The two (2) of them got in another physical altercation and then the staff person exited the classroom. The child punched the staff person in the back as she exited the classroom. The other children present in the school age classroom at the time of the incident are observed to be visibly upset and scared during the incident and this was also confirmed during an interview with staff. Staff stated that children in the school age classroom were crying, scared and asking to call their parents as a result of the incident. Staff also stated during the investigation that they heard the staff person stomping up the stairs, hitting the walls and screaming profanity when she came upstairs calling out for the director. The director pointed to a hole in the wall in the front lobby during the investigation and stated that the staff person punched the wall with her fist because she was so mad. The director stated during interview, "I could not go downstairs with the school age children because I was holding a baby and helping the photographer that was at the facility taking pictures, but I instructed someone else to go down there. I told the staff person (hire date: 5/9/16) to stay in the lobby while I was stepped out to get someone, but she went back downstairs and hit the child again." Interviews with staff and parents during the investigation revealed that the situation further escalated when the child's parents were contacted to come to the facility and the staff person's family members arrived at the facility. Administrative staff at the facility, the director and a co-owner that was also identified as being present, allowed a verbal altercation to occur between the adults in the front lobby of the facility and it could be heard by the children present in the building. This verbal altercation was not stopped until police arrived and separated the adults to different areas. 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 Review of Documentation and interview, this regulatory requirement was not met. On 12/9/16 the director reported an incident to the DRCC office involving a staff person and a ten (10) year old male child on 12/9/16. The staff person that had been working in the school age classroom in the basement came upstairs "cussing and fussing" because a ten (10) year old male child had hit her in the eye. A review of facility video footage of the incident revealed two (2) separate physical altercations between the staff person and the ten (10) year old child. During the first incident, the staff person reached out to stop the child from walking by her and grabbed his arm. The child tried to pull away from the staff person and the two (2) of them got into a physical altercation. The staff person swung the child around on the other side of her, put him in a head-lock with both of her arms and then pulled him over to the other side of the room out of the view of the camera. Five (5) seconds later the child re-appeared on the video footage alone. The staff person re- appeared on the video footage at 4:09:16PM and this is when the second incident occurred. The staff person walked straight over to the same child, grabbed him around the neck and began punching him on the back of his neck and head area. The two (2) of them got in another physical altercation and then the staff person exited the classroom. The child punched the staff person in the back as she exited the classroom. The other children present in the school age classroom at the time of the incident were observed to be visibly upset and scared during the incident. Staff stated during the investigation that they heard the staff person stomping up the stairs, hitting the walls and screaming profanity when she came upstairs calling out for the director. The director pointed to a hole in the wall in the front lobby during the investigation and stated that the staff person punched the wall with her fist because she was so mad. The director stated during interview, "I could not go downstairs with the school age children because I was holding a baby and helping the photographer that was at the facility taking pictures, but I instructed someone else to go down there. I told the staff person (hire date: 5/9/16) to stay in the lobby while I was stepped out to get someone, but she went back downstairs and hit the child again." Interviews with staff and parents during the investigation revealed that the situation further escalated when the child's parents were contacted to come to the facility and the staff person's family members arrived at the facility. Administrative staff at the facility, the director and a co- owner that was also identified as being present, allowed a verbal altercation to occur between the adults in the front lobby of the facility and it could be heard by the children present in the building. This verbal altercation was not stopped until police arrived and separated the adults to different areas.

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

General: Based on Review of Documentation and interview, this regulatory requirement was not met. On 12/9/16 the director reported an incident that occurred earlier that afternoon (12/9/16) by faxing a written statement to the DRCC office. The director stated that the staff person (hire date: 5/9/16) working in the school age classroom in the basement came upstairs "cussing and fussing" because a ten (10) year old male child had hit her in the eye. An interview with staff during the investigation and a review of facility video footage of the incident revealed that no other staff were working in the basement at the time of the incident (4:08PM). Staff stated that they heard the staff person stomping up the stairs, hitting the walls and screaming profanity when she came upstairs calling out for the director. The director made arrangements for a staff person on the main floor to go downstairs with the school age children; however, the school age children were left alone and unsupervised for an undetermined amount of time while this arrangement was being made. It is important to note that an interview with staff during the investigation and a review of facility video footage found that the children in the school age classroom were visibly upset and scared during and after the incident. 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 and interview, this regulatory requirement was not met. Upon arrival ( 12/16/16 at 10:00AM) the director escorted the surveyor and the DCBS Worker on a tour of the facility. During a tour of the first classroom (preschool), the director identified the names of two (2) staff present with fifteen (15) children; however, a second tour through the same classroom a few minutes later revealed that only one (1) staff person was present in the classroom with fifteen (15) children. A staff person that had been working in the kitchen was now observed working in the preschool classroom as the second staff person. A review of facility time cards and an interview with staff revealed that the staff person that had been present in the preschool classroom clocked out and left for the day at 9:49AM. The director stated during interview, "I thought she was in the preschool room when we first walked through, but she wasn't. She was sent home early, but I don't know why." Therefore, the preschool classroom was not in compliance with staff-to-child ratios from 9:49AM to approximately 10:10AM because one (1) staff person (co-owner) was observed caring for fifteen (15) children (fourteen (14) three - four (3 - 4) year olds and a school age child) alone until the kitchen staff person stepped into the classroom. The youngest child in the group was three-year-old, making the minimum staff to child ratio one staff person for twelve (12) children. The facility exceeded the staff/child ratio by three (3) children. General Administration 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 6. License Issuance.

General: Based on Review of Documentation, observation and interview, the facility failed to comply with regulatory requirements. Inspections completed on 10/11/16, 6/20/16, 4/6/16, 5/5/15 and 4/22/15 found regulatory violations that included failure to meet minimum staff-to-child ratios. This same violation was found during this inspection despite plans of correction that indicated steps were taken to correct the violations.

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, observation, and interview, the facility failed to cooperate with the state agency during an investigation. The following was found: 1. On 12/12/16 the director stated during a phone interview that a staff person hit a ten (10) year old male child in the shoulder on 12/9/16 as a result of him hitting her in the eye; however, a review of facility video footage of the incident revealed the staff person and the child getting into two (2) different physical altercations in the classroom. Although the ten- year-old child may have hit the staff person in the eye, the video surveillance footage clearly shows that the staff person initiated the altercation during both incidents and she did a lot more to the child than "hit him in the shoulder". 2. The facility failed to cooperate with the cabinet during an investigation when the director provided false information. Upon arrival (10:00AM) the director escorted the surveyor and the DCBS Worker on a tour of the facility. During a tour of the first classroom (preschool), the director identified the names of two (2) staff present; however, a second tour through the same classroom a few minutes later revealed that only one (1) staff person was present in the classroom with fifteen (15) children. The other staff person that had been present in the preschool classroom clocked out and left for the day at 9:49AM. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation and interview, the following was found: 1. The licensee/co-owners failed to operate the facility according to the regulations as evidenced by a pattern of regulatory deficiencies regarding staff-to-child ratios. Inspections completed on 10/11/16, 6/20/16, 4/6/16, 5/5/15 and 4/22/15 found the licensee/co-owner failed to operate the facility according to the regulations regarding minimum staff-to-child ratios. It is important to note that the licensee/co-owners work with the children on a regular basis. 2. As evidenced in the information provided within this inspection report, the licensee/co-owner was present in an adjacent classroom during a verbal altercation between a staff person and a child's parents; however, he did not intervene or do anything to diffuse the situation. The director (also co-owner) was identified as being present during the verbal altercation; however, this situation was allowed to go on until police arrived and separated the adults to different areas. Director Requirements 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 following was found: 1. At the time of the survey it was found that the facility failed to offer appropriate programming for the school age child (twelve (12) year old) that was observed watching cartoons with the children in the preschool classroom. This child was grouped with the preschool children (age range: 3 -4 years old) and followed the same programming. The staff person in charge stated that the school age child was present at the facility because she was suspended from her school. 2. No planned programming for children in the one (1) year old classroom and two (2) year old classroom was observed. During a tour of the facility the surveyor observed a chair being used to prop open the door between these two (2) classrooms. The children in these two (2) rooms (thirteen (13) children total) were observed running back and fourth between the two (2) rooms and chasing each other. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, this regulatory requirement was not met. Upon the surveyor’s arrival to the facility a group of fifteen (15) children (fourteen (14) three - four (3-4) year olds and a school age child) were in the preschool room watching cartoons. This television show was not part of the children’s planned program of activities and it was not an educational tool for the children.

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, at approximately 10:15 a.m. the surveyor observed thirteen (13) children in the pre-school classroom located downstairs. The surveyor asked for the ages of the children. The staff person stated, "They are five (5)." A female child spoke up and said, "I am three." The director said to the child, "No, you are four (4)." The director got the child's enrollment form and presented it to the surveyor. The surveyor noted that the date of birth listed on the child's enrollment form was 5/10/2013. The director stated that she did not realize that the child was three (3) years old. The director stated that the child only attends every other week and had just arrived. The director removed the child from the classroom and placed her in the pre-school classroom located upstairs. In short, the pre-school classroom located downstairs was over ratio by one (1) child because the youngest child present was a three (3) year old. It is unknown how long the pre-school classroom was over ratio. 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

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, the facility failed to ensure adequate supervision. At approximately 2:30 p.m the surveyor observed a staff person in the two year old classroom walk back into her classroom through a side door. This staff person had been in the connecting toddler room. It was undetermined how long the staff person had been out of the room. 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, on 10/11/16 at approximately 2:25 p.m. a staff person answered the facility's door and the surveyors proceeded to follow the staff person into the pre-school classroom. Upon entry into the pre-school classroom the surveyors observed eighteen (18) children ages three to four (3-4) years old sitting on the floor and watching television. The classroom was over ratio by six (6) children. The staff person who had answered the door stated that she had forgotten that there were supposed to be two (2) teachers in the room. She stated, “I just got back from break and I answered the door on impulse; I forgot to press the intercom." Next, the surveyors found that there was one (1) staff person supervising seven (7) children in the two (2) year old classroom. In an interview with the staff person and record review, it was found that the youngest child in the group was a one year old. Therefore, the group was over ratio by one (1) child. The staff person said that she had been working alone with this group for most of the afternoon. Finally, the surveyors observed seven (7) children in the toddler classroom with one (1) staff person. The staff person told the surveyors that the children present in her classroom were all one year olds. The staff person pointed to a male toddler and stated, “He is not supposed to be here and should leaving soon.” The staff person stated that she had been over ratio for approximately twenty (20) to thirty (30) minutes. General Administration 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 7. First Aid and Medicine.

