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

Based on review of documentation, it was confirmed that the health safety and comfort of children was compromised by a staff member. Video documentation showed a staff member lifting a child by one arm to remove them from a highchair. The staff member was also seen lifting a child by one arm to place them on a cot. The staff member also forcefully pushed a child's head down onto the cot to get them to lay down.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the personnel file for a staff member (DOH: 08/09/24) did not include a negative TB skin test result or a physician’s statement indicating the staff member was free of active TB. Programming In Compliance Premises In Compliance 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

Open / not marked corrected.

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

General: Based on observation of the Toddler C Room, a staff member was changing a child’s diaper; after the diapering procedure was completed, the staff member placed the child on the floor. The staff member did not wash the child’s hands after the diapering procedure. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the paper towel dispenser within the K3 bathroom was broken, the dispenser would not close shut. Further observation revealed, there was blue tape on the piece of equipment. Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals 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 interview and review of documentation, the facility failed to ensure the health, safety, and comfort of a child when the wrong bottle was given to her. The bottle contained breastmilk. Director Requirements In Compliance Employee Records 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 of the inspection, the following was found: Room 108 1) The tile flooring around a floor vent was broken and missing pieces of tile, leaving the flooring with sharp edges that was accessible to the children. Main hallway 1) There were ceiling tiles that contained brown water stains, indicative of water damage. Room 102 1) There was a stain on a ceiling tile, indicative of water damage. 2) There was a hole in a ceiling tile. There were wires exposed. Room 106 1) There were four (4) ceiling tiles that contained brown stains, indicative of water damage. Room 103 1) There were two (2) holes in a wall, causing the paint to chip and the drywall to be exposed. 2) There was a wall adjacent to the handwashing sink and behind the handwashing sink that was soiled with an accumulation of dried food, dust, and debris. Room 104 1) The floor throughout the classroom was soiled with an accumulation of a sticky substances, dried food, dust, debris, and grey spots were on the floor, indicating that the floor had not been cleaned on a regular basis. Bathroom within room 101 1) The floor in front of the hand washing sink was soiled with an accumulation of dirt, debris, and a grey substance.

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 during the inspection, the following was found: Room 103 1) The hand washing sink and cabinet were soiled with an accumulation of dried food, dust, and debris. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 6 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. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation during the inspection, the following was found: Room 110 1) The changing table and the attached two (2) drawers contained dried substances, dust, and debris. Room 105 1) The changing table contained an accumulation of dust and debris. Also, there was dust and debris around and under the changing pad. Room 102 1) The changing pad was torn on the corner. The inside absorbent material was exposed. 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 of the outdoor play area, there was a large climbing structure that contained five (5) steps with a plastic coating that was chipping and broken, causing the steps to have sharp, pointed, and jagged edges. 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, there were numerous children’s coats and backpacks stacked on top of each other on the floor in Room 110. The staff in charge acknowledged the deficiency. 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

Open / not marked corrected.

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

General: Based on observation during the inspection, the following was found: Bathroom in Room 101 1) There was a toilet plunger sitting on the floor adjacent to the toilet that was accessible to the children. Room 102 1) There was a bottle of Jergins lotion sitting on a low table at the entry door of the classroom that was accessible to the children. 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 review of documentation, a staff member's (DOH: 08/26/21) record did not contain an annual written performance evaluation on the day of the inspection. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 6 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, two (2) staff members' (DOH: 07/01/23 and 11/06/23) record did not contain a high school diploma, GED, or qualifying documentation from a comparable educational entity; or a Commonwealth Child Care Credential on the day of the inspection.

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's (DOH: 08/26/21) record did not contain documentation of a current tuberculosis skin test or a statement from a health care professional stating that the adult was free from active tuberculosis on the day of the inspection.

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 staff members (DOH: 08/26/21, 10/24/22, and 07/01/23) did not complete the required first aid and cardiopulmonary resuscitation training within ninety (90) days of employment.

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 during the inspection the following was found: 1) A staff member's (DOH: 10/24/22) record did not contain documentation verifying the staff member had completed one and one-half (1.5) hours of cabinet-approved pediatric abusive head trauma training. 2) Three (3) staff members' (DOH: 10/24/22, 07/01/23, and 08/15/23) records did not contain documentation verifying that the six (6) hours of cabinet-approved orientation training had been completed within the first three (3) months of employment on the day of the inspection. Review of the Early Care and Education Training Records Information System (ECE-TRIS) did not verify that the training had been completed by the staff member. 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 3. General Requirements.