Based on interviews, the staff indicated that there was not a clear policy on what to do if a child gets ill while in their care when the Director is not present. The staff stated that they did not have access to the children's files when the Director is not present in the facility. During interviews, a staff person stated if a child gets ill in her classroom she yells for staff to tell the Director. She stated if the Director is not there, she tells another staff person. Another staff person stated that she notifies the Director if a child is ill. When asked what she does when the Director is not in the facility she stated, "None of us have the parent's phone numbers, so I guess if it is an emergency we would call 911." It is important to note that the infant/ toddler classrooms are far from the Director's office. The staff stated that they "yell" for the Director in case they need let her know that a child is sick. The distance from the rooms to the office is too far for the Director to be able to hear them "yelling" for her. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on interviews with staff it was found that during the Director's absence there is not a designated staff person to carry out the Director's duties. During the investigation, the surveyors asked to review a child's file. Staff told the surveyors that they did not have access to the children's files. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, there was no planned programming provided to the children in the two year old classroom. Observation during the visit found that there were seven (7) children in the room and there was no apparent programming. Two (2) children were observed repeatedly climbing and standing on one of the tables then jumping off the end. After six (6) times of climbing on the table one child was observed to fall off the end of the table, land on her stomach, and start crying loudly. Another child was observed climbing on one of the shelves then lying in the floor crying.

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 interviews with staff, the surveyors found that toddlers are combined with the pre-school children every day at approximately 4:00 p.m. The toddler staff person stated that there are times when the toddlers go up front to the "big room" when she leaves for the day. She stated that they watch television or go outside. Another staff person stated that she had fourteen (14) or fifteen (15) children in the "big room" on 9/16/16. She stated, "I probably had six (6) or seven (7) toddlers. I had to put them in small high chairs and snap them in so they wouldn't run around." When asked how long the toddlers are in their seats she replied, "An hour or two." She stated, "They watch Disney, Mickey Mouse, or Sponge Bob on TV." The Director stated that there are typically two (2) toddlers in the group at the end of the day. She also stated that they sit in little chairs. She stated, "They will watch a cartoon like SpongeBob, color, or play with blocks."

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.

Based on interviews with staff, the surveyors found that toddlers are combined with the pre-school children every day at approximately 4:00 p.m. The toddler staff person stated that there are times when the toddlers go up front to the "big room" when she leaves for the day. She stated that they watch television or go outside. Another staff person stated that she had fourteen (14) or fifteen (15) children in the "big room" on 9/16/16. She stated, "I probably had six (6) or seven (7) toddlers. I had to put them in small high chairs and snap them in so they wouldn't run around." When asked how long the toddlers are in their seats she replied, "An hour or two." She stated, "They watch Disney, Mickey Mouse, or Sponge Bob on TV." The Director stated that there are typically two (2) toddlers in the group at the end of the day. She also stated that they sit in little chairs. She stated, "They will watch a cartoon like SpongeBob, color, or play with blocks." Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the surveyors observed seven (7) children in the toddler classroom with one (1) staff person. The staff person told the surveyors that the children present in her classroom were all one year olds. The staff person pointed to a male toddler and stated, “He is not supposed to be here and should leaving soon.” The staff person stated that she had been over ratio for approximately twenty (20) to thirty (30) minutes. It it important to note that the square footage for this classroom only allows a capacity of five (5) children. The classroom was not only over ratio but over room capacity as well. 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 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

General: Based on Review of Documentation, from the hospital dated 6/29/16, an eight (8) month old male child received a second degree burn to his left fifth toe. During the investigation, the surveyor and DCBS representative found that a Quick Serve bottle warmer that is used to warm bottles in the infant classroom is at times accessible to the children in care. Based on interviews with staff, the bottle warmer is plugged into an outlet that is located behind a crib and then positioned on the floor within the child care space. One (1) staff person stated that there are typically two (2) babies on the floor while a bottle is heating. Another staff person stated that she has also observed the bottle warmer in the floor between cribs. She stated that after the bottle warmer is used, then it is placed back on the shelf. Furthermore, based on a written statement presented by a staff person, on 6/29/16 the bottle warmer was observed plugged into the outlet and on the floor between cribs. It was reported that during this observation the bottle warmer was turned off. However, it is not known if hot water was still within the chamber of the bottle warmer. The surveyor and DCBS representative tested the water inside of the bottle warmer with a caliberated thermometer and found it to read 212 degrees Fahrenheit. In short, the bottle warmer was found to be accessible to the children in care. It is important to note that at this time it is uknown if the bottle warmer caused the second degree burn on the eight (8) month old child's toe. Employee Records

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, upon arrival to the center a staff member was outside next to a car in the parking lot. The staff member saw the surveyors and ran to the front door of the facility and he was asked to hold the door for the surveyors, but he did not. The surveyors knocked on the door and the staff member then let them inside. This staff member went to the basement immediately. The school-age children were being cared for in the basement. There were twenty-two (22) children five to twelve (5-12) years of age in the basement and one (1) staff member until the other staff member returned to his classroom from the parking lot. Premises

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, it was found that there were nine (9) children napping in the Three Year Old classroom. This classroom has enough square footage to accommodate six (6) children. The teacher stated that she was aware of the capacity limitation and there was a sign on the door listing the capacity of the classroom as six (6).

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, interview and review of documentation, this regulatory requirement was not met. During a tour of the facility the surveyor observed one (1) staff person working alone with eleven (11) children in the preschool classroom. A review of this staff person's file during the investigation found no evidence or results of a criminal records check (CRC). The staff person in charge stated that this documentation has been obtained; however, she was not able to locate it during the visit. Employee Records

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 Observation, interview and review of documentation, this regulatory requirement was not met. During a tour of the facility the surveyor observed one (1) staff person working alone with eleven (11) children in the preschool classroom. A review of this staff person's file during the investigation found no evidence or results of a criminal records check (CRC). The staff person in charge stated that this documentation has been obtained; however, she was not able to locate it during the visit.

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 person (hire dates: 5/2/16) did not have T.B. documentation on file. Premises

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on observation and interview, this regulatory requirement was not met. A tour of the preschool classroom found that the door leading out to the playground was propped open. The door did not contain a screen. The staff person in charge stated that she was not aware that staff had propped open the door and indicated that she would address the situation. Written Documentation

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on interview and review of documentation, there was not a written schedule for the staff. The staff person in charge stated that she did not have a written schedule of staff working hours. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation and interview, this regulatory requirement was not met. The staff person in charge (director) was not able to provide T.B. and educational documentation for a staff person that was employed at the facility from 2/29/16 - 4/14/16. The director stated that this documentation had been obtained; however, she was not able to locate it during the investigation.

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, it was found that one (1) staff person was supervising eight (8) children ages one (1) year to two (2) years old in the Two Year Old classroom. The director stated that the staff must have moved children around to different classrooms.

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, two (2) staff both hired on 3/17/15 did not have an annual evaluation on file. Another staff hired on 1/30/14 had an evaluation on file that was not dated. The staff in charge acknowledged the items. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 5 of 28 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, it was found that 1) there were two (2) uncovered electricial outlets in the eating area used by the children; 2) there were two (2) uncovered electrical outlets by the door of the Two Year Old classroom; 3) the children's coats in the Preschool classroom were found to be overlapping and touching each other; 4) in the Infant classroom, two (2) of the mattresses were found to be curled up at the corners due to the crib sheets being too tight. A three-month-old child was observed to be laying in one (1) of these cribs with the corners of the mattress curled up around his head; 5) in the Infant classroom, a six-month-old child was observed to be sleeping in a bouncy seat. The teachers reported that the child had been asleep for approximatley twenty (20) minutes. The facility did not have documentation from a physician stating that the child must sleep in the bouncy seat. The director stated that the plugs for the outlets would be replaced, the coats would be moved and the crib sheets would be replaced. She stated that she was unaware of the teachers allowing the children to sleep in bouncy seats.

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, hired on 4/1/16, did not have proof of education on file. The staff in charge acknowledged the item.

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, hired on 8/8/11, did not have written evidence of negative TB documentation. Two (2) other staff, hired on 9/17/14 and 1/1/15, had TB skin tests on file that were no longer current. The TB skin tests were dated 3/3/14 and 3/12/14. The staff in charge acknowledged the item.

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 staff did not complete fifteen (15) hours of cabinet-approved early care and education training during their year of employment: Staff #1 hired on 12/29/14 had 12 hours of training, Staff #2 hired 3/21/13 had 9 hours of training, Staff #3 hired 10/10/12 had 6 hours of training, Staff #4 hired 3/17/15 had 3 hours of training, Staff #5 hired 3/26/15 had 3 hours of training, Staff #6 hired 8/8/11 had 9 hours of training, Staff #7 hired 8/8/11 had 3 hours of training, Staff #8 hired 9/17/14 had no training hours, and Staff #9 hired 1/1/15 had 3 hours of training. In addition three (3) staff hired 12/29/14, 3/21/13, and 10/10/12 did not have pediatric abusive head trauma training. A staff hired on 3/21/13 also did not have orientation training. Training hours were reviewed on the TRIS system for each staff as well as the staff files presented. The staff in charge acknowledged the items.

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, it was found that 1) a current program of planned daily activities was not posted in the Preschool classroom or the Two Year Old classroom. The director stated that she was unaware of these documents not being posted; 2) in the Two Year Old classroom, one (1) child was not provided with a chair or coloring materials. There were only seven (7) chairs available and eight (8) children in the classroom. The child stood and looked around for approximately fifteen (15) minutes before the teacher asked him if he wanted paper. During this same time, two (2) girls were made to share a piece of paper during coloring time. The girls were fighting over the paper and coloring on the table. The teacher stated that she did not have time to make sure she got out enough paper for all of the children because she had to change their diapers. The director stated that there were only seven (7) chairs in the classroom because the capacity of the classroom is seven (7) children.

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, it was found that the children in the Preschool classroom were watching Bob the Builder on television. The teachers in the classroom were unable to explain how the show was educational and tied into the schedule of daily activities. One teacher stated that they were watching that particular show because the children liked it.

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, it was found that there were seven (7) chairs and eight (8) children in the Two Year Old classroom. During a coloring activity, one (1) of the children was not provided with a chair or coloring materials. He was made to stand for approximately fifteen (15) minutes with nothing to do while the teacher changed diapers.

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, it was found that the children in the Preschool classroom were watching Bob the Builder on television. Movie time was listed on the daily schedule, however, it was not listed on the schedule of daily activities or tied into the days learning theme.

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, it was found that a one-year-old child was present in the Two Year Old classroom. The teacher stated that the child had been in the classroom since her early morning arrival and would be in the classroom until she was picked up in the afternoon.

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, it was found that a twenty-one month old child was present in the Two Year Old classroom. The teacher stated that the child had been with the class since her arrival and would remain in the classroom until she was picked up in the afternoon. The facility did not have a written transition plan for this child. The teacher and the director stated that they did not know what a transition plan was.

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, it was found that 1) the paint on the boards enclosing the steps leading to the playground areas was peeling off in multiple places. It was also found that a post on the right side of the enclosure near the gate was rotting and splintering. The director stated that she was aware of the need to repaint and repair the enclosure; 2) a black fuzzy substance was observed to be growing on the ceiling of the downstairs school-age classroom by the vents; 3) the light switch and the wall area around it in the peach bathroom was found to be smudged with an accumulation of grime and dirty fingerprints; 4) the vent in the peach bathroom was found to have an accumulation of dust on it; 5) the toilet paper holder in the peach bathroom was found to be missing the spool. The toilet paper was being stored on the tank of the toilet. The director stated that she was unaware of these areas needing attention.

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 1) there were seven (7) children in the Three Year Old classroom. Measurement of the room found that the square footage of the classroom is adequate for six (6) children. A sign on the door of the classroom also stated that the capacity of the classroom was six (6) children; 2) it was also found that there were eight (8) children in the Two Year Old classroom. Measurement of the room found that the square footage of the classroom is adequate for seven (7) children. A sign on the door of the classroom also stated that the capacity of the classroom was seven (7) children; 3) in addition, it was found that there were six (6) children in the One Year Old classroom. Measurement of the room found that the square footage of the classroom is adequate for five (5) children. A sign on the door of the classroom also stated that the capacity of the classroom was five (5) children. The director stated that she was unaware of the classrooms operating over capacity.

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, it was found that the unscreened window in the kitchen was open. The staff person in the kitchen stated that it gets very hot in the kitchen when she is cooking. The director stated that a removable screen was purchased for the window, but apparently was not put in place.

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, it was found that the toilet in the bathroom with the flower border contained urine and feces. The base of the toilet was found to be soiled with an accumulation of hair, debris and a dried yellow substance. The base of the toilet in the grey bathroom was found to have multiple yellow and brown stains and an accumulation of debris. The director stated that the toilets would be cleaned immediately. Hygienic Practices

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, it was found that a child arrived in the Preschool classroom at 9:36a.m. The child was directed to sit with the other children in circle time. The child's hands were not washed upon arrival as required. The teacher stated that they forgot to remind the child to wash her hands. In the Two Year Old classroom, two (2) diaper changes were observed. Neither child had their hands washed after the diaper change.

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, it was found that the teacher in the Two Year Old classroom did not wash her hands prior to conducting a diaper change. The teacher wore gloves. After the diaper change, the teacher put the child on the ground, got a new diaper out of a backpack, picked up crayons from the floor and gave them to a child, touched the heads of two (2) children and took another child by the hand to walk to the diaper changing area. The teacher wore the gloves from the first diaper change the entire time. Her hands were not washed prior to or after any of the observed diaper changes.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, it was found that an infant was mouthing a plastic toy. When the infant put the toy down on the floor, a toddler picked the toy up and began to play with it. The teachers in the classroom did not take the toy from the toddler. When questioned, the teachers stated that toys are washed during nap time and after closing. The mouthed toys are not taken from the children until these times. First Aid/Medication

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, it was found that the weed guard on the playground used by the school-age children was pulled through the mulch in multiple places, creating a tripping hazard. The director stated that she was aware of the need to fix the weed guard.

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 1) on the playground used by the toddlers, a metal car-shaped climber was located on grass; 2) on the playground used by the two-year-old children, a slide and a metal car-shaped climber with a tunnel was located on grass and sparse mulch; 3) on the playground used by the three and four-year-old children, a white climber with a tunnel and two (2) metal car-shaped climbers were located on grass, dirt and sparse mulch; 4) on the playground used by the four and five-year-old children, a multi-colored car-shaped climber and the swings were found to be located on dirt and sparse mulch; 5) on the playground used by the school-age children, the monkey bars and swings were found to be located on dirt and sparse mulch. The director stated that she was aware of the need to add mulch to the playground areas.

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, it was found that the bottom of the vanity located in the yellow bathroom was warped. The front surfaces of this same vanity were found to be soiled with an accumulation of dust and grime. It was also found that the paint on the changing table located in the Two Year Old classroom was chipping and peeling. The director stated that she was aware of the need to fix and clean the vanity, but was unaware of the chipping paint on the changing table.

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, it was found that 1) a ride-on toy located on the playground used by the two-year old children was broken on the front left fender, creating sharp edges; 2) on the playground used by the three and four-year-old children, the paint on a picnic table, a metal climber with a tunnel and two (2) metal car-shaped climbers was found to be peeling; 3) on the playground used by the four and five-year-old children, the paint on a large wooden structure, a bicycle-shaped spring ride-on toy, a car-shaped metal climber and a multi-colored car-shaped metal climber with a tunnel was found to be peeling in multiple spots; 4) on the playground used by the school-age children, the paint on a large metal and wooden slide and a picnic table was found to be peeling; 5) on the playground used by the school-age children, it was found that there was a two (2) inch gouge in the top of the wooden picnic table. The area around and in the gouge was splintering; 6) on the playground used by the four and five-year-old children, it was found that one (1) of the tires on a metal car-shaped climber was shredded around the top, exposing the wires from the steel belts. The director stated that she was aware of the equipment needing to be repaired and repainted. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 18 of 28 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 11. Toys and Furnishings.

General: Based on Observation, it was found that a six-month-old child had been sleeping in a bouncy seat for approximatley twenty (20) minutes. The manufacturer's guidelines state that the bouncy seat is intended for play, not sleeping. The director stated that she was unaware of the teachers allowing children to sleep in bouncy seats.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the facility was unable to produce a current inspection from the Transportation Cabinet for the 2007 Ford fifteen (15) passenger van used to transport the children. The staff person in charge of transportation stated that the vehicle had not yet been taken to be inspected. The date of the inspection from the previous year was unable to be determined. The director stated that a lot of paperwork was stolen during a break-in in December of 2015.

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 were four (4) uncovered bottles and three (3) unlabeled bottles in the refrigerator located in the One Year Old classroom. The teacher acknowledged the bottles and stated that they belonged to children in the Infant classroom.

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, it was found that a one-year-old child was given a bottle to drink while he was sitting on the floor. The teachers stated that they thought it was all right to do this since they were sitting on the floor with him.

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, it was found that four (4) out of ten (10) children's files reviewed did not contain current immunization certificates. The director stated that she would obtain the immunization certificates as soon as possible.

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, it was found that 1) two (2) out of ten (10) children's files reviewed did not contain information regarding the parent's preferred hospital; 2) three (3) out of ten (10) children's files reviewed did not contain a physician's telephone number; 3) two (2) out of ten (10) children's files reviewed did not contain information regarding authorization for emergency medical care; 4) one (1) child present at the facility did not have any records on file at the facility. The day of the survey was the child's first day attending the facility.

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, the emergency preparedness plan on site was dated 4/18/14. The regulations require the plan to be updated annually. The staff in charge indicated that she was unaware that the plan was to be updated annually, but she indicated that she would take care of that.

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, it was found that 1) two (2) of the children present in the facility were not signed in; 2) when a child is signed in by a staff person or arrives from a van pick-up, the attendance sheet is marked "staff" or "van" instead of a person's name or initials; 3) several parents were found to have already signed the box on the attendance form verifying their child's attendance for the week. The survey was conducted on a Wednesday morning; 4) the sign in and out times documented did not indicate a.m. or p.m., therefore it could not be verified how many children were present in the facility during a given time period. The director stated that she was unaware of these issues.

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, six (6) staff did not have professional development plans on file. These staff were hired on 1/30/14, 1/25/12, 12/29/14, 3/21/13, 3/17/15, and 8/8/11. In addition, two (2) other staff had professional development plans on file that were no longer current. These staff were hired on 8/11/11 and 10/10/12. The staff in charge acknowledged the items.

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, it was found that the statements of deficiencies issued and plans of correction submitted for a follow-up inspection conducted on 8-7-15 and allegation investigations conducted on 4-22-15, 5-5-15 and 6-3-15 were not posted. The director stated that she was unaware of the documents not being posted.

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, it was found that there was not a schedule of daily activities posted in the Preschool classroom. It was also found that the posted schedule of daily activities located in the Two Year Old classroom was dated for the week of January 11, 2016. The director stated that she was unaware of the schedules of daily activities being out of date or not posted.

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, it was found that the hand-washing procedure was not posted at the diaper changing area located in the yellow bathroom. The teacher stated that she did not know where the hand-washing procedure was. Animals

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 Threes classroom measures 229.71 sqaure feet which makes the room's capacity six (6) children. At the time of the visit, there were nine (9) children present in the classroom.

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, a follow-up inspection to check room capacity was conducted at approximtately 12:30 p.m. The surveyor observed seven (7) children in the three (3) year old classroom. The square footage for the three (3) year old classroom is 229.71 which equals six (6) children per square footage. Therefore, the classroom was over room capacity by one (1) child.

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, a staff person in the Ones classroom did not wash her hands after wiping a child's nose.