General: Based on observation during the inspection, the following was found: Room 110 1) A container of Clorox wipes was sitting on a low table upon entry into the classroom. The warning label on the container stated, “Keep Out of Reach of Children”. The Clorox wipes were accessible to the children. Room 102 1) A staff member’s purse was sitting on a low shelf within the classroom. Interview with the staff member revealed the purse belonged to him/her. 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 4. Premises Requirements.

General: Based on observation during the inspection, the following was found: Ladies’ bathroom in the hallway of the child care center: 1) The air vent was not working on the day of the inspection; therefore, there was no ventilation to outside air in the bathroom. Room 104 1) A window sill was chipping paint. The window sill was accessible to the children. Room 103 1) There were two (2) air vents that were soiled with an accumulation of dust and debris. Bathroom within room 102 1) There was an air vent that was soiled with dust, debris, and rust.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation during the inspection, the following was found: Room 105 1) A rail on a crib was chipping white paint. 2) The trash can lid was soiled with a dried yellow substance. 3) The rubber seal on the refrigerator door was partially detached. Room 104 1) An area rug was soiled with debris, indicating that it was not clean. Room 103 1) There was a wooden shelf that was chipping red paint. Room 102 1) The trash can and lid was soiled with an accumulation of dust, debris, and dried food. Transportation Not Applicable Kitchen 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 8. Kitchen Requirements.

General: Based on observation during the inspection, the following was found: Room 105 1) The refrigerator freezer contained a brown sticky substance and dried food particles. 2) There were black spots of the seal of the refrigerator door, indicative of mold. Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation a file for a child (DOE: 07/12/21) did not contain a preferred hospital. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 6 Inspection Report Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, two (2) caregivers, hired 4/18/16 and 12/7/20, had an annual written performance evaluation on file that was dated 7/1/21. A caregiver, hired on 12/7/20, had an annual written performance evaluation on file that was dated 6/25/21. A caregiver, hired on 12/6/19, had an annual written performance evaluation on file that was dated 6/30/21. Three (3) caregivers, hired on 5/26/21, 6/1/21 and 9/20/21, did not have an annual evaluation. Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on interview and review of documentation, two (2) caregivers, hired on 5/10/22 and 8/18/22, did not have education verification 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 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on interview and review of documentation, a caregiver, hired on 2/21/22, had TB documentation that was dated 7/6/20.

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 interview and review of documentation, a caregiver, hired on 4/18/16, completed fourteen and a half (14 1/2) hours of training during the subsequent year of employment. A caregiver, hired on 5/26/21, completed thirteen (13) hours of training during the subsequent year of employment. 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation and interview, the hot water temperature registered seventy-five (75) degrees Fahrenheit in the sink in rooms 101, 103, 104, 105, and 106. The hot water temperature registered sixty-five (65) degrees Fahrenheit in the sink of room 109B. 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 caregiver did not wash her hands after diapering a child in room 101. First Aid/Medication In Compliance Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Equipment Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation and interview, the ends of two (2) blue mats were torn and foam was exposed in room 102. A crib mattress was torn and foam exposed in room 105. Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation 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 interview and review of documentation, two (2) caregivers, hired on 12/6/19 and 7/1/21, had an annual professional development plan on file that was dated 7/1/21. A caregiver, hired on 9/3/0, had an annual professional development plan on file that was dated 7/8/21. A caregiver, hired on 12/7/20, did not have an annual professional development plan on file. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, the staff in charge did not provide verification that the employees with the hire dates of 04/26/2012,04/18/2016, 05/13/2019 and 10/21/2020 had met the requirement of fifteen (15) hours of cabinet-approved early care and education training during the last year of employment. Continued review revealed the employee with the hire date of 10/21/2020 had not completed Orientation and Pediatric Head Training training within the required timeframes. Review of documentation in the ECE-TRIS training system revealed the staff members listed above had not met the requirements. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, a four-month-old and an eleven-month-old infant were sleeping in separate cribs with loose bedding. 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 ceiling tiles in the infant restroom and in the four and five-year-old classroom contained brown stains that were indicative of water stains.

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, the handwashing sink in the two-year-old classroom was not equipped with hot, running water. The water temperature was sixty-two (62) degrees Fahrenheit. 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. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the changing pad located in the infant classroom had duct tape on the bottom of the pad and the vinyl did not completely cover the area underneath. Continued observation revealed the top of the pad was ripped, exposing the material inside. Therefore, the changing pads were not kept in a hygienic manner. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the multi-color climbing blocks in the playroom were torn and ripped on the seams, exposing the material inside. Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance 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 interview and review of documentation, the staff in charge did not present verification that the records for children with the enrollment dates of 02/09/2021,03/17/2021 and 09/01/2021 contained a current immunization certificate. The documentations presented had expired. Written Documentation In Compliance Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on interview and review of documentation, the staff in charge did not present verification that a written plan outlining the course of action in the event of a natural or manmade disaster was posted in a prominent place. Animals Not Applicable

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, the bathroom located in the classroom known as Two A had a plunger next to the toilet, which was accessible to children. In additon, the bathroom located in the classroon known a K3 had a toilet brush next to the toilet. Employee Records In Compliance Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a review of ten (10) children's files revealed that one file did not have a current, certificate of immunization.