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, during a tour of the one (1) year old room a piece of paper with children's names and items they are allergic to was posted on the wall in view of anyone who comes in the room. An interview with the director found that they do not have documentation on file from each child's parent giving permission to post their child's allergies. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 1 of 5 Web site: http://chfs.ky.gov/ Inspection Report Programming

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 a tour of the three (3) to five (5) year old room located upstairs the planned program of activities that was posted was dated 5/4/15-5/8/15. Let it be noted this is the same planned program of activities that was posted on the day of the relicensure survey conducted on 5/5/15. The activities listed once again included observing an ant farm and observing fish in the fish tank. However, these activities did not have the necessary materials. During a tour of the infant room the planned program of activities posted had activities that included, meal time and bath time. Bath time is not a part of the infant's daily routine. Let it be noted that this is the planned program of activities that was posted on the day of the relicensure survey conducted on 5/5/15. During a tour of the one (1) year old room the posted planned program of activities included but are not limited to: Jump rope, draw the four (4) main shapes, draw butterflies, tracing letters with string, counting in Spanish and repeating site words. These activities are not developmentally appropriate for one (1) year old children. Developmentally inappropriate activities for the one (1) year old room were cited during the relicensure survey conducted on 5/5/15. During a tour of the three (3) year old room it was found there was not a daily planned program of activities posted. During a tour of the school age room the daily planned program of activities posted was dated for the week of 6/1/15. During a tour of the two (2) year old room the planned program of activities posted was dated 6/1/15-6/5/15. While in the two (2) year old room at 10:05 a.m. the staff person was observed sitting in a chair while she held up her cell phone for the children to watch the television show Bubble Guppies. Those children who were trying to watch were standing very close to the screen so they could see. The use of the cell phone is also not an appropriate use for television viewing. This activity was not listed on the lesson plan and not all children were participating. Some of the children who were not watching bubble Guppies were observed wrestling in the corner. Others were just laying on the floor doing nothing.

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 a tour of the facility's downstairs a group of school age children were watching the movie Hancock. This movie is rated PG-13. This movie is not appropriate for viewing for this age group.

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 two (2) year old room the staff person was observed sitting in a chair holding her cell phone up while some of the children tried to watch the television show Bubble Guppies. This was not listed on the daily schedule or on the posted planned program of activities for the day. During a tour of the facility downstairs a group of school age children were observed watching the movie Hancock. This movie is rated PG-13. Television viewing was not listed on the daily schedule or the planned program of activities for the school age children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 5 Web site: http://chfs.ky.gov/ Inspection Report Premises

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 white bathroom located upstairs in the three (3) to five (5) year old room there was an accumulation of dirt and grime along the baseboards. A dime sized hole was found near the baseboard by the sink. There were orange crayon marks and a brown substance smeared on the wall by the toilet. During the relicensure survey conducted on 5/5/15 the baseboards with dirt and grime and the dime sized hole in the wall were cited. The plan of correction indicated that the baseboards would be washed down and a carpenter had been called and this would be completed by 6/30/15 and that the owner will do a weekly walk through to see what needs to be done. Hygienic Practices

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 pad in the Infant classroom had a tear in the plastic covering. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 3 of 5 Web site: http://chfs.ky.gov/ Inspection Report First Aid/Medication

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, the first aid kit on van #1 did not contain liquid soap or flashlight. The first aid kit on van #2 did not contain liquid soap. 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 one (1) year old playground there was a Little Tikes climber sitting on grass. Grass is not an acceptable form of surfacing. On the other play grounds there was a scattering of mulch under two (2) wooden playsets used to climb and slide as well as two (2) sets of swings. In addition there was a yellow metal climber that had a scattering of mulch. The plan of correction indicated that mulch had been purchased and was completed by 6/25/15. Equipment

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 three (3) to five (5) year old room located up stairs a white trashcan was observed sitting by the back door. The lid to the trashcan had areas of dirt and grime. This was cited during the relicensure survey conducted on 5/5/15. The plan of correction submitted indicated the trashcan had been cleaned. Transportation

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, there were no sign on/off times recorded for the eighteen (18) children that were transported by the facility on the day of the visit. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 4 of 5 Web site: http://chfs.ky.gov/ Inspection Report Food Service

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on Observation, there were three (3) bottles not labeled with a child's name and one (1) bottle that was not covered in the refrigerator in the Ones classroom. Written Documentation

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, it was found that there were seventy-five (75) children present in the facility at the time of the visit. However, a review of the facility's attendance records found that there were only six (6) children signed into the facility.

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 review of documentation, the surveyor found the following classrooms contained too many children based on the square footage of the classrooms: two (2) year old classroom, three (3) year old classroom, preschool classroom, and the schoolage classroom. On the day of the investigation, the two (2) year old classroom had ten (10) children, the three (3) year old classroom had ten (10) children, the preschool classroom had twenty two (22) children, and the school age classroom had twenty four (24) children. The square footage measurements recorded during the initial survey done on 7/25/11 are as follows: two (2) year old room 250.75 equals seven (7) children per square footage, three (3) year old classroom 250.75 equals six (6) children per square footage, preschool classroom 728 equals twenty (20) children per square footage, and the schoolage classroom 638 equals eighteen (18) children per square footage. The staff person in charge stated there has always been ten (10) children allowed in the two (2) and three (3) year old classroom and the classrooms have always been set up that way since there initial inspection. However, based on documentation from the initial inspection completed on 7/25/11 a capacity of ten (10) children was never given for any of the classrooms. Furthermore, the two (2) year old classroom was originally set up to be an infant classroom. In short, the two (2) year old classroom was over capacity by three (3) children, the three (3) year old classroom was over capacity by four (4) children, the preschool classroom was over capacity by two (2) children and the school age classroom was over capacity by six (6) children based on square footage measurements in each classroom.

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, there was no documentation made available at the time of the survey regarding current liability insurance.

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, two (2) out of nineteen (19) staff eligible for an annual evaluation did not have evidence of an evaluation on file in the facility.

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, staff person hired 8/8/11 did not have documentation of negative T.B. results on file in the facility that had been obtained within the past two (2) years.

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, four (4) out of nineteen (19)staff files did not have evidence of fifteen (15) hours of annual training on file for the last full year of employment.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, two (2) of the five (5) staff identified as van drivers did not have a current driving record on file. Programming

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 initial walk through that began at approximately 9:08 AM, the staff in the three (3) to five (5) year old room were lining the children up to take them outside. At 9:55 AM the surveyor went outside on the playground and observed the staff lining this group of children up to take them inside to get a drink and go to the bathroom. The group was then immediately taken back outside at 10:05 AM. At 10:40 the group was brought back inside and a movie was put in the DVD player until lunch was served at 12:00 PM. Further, the children in the two year old room were observed sitting on the floor from 9:08 AM until 10:40 AM. The only activity observed for this group was staff singing songs with them. Although there was a planned program of activities posted for each of these groups, the activities were not implemented. In addition, some of the activities listed did not have the necessary materials. Examples included but are not limited to observing an ant farm and observing fish in the fish tank. However, there was no ant farm or fish in a fish tank in the facility. The planned activities in the Infant room included meal time, bath time, and then a song under those headings. However, bath time is not part of the infants' daily routine at the facility. There were no blocks available in the one year old room, school-age room, three year old room and the three to five year old room. Further, the planned activities in the one-year old room included the following: Art – Trace and cut out numbers, Cut out pictures, and Count to ten in Spanish. These activities are not developmentally appropriate for this age group.

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 facility failed to ensure that a three year old child was escorted to the Early Head Start bus. Further, the facility did not attempt to transport the child to Early Start. As a result the child was kept at the facility which is not part of the normal daily schedule that he is familiar with.

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 children in the two (2) year old room were observed sitting on the floor singing songs. At 9:45 AM, the two year old children were still sitting on the floor while a staff person was talking to them. At 10:40 am, the two year old children were still sitting on the carpet and some of the children were crying while staff put out their cots for nap time.

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 staff person in the three year old classroom yelled at the children continuously throughout the duration of the survey. While outside, the staff was observed yelling across the playground when telling the children to stop doing something or telling them to “come here. The staff person’s tone of voice was very harsh, loud and rough. The staff person also sounded very irritated with the children. The staff person could be overheard by the surveyor touring the facility as well as from the office where the director and another surveyor were.

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, during a tour of the infant room a six (6) month old child was observed sleeping with a pacifier in his mouth. The pacifer had a teather attached to the end which attaches to the child's clothing.

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 facility the following items were observed; 1) In the three (3) to five (5) year old room the threshold at the door leading out on to the playground had areas of dirt and grime and chipping a peeling paint. There was a hole in the floor in front of the threshold and the linoleum was torn. The baseboards in the room were covered in dust, dirt and grime and the wall where the cots are stacked had areas of chipping and peeling paint. 2) In the orange bathroom in the three (3) to five (5) year old room there was a thin piece of wood that had been nailed over a large hole in the ceiling. The piece of wood was coming loose due to some of the nails missing. In the same bathroom there was drywall mud around the soap dispenser. 3) In the bathroom located beside the orange bathroom there was a hole the size of a dime in the wall near the baseboard. In addition there was dust, dirt and grime around the baseboards. The doors of the cabinet under the sink in this bathroom had areas of dirt, dust and grime. 4) In the bathroom located in the one (1) year old room there was dirt and grime along the baseboards as well as dirt and grime on the walls. There were two (2) signs taped to the walls. One (1) of the signs read "Did you wash'em". The tape around the sign was coming loose and had dirt accumulated on the sticky part of the tape. 5) In both bathrooms located downstairs the walls and baseboards were stained, and had areas of dirt and grime. There was an accumulation of dirt and grime around the sink and light switch plates.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, during a tour of the two (2) year old room there were thirteen (13) children. A measurement of the room was taken and found the room to have a square footage of 250.75 feet. This only allows for seven (7) children to be in this space at one (1) time. In addition there were ten (10) children observed in the three (3) year old room. A measurement of this room was taken and was found to have a square footage of 229.71 feet. This only allows for six (6) children to be in the room at one (1) time.

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, a staff person in the two (2) year old room changed a child's diaper and did not have the child wash his hands afterwards.

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, a staff person in the two (2) year old room changed a child's diaper and did not have the child wash her hands afterwards.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, a staff person in the two (2) year old room changed a child's diaper on a mat placed on top of the child size table in the room. Once the staff person finished changing the child's diaper the staff person took the mat from the top of the table and put it back by the sink located on the other side of the room. The changing mat was not sanitized after the child's diaper was changed.

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, during and inspection of the first aid kit located inside the facility several individual packets of aspirin and non-aspirin pain reliever were found in the first aid kit. These packets of medication were not labeled for an individual person. In addition the first aid supplies inside the facility did not include medical tape. During an inspection of first aid supplies on both vehicles used to transport children it was found that neither vehicle had a flashlight and liquid soap. During a tour of the one (1) year old room there was a bottle of Walgreen Pediatric Oral Electrolyte Solution that was not labeled for an individual child was found in the refrigerator. 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, a Little Tikes slide was observed sitting on grass on the playground used by the one (1) year old children. Grass is not an acceptable form of surfacing to use under equipment used to slide. Further inspection of the outdoor play area found that there was only a scattering of mulch beneath two (2) large wooden play structures that are used to climb and slide as well as two (2) sets of swings. In addition there was a yellow metal climber. The mulch under all of these pieces of equipment was minimal.

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, during a tour of the infant room one (1) of the cribs had a sheet that was soiled with dirt.

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 large school age room located downstairs there was a long yellow shelf attached to the wall that had numerous areas of chipping and peeling paint. There was also an area on top of the shelf that had pieces of cardboard that appeared to have been stuck to the shelf and then peeled off leaving pieces of cardboard remaining. There was a trash can by the back door in the three (3) to five (5) year old room that had an accumulation of dirt and grime on the lid. An inspection of vehicle # 1 old french fries, trash, dirt and other food items were found on the floor.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, found that on 4/1/15 there was no documented time on or off for children picked up at one (1) of the local elementary schools and then dropped off at the facility. In addition there was no documented time on or off on the same day for children who left from the facility on the facility van and were dropped off at home in the afternoon.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on Observation, while in the infant room a staff person was observed preparing a child's bottle. This staff person poured water from a water bottle into a baby bottle and then added the powdered formula. An interview with the director found that the parents provide the formula for their child.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Review of Documentation, three (3) of the ten (10) children's files presented for review did not contain a current 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, 1. Child enrolled 3/16/13 did not have a physician’s name and contact information or the name of a preferred hospital on file in the facility. 2. Child enrolled 2/3/15 did not have the name of a preferred hospital on file in the facility.

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 and interview, the facility failed to ensure that a three year old child was escorted to the Early Head Start bus. Further, the facility did not attempt to transport the child to Early Start. As a result the facility did not implement their policy and procedure with this child's parent in assuring the child would be placed on the bus to attend the Early Start program.

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, three (3) of the nineteen (19) staff files presented for review did not have evidence of a professional development plan.

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, there was no evidence of a documented fire drill for April, 2015.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Observation, during a tour of the four to five (4-5) year old room located downstairs it was found that a schedule of daily planned activities that includes dates and times activities are to be conducted with the children was not posted.

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, it was found that on 5/4/15 nine (9) children ages fourteen (14) months to two (2) years old were left alone in the eating area with a visitor from another agency. The staff person in charge of the group stepped into the kitchen located beside the area three (3) to four (4) times within a twenty (20) minute period. Interviews also found that the cook was in and out of the kitchen with the staff person and did not remain in the eating area with the children. 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 Staffing Requirements

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 Interview, it was found that on 5/4/15 from 8:15 a.m. to 8:35 a.m. one (1) staff person was observed in the two (2) year old room and the eating area with nine (9) children ages fourteen (14) months to two (2) years old. Further interviews found that at approximatley 10:30 a.m. there were twenty (22) children ages four (4) to five (5) years old on the playground with one (1) staff person. It could not be determined how long this staff person was left with the twenty (22) children. An interview with the staff person in charge found that she acknowledged the staff person on the playground was left alone with twenty two (22) children and confirmed they were short staffed.

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. At 9:39AM the surveyor entered the infant room and observed one (1) staff person caring for six (6) children. The youngest child in the group was an infant; therefore, staff-to-child ratios were not in compliance. The staff person acknowledged that she had six (6) children and then moved the one (1) year old child that was present in the infant classroom over to the toddler classroom. Director Requirements

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.

Based on interview and record review, the facility failed to provide for the safety of the children. Allegations regarding a staff person with 11/28/14 hire date "coming to the facility high and telling the children about it" were reported to the DRCC office. An investigation was conducted at the facility on 4/22/15. The staff person was observed caring for ten (10) preschool children alone in the facility's lower level during the visit. The staff person in charge escorted the staff person to get a drug test on 4/22/15 as a result of the investigation. A review of the drug test found positive results for marijuana. The staff person in charge stated that the staff person was terminated on 4/28/15. Programming

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 and interview, the facility failed to ensure that a child not be subjected to threatening or frightening language. A review of staff files during a complaint investigation revealed an incident involving two (2) staff that occurred in front of the children the morning of 4/2/15. A staff person with a 11/28/14 hire date made threatening statements to the other staff person such as, "You don't know who you're messing with. I'm going to black your eye". A staff person that witnessed the incident stated that she stepped in front of the staff person making the threats and told her she needed to "chill-out". Staff stated during interview that approximately ten (10) - fifteen (15) children were present in the room when the incident occurred. The staff person in charge stated that she met with the two (2) staff involved the same day as the incident and gave them a written reprimand. A review of the written reprimand for the staff person hired on 11/28/14 found "Attitude, Conduct, Safety Violation and Work Rule Violation" marked as the type of violation. The reprimand contained the following statement, "Two (2) employee's fussing with each other in front of children was witnessed by two (2) Kid's House teachers using the word fighting in front of the kids". An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report Food Service

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, this regulatory requirement was not met. At 9:39AM the surveyor entered the infant room and observed two (2) children lying in their cribs while drinking bottles. The staff person working in the classroom identified both children as being under twelve (12) months old.

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 rang the doorbell at 12:30 p.m. in order to gain access into the facility. A male staff person opened the door and the surveyor proceeded to follow that staff person into the pre-school classroom. Upon entry into the pre-school classroom the surveyor observed thirteen (13) children on their cots. One (1) female child was still awake and the rest of the children were asleep. Further observation revealed that there was not another staff person in the classroom. The surveyor asked the staff person if he had been alone in the classroom. He then called out a staff person's name and that staff person walked into the room. The staff person stated that she was in the kitchen. When asked how long she was in the kitchen; she replied, "Not long." In short, the male staff person left the pre-school classroom unattended and without supervision in order to answer the front door. Staffing Requirements

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 9. Statement of Deficiency and Corrective Action Plans.

A PLAN OF CORRECTION WAS DUE ON 08 Dec 14 AND AS OF 16 Dec 14, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Transportation

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Interview, Kids House day care used a fifteen (15) passenger van that is owned and insured by North Star Academy, a day care owned by a separate entity, to pick up children from three (3) elementary schools on October 24, October 27, and October 28, 2014. The cabinet was not notified in writing before the vehicle was used to transport children. Furthermore, there was not a third party agreement or contract detailing these arrangements presented for review at the time of the investigation.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on interview and record review; it was confirmed that on 11/4/14 a school age staff person had seventeen (17) school age children ages five (5) to eleven (11)years old in his care when an altercation occurred between a seven (7) year old and an eleven (11) year old while on the playground. The school age staff person was over ratio by two (2) children and was several feet away with his back turned when the altercation took place. The staff person stated he was at the back door of the facility asking the owner for the key to the water fountain. He stated when he turned around toward the playground he saw that the seven (7) year old child was on the ground and the eleven (11) year old child was on top of him. He stated that he had to run to reach them and "break them up." He stated, "The older brother (eleven (11) year old) had been at the gate trying to get my attention to tell me that a child had punched his little brother in the chest three (3) times." An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 1 of 3 Web site: http://chfs.ky.gov/ Inspection Report Staffing Requirements

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, at 1:10 p.m. the one (1) year old staff person opened the front door to allow the surveyor and DCBS representative to enter. The one (1) year old staff person then proceeded to walk through the facility and back to the one (1) year old classroom. As the surveyor and DCBS representative toured the facility to check staff-to- child ratios it was revealed that the one (1) year old staff person had left another staff person over ratio by four (4) children. The one (1) year old classroom had a total of ten (10) children that were sleeping on cots. Furthermore, the infant classroom had a total of six (6) infants with one (1) staff person. Therefore, the classroom was over ratio by one (1) child. During interviews and record review; it was confirmed that on 11/4/14 a school age staff person had seventeen (17) school age children ages five (5) to eleven (11) in his care when an altercation occurred between a seven (7) year old and an eleven (11) year old while on the playground. The school age staff person was over ratio by two (2) children. Programming

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 interviews and review of documentation, it was revealed that there are occasions when a three (3) year old child rides on the van for approixmately one (1) hour and forty five (45) minutes. On 11/4/14 it was noted the three (3) year old child did not get off of the van until 3:45 p.m. The time on the van was not recorded; however, staff stated that the child gets on the van between 2:00 p.m. and 2:25 p.m. each day. The child's teacher stated she wakes him up every day from nap at approximately 2:00 p.m. makes him use the bathroom, feeds him a snack, and then escorts him to the van at approximately 2:15 p.m. The van monitor stated the child gets on the van at 2:00 p.m. and sometimes has fallen asleep during the ride home. Another staff person stated the van leaves at approximately 2:25 p.m. Based on interviews, it was found that the child does not have much time to transition from nap time, to snack time, to the van for the departure home. Furthermore, the child has to endure a long time on the van and has fallen asleep before reaching his home. Therefore, this daily planned routine is not developmentally appropriate for this child. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report Transportation

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Interview, it was revealed that the facility is using a Ford Escape to transport children. The facility did not notify the DRCC office that the vehicle was going to be used to transport children.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, a transportation schedule dated for 11/4/14 was presented for review during the investigation. The documentation did not include the time of day each child was loaded onto the van. It could not be determined if someone other than the van driver signed the children on and off off the van. Food Service

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

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

General: Based on Observation, on 11/4/14 the surveyor observed an infant sitting in a slight upright position in a floor swing drinking a bottle at approximately 1:10 p.m.

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, it was found that there were two (2) staff caring for twenty-seven (27) three (3)to five (5) year old children on the playground. The maximum group size is two (2) staff to twenty-four (24) children. The ratio is one (1) staff to twelve (12) children. 45 - Ratio/Group Size Not Applicable 922 KAR 2:120. Section 2. Child Care Services. (2)(b) The age of the youngest child in the group shall determine the: 1. Staff-to-child ratio; and 2. Maximum group size.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Observation, at the time of the visit conducted on 6/5/14 the facility van was observed transporting children without the headlights on while picking children up at a local elementary school.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Observation, at the time of the visit conducted on 6/5/14 the van driver was observed standing on the sidewalk at the back of the elementary school where he was waiting for school to dismiss. The van was left running. There were children on the van as well as the adult monitor who was sitting in the passenger seat.

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, it was found that three (3) preschool age children were left unsupervised in the kitchen eating area. Interview with staff found that another teacher stepped out of the classroom to go into the front office leaving the three (3) children unsupervised.

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, it was found that one (1) was left to care for eighteen (18) three (3) to four (4) year old children in the preschool classroom. The staff to child ratio for this age group is one (1) staff for twelve (12) children.

Open Not marked corrected in the state record

Category: ratio. 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 facility did not have evidence of proof of zoning.

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, it was found that there was no evidence of a current copy of the state regulations. The most recent copy provided was from 2011.

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, staff member hired on 08/08/11 did not have a current evaluation on file.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that there was no evidence of family involvement activities. Employee Records

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, staff member hired on 08/08/11 and 08/09/11 did not have a current professional development plan on file.

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, staff member hired on 08/11/11 did not have the required education documentation on file.

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, staff member hired on 08/09/11 and 10/10/12 had no cabinet approved training hours on file. Staff member hired on 10/05/12 had only two (2) cabinet approved training hours on file.

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, it was found that there were no dated program of activities for both one (1) year old classrooms, preschool, two (2) year old classroom, four (4) and five (5) year old classroom and in the school age classroom. It was found that there were no music and tactile materials in the two (2) year old classroom nor were those activities listed on the lesson plan. It was found that there were no cutural materials in the one (1) year old or the infant classroom nor was there anything listed on the lesson plan. Additionally it was found that the children in the preschool classroom, one year old classroom, two year old classroom and four and five year old classroom had no programming provided. The children were observed to be climbing on top of chairs, tables and shelves.

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.

Based on Observation, it was found that the children in the preschool classroom, one year old classroom, two year old classroom and four and five year old classroom had no regularity of routine. The children were observed to be climbing on top of chairs, tables and shelves and no programming or routine was offered to the children.

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, it was found that there were an adult pair of sharp scissors on the sink in the toddler classroom where the children do their handwashing. It was also found that there was some kind of brown liquid substance in a water bottle on the sink in the toddler classroom.

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, it was found that there were crumbs and dirt all over the floor in the toddler classroom. There were several areas of chipped paint on the walls in the toddler classroom, school age classroom and in the kitchen eating area. There was observed to be torn carpet on the stairs leading to the school age area. There was also observed to be damaged bathroom doors in the school age classroom. The rugs in the two (2) year old classroom and in the infant classroom were covered in brown and black stains. It was also found that there was broken trim around the wall in the one (1) year old classroom.

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 Interview, it was found through interview with the staff in the infant classroom that she was cleaning the mobile infants hands with wipes and not using soap and water. It was found that a staff in the two (2) year old classroom wiped a child's nose and did not wash the child's hands.

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, it was found that the staff in the two (2) year old classroom wiped a child's nose and did not wash her hands after wiping the child's nose.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that there was no staff schedule available for the drivers of the vehicle not were the current routes for the children being transported to and from the residences.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that there were no loading and unloading procedures for the vehicles used to transport the children.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that there was no current inspection documentation for the 2007 Van Ford.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that there was no evidence of pre-inspection trip documentation noted for children that were transported on 04/15/2014

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 no thermometer in two (2) of the freezers being used to store food.

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 was a brown liquid stain on the inside of the refrigerator door in the kitchen area.

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, children enrolled on 11/27/12 and 11/11/13 had expired immunization certificates on file.

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, three (3) children enrolled on 11/11/13 did not have the physicians' contact information nor the preferred hospital information on file. Child enrolled on 05/02/12 did not have the preferred hospital information on file. Child enrolled on 11/02/11 did not have the physicians' contact information on file.

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, it was found that there was no evidence of the Consumer Product Safety Form being posted.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 13. Animals.

General: Based on Review of Documentation, it was found that there was no written parental consent for the fish that were in the preschool classroom and in the four (4) and five (5) year old classroom.

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, it was found that the children in the preschool classroom, one year old classroom, two year old classroom and four and five year old classroom had no programming provided. The children were observed to be climbing on top of chairs, tables and shelves. 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

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, it was found that the children in the preschool classroom, one year old classroom, two year old classroom and four and five year old classroom had no regularity of routine. The children were observed to be climbing on top of chairs, tables and shelves and no programming or routine was offered to the children.

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, it was found that on 04/07/2014, one (1) car seat was observed to not be buckled in that contained a child. The van was being driven on a road at the time of the observation. It was also found on 04/08/2014 that the children being picked up from Mary Todd Elementary were not buckled into their seats. The children were observed to load on to the vehicle and the vehicle immediately pulled out of the driveway. Interview with a staff person also found that the staff on the vehicle do not check to make sure that the children are buckled in their seats. The staff stated that the children get on the van and they pull off of the school's property. Transportation

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Observation, it was found that on 04/07/2014, one (1) car seat was observed to not be buckled in that contained a child. This observation was made while the vehicle was being driven on a public road. It was also found on 04/08/2014 that the children being picked up from Mary Todd Elementary were not buckled into their seats. The children were observed to load on to the vehicle and the vehicle immediately pulled out of the driveway. Interview with a staff person also found that the staff on the vehicle do not check to make sure that the children are buckled in their seats. The staff stated that the children get on the van and they pull off of the school's property.

Open Not marked corrected in the state record

Open / not marked corrected.

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

TYPE B CITATION: Based on Review of Documentation, there is a staff person hired 1/12/14 who did not have the results of a child abuse and neglect check on file. This staff person was observed supervising three (3) one (1) year old children alone. This was observed from 9:40 a.m. until 10:00 a.m. An interview with the staff person in charge found that this staff person arrives at the facilty at 5:45 a.m. A review of files also found that the results of the criminal records check for this same staff person was dated 1/16/14. There was no documentation available for review to verify the application for the results of the criminal records check had been submitted prior to the date of hire or on the date of hire. In addition there was another staff person with a hire date of 1/13/14 who had the results of a criminal records check dated 1/16/14. There was no documenation available for review to verify that the application for the results of the criminal records check had been submitted prior to the date or hire or on the date of hire.

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 hired 1/13/14 who had a T.B. skin test on file dated 1/25/12. There was not a current T.B. skin test or a statement from a health professional indicating the individual is free from the symptoms of T.B.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, there were six (6) infants in the Infant classroom with one (1) staff person. The youngest child in the group was eight (8) months old. 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 Director Requirements

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Interview, it was found that the van driver routinely leaves the van engine running while he exits the van to walk a child to the door of their home. Children's Records

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, child named in the complaint allegation had an immunization certificate on file that had expired 2/3/13.

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, it was found that upon arrival to the facility, one (1) staff person was supervising eleven (11) one (1) year olds while they napped. The required staff to child ratio when a one (1) year old is present is one (1) staff person for every six (6) children. A second staff person entered the classroom approximately three (3) minutes after the arrival of the surveyor. In addition, it was found that one (1) staff person was supervising eighteen (18) school age children ages six (6) years to eleven (11) years old. The required staff to child ratio when a six (6) year old is present is one (1) staff person for every fifteen (15) children. The classroom was out of ratio for approximately twenty (20) minutes following the arrival of the surveyor. It is unknown how long the above classrooms were out of ratio prior to the arrival of the surveyor. General Administration

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, it was found that there were sixty-two (62) children present at the facility during the follow-up inspection. The facility's approved capacity is sixty (60) 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.

Based on observation, it was found that there were sixty-two (62) children present at the facility during the inspection. Due to zoning restrictions, the facility is limited to a capacity of sixty (60) children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report Director Requirements

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Interview, it was found that although a staff person identified herself as being in charge during the absence of the director, no one in the facility had access to the staff files. The staff person in charge stated that the files were locked in a filing cabinet.

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, it was found that an infant, who was holding a bottle containing what appeared to be formula, was asleep in an infant rocker. The facility did not have a note from a physician stating that the child must sleep in this piece of equipment. The staff person in the classroom admitted that the child was placed in the rocker with the bottle to help him fall asleep. Premises

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, it was found that the sheets on four (4) of the crib mattresses were very loose and ill-fitting.

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, it was found that nine (9) children in the downstairs three (3) year old classroom were sleeping on cots with no sheets or blankets. Food Service

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, it was found that an infant, who was holding a bottle containing what appeared to be formula, was asleep in an infant rocker. The staff person in the classroom admitted that the child was placed in the rocker with the bottle to help him fall asleep.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that on 7/29/13 there were seventy-five (75) children signed in at the facility from 6:00 a.m. to 12:00 p.m. The agreed order signed by the facility's legal council on 7/19/13 indicates that the facility’s capacity is sixty-one (61) except for during the hours of 3:00 p.m. to 4:30 p.m. at which time it rises to seventy-nine (79). On 7/23/13 there were ninety-three (93) children signed in before 3:00 p.m. on the facility’s attendance sheets. In an interview with the Director, she indicated that the attendance sheets that the surveyor reviewed for 7/23/13 were not accurate. The attendance sheets reviewed were the regulatory required sheets provided by the Child Care Assistance Program. Director Requirements

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Interview, a ten (10) year old child removed a container of pepper spray from the purse belonging to a staff person and sprayed it in the school-age classroom. Some of the spray got into the eyes of an eight (8) year old child that was in the area where the spraying occurred. The child's eyes began to burn and staff began administering First Aid. Employee Records

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 Interview, it was determined that a staff person's purse was hanging on the back of a chair in the School-age classroom when a ten (10) year old child removed a container of pepper spray from the purse and sprayed it in the classroom. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/

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 Observation, seventy-five (75) children were in the facility’s care on 5-31-13 which exceeded their capacity of sixty (60) children. The director confirmed that the center was over capacity. Employee Records

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, at the time of the survey there was no one on duty and present with the children during a field trip that was currently certified in CPR. Staff member hired on 10-10-12 confirmed that she supervised the children during the fieldtrip on 5-31-13. The most current documentation of CPR at the facility for this staff member expired on 7-9-12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Observation, it was found during a complaint investigation conducted on 4/23/13 that the facility was out of ratio in the preschool room and in the two (2) year-old room. At approximately 7:45 AM the preschool room contained sixteen (16) children and one (1) staff member. The staff in charge indicated that the youngest child in the group was four (4) years-old. At approximately 8:15 AM the two (2) year-old room contained twleve (12) children with one (1) staff member supervising them. At approxmimately 8:05 AM the preschool room contained eighteen (18) children and one (1) staff member. The youngest child was four (4) years-old. The maximum number of children one (1) staff can supervise with a four (4) year-old present is fourteen (14) children. The maximum number of children one (1) staff can supervise with a two (2) year-old present is ten (10) children. General Administration 39 - Unacceptable Plan of Correction 1) Amended plan submitted within ten days Not In Compliance Findings: A PLAN OF CORRECTION WAS DUE ON 24 Jun 13 AND AS OF 02 Aug 13, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Interview, it was found that although the parent's provide the formula for the children, the facility prepares the bottles for seven (7) children.

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, it was found that at 9:25 a.m., a staff person was found to be supervising seventeen (17) children ages two (2) years to four (4) years old as they played on the playground. At 10:40 a.m., this same staff person and a second staff person were observed to be supervising twenty-one (21) children ages two (2) years to four (4) years old as they played on the playground. The second staff person was then observed to leave the facility to take two (2) of the children to school thus leaving one (1) staff person with nineteen (19) children ages two (2) years to four (4) years old. The required staff to child ratio when a two (2) year old is present is one (1) staff person for every ten (10) children. This group remained out of ratio until 11:10 a.m. At 9:40 a.m., it was found that one (1) staff person was supervising seven (7) children in the one (1) year old classroom. All of the children were one (1) year old. The required staff to child ratio when a toddler is present is one (1) staff person for every six (6) children. This group remained out of ratio throughout the remainder of the survey. At 10:30 a.m., one (1) staff person was found to be supervising ten (10) children ages one (1) and two (2) years old. The required staff to child ratio when a toddler is present is one (1) staff person for every six (6) children. This group remained out of ratio for approximately twenty (20) minutes. At 10:40 a.m., it was found that one (1) staff person was supervising fifteen (15) children ages four (4) and five (5) years old while they played on the playground. The required staff to child ratio when a four (4) year old is present is one (1) staff person for every fourteen (14) children. This group remained out of ratio throughout the remainder of the survey.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, it was found that there were sixty-eight (68) children present at the facility during the survey. The licensed capacity of the facility is sixty (60) children.

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, it was found that a child was moved from the two (2) year old classroom to the preschool classroom in an attempt to maintain ratios. The staff indicated that moving children for ratio purposes was a regular practice of the facility. This practice does not allow the children to become familiar with a regular classroom routine.

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, it was found that there were sixty-eight (68) children present at the facility during the survey. Due to zoning restrictions, the facility is limited to sixty (60) children. 210 - Construction/Renovation Notification Not Applicable 922 KAR 2:120. Section 4. Premises Requirements. (19) The Department of Housing, Buildings and Construction, State Fire Marshal's Office, and cabinet shall be contacted concerning a planned new building, addition, or major renovation prior to construction.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found that the files for seven (7) eligible employees did not contain evidence of an annual performance evaluation being conducted.

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, it was found that a child in the younger one (1) year old classroom was seated on the floor drinking a bottle. Two (2) other children in the classroom were also seated on the floor while drinking from sippy cups. It was also found that the safety outlets in the younger one (1) year old classroom were not functioning properly, thus making the electrical outlets accessible to the children. In the infant classroom, two (2) staff were observed to be feeding baby food to two (2) children seated in bouncy seats, two (2) children seated on the floor, one (1) child in an exo-saucer and a child who was sitting in a staff person's lap. Proper seating was not used for any of the children being fed. In addition, it was found that a Fisher Price floor gym was being stored in a crib, thus contaminating the bedding. In the preschool classroom, it was found that the electrical outlet next to the water fountain was not covered. In the downstairs three (3) year old classroom, it was found that the electrical outlets by the window and the community poster were not covered.

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 an employee hired on 10-24-11 has lived in Ohio within the last three (3) years. The staff person in charge stated that the facility has not submitted a request for an Ohio background check. This employee has been employed for more than ninety (90) days. She was not observed to be working alone with 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, it was found that the files for four (4) employees hired on 8-8-11 and an employee hired on 10-10-12 contained the results of negative TB skin tests that were read on 12-29-10, 2-5-10, 1-29-10, 8-11-10 and 3-9-10. These dates are not within the two (2) year timeframe required by the regulation. In addition, it was found that the file for an employee hired on 3-21-13 did not contain evidence of the results of a negative TB skin test or a statement from a health professional stating that the employee is free from signs and symptoms of TB.

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 5-24-12 contained evidence that the six (6) hours of cabinet-approved orientation training was completed on 1-26-13. The file for an employee hired on 10-5-12 did not contain evidence of the six (6) hours of cabinet-approved orientation training being completed. This training is required to be completed within ninety (90) days of hire. In addition, it was found that the files for five (5) employees hired on 8-8-11 did not contain evidence of any additional annual training being completed during the first year of employment. The files for employees hired on 10-24-11, 11-20-11 and 11-29-11 contained evidence of only six (6) hours of additional annual training being completed during the first year of employment.

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, it was found that there was a Sassy mirror with soft toys attached hanging in one (1) of the cribs. Lion-shaped mirrors with toys attached were found to be hanging on the sides of four (4) of the cribs. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 10 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 4. Premises Requirements.

General: Based on Observation, it was found that the wood of the porch leading from the facility to the playground was very soft and splintered, especially the four (4) boards just before the metal stairs. In addition, it was found that the sink in the older one (1) year old bathroom was clogged and draining very slowly. In the downstairs three (3) year old classroom, it was found that the black vent cover on the lower part of the wall was bent, creating a very sharp point. It was also found that the walls and light switches throughout the facility were very dirty and smeared with an accumulation of grime.

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 Observation, it was found that a child had a loose bowel movement and had feces on her clothing. The child did not have her hands washed after having her diaper and clothes changed. In the preschool classroom, a child was observed to exit the bathroom without washing her hands. The staff person did not redirect the child to wash her hands after using the bathroom.

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, it was found that a staff person in the infant classroom did not wash her hands prior to or after changing a child's diaper. The staff person wore gloves, however, at no time did she wash her hands with soap and running water. After changing a child's diaper, the staff person was observed to hand a bottle to another staff person and then pick up a child. In addition, it was found that another staff person in the infant classroom did not wash her hands prior to feeding a bottle to a child.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, it was found that a staff person in the infant classroom did not disinfect the changing pad after each diaper change.

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, it was found that a parent had provided a written notice on 3-27-13 to give her child 1.75 ml of ibuprofen as needed. Daily permission to administer medication must be obtained and a specific time to give the medication must be noted 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, it was found that a one (1) and a half feet tall Little Tikes climber/slide combination unit was located on the grass of the one (1) and two (2) year old playground. On the preschool playground, children were observed to be climbing up the bars of two (2) metal climbing structures that were shaped like trucks. These structures were located on the grass and dirt, with no protective surfacing beneath them.

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, it was found that the facility did not have documentation indicating that two (2) of the cribs in the infant classroom met the new federal guidelines. One (1) of the cribs was manufactured on 11-17-07 and the other crib was manufactured on 7-10-02.

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, it was found that the blankets for the children in the two (2) year old classroom were being stored in a stack on a shelf. The staff indicated that the blankets were washed weekly.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the last inspection completed by the Transportation Cabinet on the 2006 van was conducted on 4-4-12. The staff person in charge stated that a current inspection was not available. 835 - Vehicle Requirements/Traffic Stop During Loading/Unloading Not Applicable An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 19 of 27 Web site: http://chfs.ky.gov/ Inspection Report 922 KAR 2:120. Section 12. Transportation. (6) A vehicle used to transport children shall meet the following requirements: (b) A vehicle that requires traffic to stop while loading and unloading a child shall be equipped with a system of: 1. Signal lamps; 2. Identifying colors; and 3. Cautionary words.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Observation, it was found that although the pre-trip inspection for the 2006 van indicated that the vehicle was free of debris, various pieces of paper, an apple core and an empty Squeezie bottle were found on the floor. In addition, it was found that the 2007 van had been used prior to and during the survey (4-10-13) to transport children. An inspection had not been completed on the vehicle prior to using it to transport children.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 12. Transportation.

General: Based on Review of Documentation, it was found that the facility did not have a written record of the first and last names of the children transported during the morning and mid-afternoon hours of 4-10-13. They also did not have record of the times the children got on and off the vehicle on 4-10-13. It was also found that the driver of the vehicle records the transportation information regarding the names and times. This information is not verified by anyone at the facility.

Open Not marked corrected in the state record

Category: transportation. 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 facility staff are washing bottles in the hand-washing sink located in the infant classroom. The bottles are then reused during the next feeding. This procedure is unsanitary.

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 Interview, it was found that a ten (10) month old child was drinking whole milk instead of breast milk or iron-fortified formula as required. The facility did not have documentation on file indicating a need to deviate from the requirement of the regulation.

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, it was found that a child in the younger one (1) year old classroom was seated on the floor drinking a bottle. Two (2) other children in the classroom were also seated on the floor while drinking from sippy cups. In addition, it was found that the two (2) staff in the infant classroom were feeding baby food to two (2) children seated in bouncy seats, two (2) children who were seated on the floor, one (1) child in an exo-saucer and a child who was sitting in a staff person's lap. Proper seating was not used for any of the children being fed.

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, it was found that the files for children enrolled on 1-27-12 and 8-15-12 contained immunization certificates that expired on 12-20-12 and 1-30-13.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Interview, it was found that the facility has yet to establish their emergency preparedness plan according to KRS 199.8982.

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, it was found that only thirty-four (34) of the sixty-eight (68) children present were signed in to the facility. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 25 of 27 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, it was found the files for five (5) eligible employees did not contain evidence of a current professional development plan.

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, it was found that a written notice dated 3-27-13 from a parent to give her child 1.75 ml of ibuprofen was posted on the wall of the infant classroom. This is confidential information and must not be accessible to the parents of the other children.

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, it was found that a daily schedule was not posted in the infant classroom, the young one (1) year old classroom or the downstairs three (3) year old classroom.

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, it was found that a schedule of daily activities was not posted in the young one (1) year old classroom or the downstairs three (3) year old classroom. The schedule of daily activities posted in the older one (1) year old classroom, the two (2) year old classroom and the preschool classroom were not dated.

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 diapering steps were not posted by the changing area in the young one (1) year old classroom. Animals 1175 - Animals in the Presence of Children Not Applicable 922 KAR 2:120. Section 13. Animals. (1) An animal shall not be allowed in the presence of a child in care: (a) Unless: 1. The animal is under the supervision and control of an adult; 2. Written parental consent has been obtained; and 3. The animal is certified as vaccinated against rabies; or (b) Except in accordance with subsection (3) of this section. 1185 - Prohibited Animals Not Applicable 922 KAR 2:120. Section 13. Animals. (3) An animal that is considered undomesticated, wild, or exotic shall not be allowed at a child-care center unless the animal is: (a) A part of a planned program activity lead by an animal specialist affiliated with a zoo or nature conservatory; and (b) In accordance with 301 KAR 2:081 and 301 KAR 2:082.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 3

Infants: Based on Observation, a two (2) monht old child was observed asleep on her stomach in a crib. The child had been wrapped in a blanket that can up to her chin and placed on top of two (2) additional blankets that were in the crib.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, 1. There were twenty-seven (27) children, ages three (3) and four (4) years, with two (2) staff on the preschool play ground. The child/staff ratio for this age group is one (1) staff for every twelve (12) children with a maximum group size of twenty-four (24) children. 2. There were twenty-three (23) children, ages six (6) to eleven (11) years, with one staff person on the school-age playground. The child/staff ratio for this age group is one (1) staff for every fifteen (15) children. 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 Transportation 309 - Seating 922 KAR 2:120 - Section 12 (10) Each child shall: (a) Have a seat; (b) Be individually belted or harnessed in the seat; and (c) Remain seated while the vehicle is in motion. 1) Each child has a seat In Compliance 2) Belted In Compliance Written Documentation 143 - Notification of Changes 922 KAR 2:110 - Section 6 (4) Written notification of the following shall be made to the cabinet to allow for approval before implementation: (a) Change of ownership; (b) Change of location; (c) Increase in capacity; (d) Change in hours of operation; (e) Change of services in the following categories: 1. Infant; 2. Toddler; 3. Two (2) years to school-age; 4. School-age; 5. Nontraditional hours; or 6. Transportation; or (f) Addition to the square footage a child-care center's premises. 3) Capacity Not In Compliance Findings: General: Based on Observation, at the time of the visit there were seventy-three (73) children being cared for at the facility. The facility's capacity is sixty (60) children.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, it was found that this regulatory violation was issued in EEB #9292 that was conducted at the same time as this inspection. 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 128 - CPR/First Aid Coverage 922 KAR 2:110 - Section 5 (3) At least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a)Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. 1) CPR In Compliance 2) First Aid In Compliance Food Service - Classroom 194 - Bottle Feeding 922 KAR 2:120 - Section 3 (10) While bottle feeding an infant, the: (a) Child shall be held; and (b) Bottle shall not be: 1. Propped; 2. Left in the mouth of a sleeping infant; or 3. Heated in a microwave. 1) Child held Not In Compliance Findings: Infant Room: Based on Observation, it was found that a seven (7) month-old was observed drinking a bottle while lying on their back in a crib. During a second tour of the infant room, a few minutes after the first tour, another infant was observed in a crib lying on their back drinking a bottle. This infant was eleven (11) months-old. Infants shall be held while being bottle fed.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, it was found that eleven (11) two (2) year old children were being supervised by one (1) staff person on the playground. The required staff to child ratio when a two (2) year old is present is one (1) staff person for ten (10) children. One (1) of the children was picked up by a parent approximately fifteen (15) minutes after the arrival of the surveyor. It is uncertain how long the class was out of ratio prior to the surveyor's arrival. Outdoor Play Area - Supervision 167 - Children supervised/Protected 922 KAR 2:120 - Section 2 (3) (a) Each center shall maintain a child care program that assures each child will be: 1. Provided adequate supervision at all times; and 2. Protected from abuse or neglect. 1) Adequately supervised at all times In Compliance Equipment - Classroom

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Observation, This regulatory violation was cited on the report for inspection #12463. Employee Records 128 - CPR/First Aid Coverage 922 KAR 2:110 - Section 5 (3) At least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a)Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. 1) CPR In Compliance 2) First Aid In Compliance Hygienic Practices 188 - Child Personal care/Handwashing 922 KAR 2:120 - Section 3 (4) A child shall; (a) Be helped with personal care and cleanliness; and (b) Wash his or her hands with liquid soap and warm running water: 1. Upon arrival at the center; 2. Before and after eating or handling food; 3. After toileting or diaper change; 4. After handling animals; 5. After wiping or blowing nose; 6. After touching items soiled with body fluids or wastes; and 7. After outdoor or indoor play time. 3) Handwashing before eating/handling food and after eating/handling food Not In Compliance Findings: School Age: Based on Observation, This regulatory violation was cited on the report for inspection #12463. Preschool: Based on Observation, This regulatory violation was cited on the report for inspection #12463. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report Outdoor Play Area - Staffing Requirements

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, This regulatory violation was cited on the report for inspection #12463.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on Review of Documentation, employee hired 2/17/12 did not have evidence of a high school diploma, GED or CCC on file in the facility.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 5 (1)

General: Based on Review of Documentation, 1. Employee with hire date 1/23/12 did not have evidence of a negative T.B. test on file. 2. Employee with hire date 8/9/11 did not have evidence of a current negative T.B. test on file. 3. Employee with hire date 8/8/11 did not have evidence of a current negative T.B. test on file. 4. Two (2) employees, both hired 7/14/11, did not have evidence of a current negative T.B. test on file. 5. Employee hired on 3/16/12 did not receive the results of a negative T.B. test prior to employment. The results were dated 3/20/12. 6. Employee hired on 10/27/11 did not receive the results of a negative T.B. test prior to employment. The results were dated 11/1/11. 128 - CPR/First Aid Coverage 922 KAR 2:110 - Section 5 (3) At least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a)Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. 1) CPR Not In Compliance Findings: General: Based on Review of Documentation, it was determined that there is no one on duty and present with children with current CPR certification from 6:00 p.m. to 7:30 p.m. on a daily basis. 2) First Aid Not In Compliance Findings: General: Based on Review of Documentation, it was determined that there is no one on duty and present with children with current First Aid certification from 6:00 p.m. to 7:30 p.m. on a daily basis. 131 - Adequate Substitute(s) 922 KAR 2:110 - Section 5 (6) Child-care centers shall have available in case of need: (a) One (1) qualified substitute staff person for a Type II child-care center; or (b) Two (2) qualified substitute staff persons for a Type I child-care center 1) Type I In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 8 of 43 Web site: http://chfs.ky.gov/ Inspection Report 131 - Adequate Substitute(s) 922 KAR 2:110 - Section 5 (6) Child-care centers shall have available in case of need: (a) One (1) qualified substitute staff person for a Type II child-care center; or (b) Two (2) qualified substitute staff persons for a Type I child-care center 2) Type II Not Applicable 139 - Training 922 KAR 2:110 - Section 5 (14) A staff person with supervisory authority over a child shall complete the following: (a) Six (6) hours of cabinet-approved orientation within the first three (3) months of employment; (b) Nine (9) hours cabinet-approved child development training within the first year of employment; and (c) Fifteen (15) hours of cabinet-approved training during each subsequent year of employment. 1) Orientation Not In Compliance Findings: General: Based on Review of Documentation, 1. Employee with hire date 10/27/11 had documentation of the orientation training being completed on 3/24/12. The training was not obtained within the first three (3) months of employment. 2. Employee with hire date 11/29/11 had documentation of the orientation training being completed on 3/24/12. The training was not obtained within the first three (3) months of employment. 139 - Training 922 KAR 2:110 - Section 5 (14) A staff person with supervisory authority over a child shall complete the following: (a) Six (6) hours of cabinet-approved orientation within the first three (3) months of employment; (b) Nine (9) hours cabinet-approved child development training within the first year of employment; and (c) Fifteen (15) hours of cabinet-approved training during each subsequent year of employment. 2) 9 hours-first year Not Applicable 3) 15 hours annually Not Applicable 317 - Driver requirements 922 KAR 2:120 - Section 12 (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; (d) Not have had any convictions concerning vehicle operation in the past twelve (12) months; and (e) Not caused an accident which resulted in the death of a person. 1) Be 21 years old or over In Compliance 2) Background checks In Compliance 3) Drivers license In Compliance 4) No convictions for vehicle operation In Compliance 5) No accident causing death In Compliance Programming 169 - Program of Activities Followed 922 KAR 2:120 - Section 2 (4) The child-care center shall provide a daily planned program of activities: (a) Posted in writing in a conspicuous location with each age group and followed; 1) Posted In Compliance 2) Followed In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infants: Based on Observation, a staff person in this classroom was observed handling an eleven (11) month old child inappropriately during the survey. While holding an infant, a staff person walked over to an eleven (11) month old child that was sitting in an excersaucer and pulled the child out of the excersaucer by one (1) arm and then sat the child on the floor. Therefore, not providing for the child's health, safety and comfort. 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 1) Toxic cleaning supplies, poisons, and insecticides In Compliance 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff In Compliance 197 - Premises Requirements 922 KAR 2:120 - Section 4 Premises Requirements. (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with a land-line telephone accessible to a room used by a child. 1) Suitable In Compliance 2) Clean In Compliance 3) Good repair In Compliance 4) Land-line phone accessible In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 43 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 2:110 · 922 KAR 2:110 - Section 3

General: Based on Review of Documentation, child with enrollment date 11/4/11 had an immunization certificate on file that had expired 2/24/12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.