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 observation and review of documentation, a review of ten (10) children's files revealed a file did not contain the name of the preferred hospital (the file noted "nearest hospital") and another file did not disclose a physician. Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable Emergency Regulation In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, The child care center director failed to comply with regulatory requirements in regard to health, safety and comfort of children in care. A daycare teacher smacked a child on the hand/arm multiple times, because the child was hitting his tray. Interviews confirmed that the staff member confessed to hitting the child on the arm as a way to get him to stop. The staff member cares for the child at home away from the center and is used to disciplining him in that manner. Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, The child care center director failed to comply with regulatory requirements in regard to the discipline of children in care. A daycare teacher smacked a child on the hand/arm multiple times, because the child was hitting his tray. The staff member hired on 8/10/19, confessed to smacking the child on the hand one time as a form of discipline. Premises Discussed

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to maintain background checks in accordance with regulatory requirements. Review of the KARES database revealed a current staff member with a hire date of 5/7/19 was listed as "eligible not employed." The staff member in charge acknowledged that she failed to change the employment status of the aforementioned staff member to "current employee" in the KARES database upon hire. 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, the child care center director failed to assure compliance with regulatory requirements. Observation of the K 4 A Room revealed an outlet was uncovered. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, interview and review of documentation, the child care center failed to maintain employee records in accordance with regulatory requirements. Upon request, the staff member in charge did not present verification that a staff member with a hire date of 10/31/16, who is a high school student, is currently enrolled in high school.

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 interview and review of documentation, the child care center failed to maintain employee records in accordance with regulatory requirements. Upon request, the staff member in charge did not present verification that the file for a staff member with a hire date of 4/17/17 contained a current statement from a health professional that the individual is free of active tuberculosis; or a copy of negative tuberculin results.

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 interview and review of documentation, the child care center failed to maintain employee records in accordance with regulatory requirements. 1) Upon request, the staff member in charge did not present verification that staff members with hire dates of 4/26/12, 1/28/13, 5/9/16, 5/16/16, 10/31/16, and 12/4/17 had completed fifteen (15) annual hours of cabinet approved early care and education training. 2) Continued review revealed the files for staff members with hire dates of 1/29/19 and 2/8/19 did not contain verification that the staff members had completed six (6) hours of cabinet-approved orientation within the first three (3) months of employment. 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 3. General Requirements.

General: Based on observation, the child care center failed to maintain the premises in accordance with regulatory requirements. 1) Observation of the Pre K 4 B Room revealed an unlocked cabinet under a sink in the classroom contained: two (2) thirty-two (32) ounce spray cans of Clorox 4 in 1 Disinfectant Spray, one (1) thirty-three (33) fluid ounce bottle of DG Home Multi-Purpose Cleaner, and one (1) thirty-two (32) fluid ounce spray bottle of Clorox Clean Up, which were accessible to the children in care. 2) Observation of the Three's Room revealed a staff member's purse was on a table, and accessible to the children in care. 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 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the child care center failed to maintain the premises in accordance with regulatory requirements. 1) Observation of the Older Twos Room revealed the cover of a fluorescent light was hanging off of the light fixture. 2) Continued observation of the Older Twos Room revealed a fluorescent light was flickering continuously, indicating that it was not functioning properly.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain the premises in accordance with regulatory requirements. 1) Observation of the Toddler A Room revealed there was a hole in the ceiling tile. 2) Continued observation of the Toddler A Room revealed a ceiling tile was separated from its 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 child care center failed to maintain the premises in accordance with regulatory requirements. Observation of the sink in the Men's and Women's bathrooms in the hallway revealed the hot water temperature exceeded 120 degrees.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain the premises in accordance with regulatory requirements. Observation of the toilet in the Threes Room bathroom revealed the toilet seat was cracked from top to bottom. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain an outdoor play area in accordance with regulatory requirements. Observation of the playground revealed four (4) new fence posts laid on the ground, and were accessible to the children in care, creating a potential safety hazard. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and observation, the child care center failed to maintain written documentation in accordance with regulatory requirements. 1) Allergy lists were posted and visible to the public in all ten (10) of the classrooms in the center. 2) Continued review revealed a child's pick-up list was posted and visible to the public in the Threes Room. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center director failed to assure compliance with regulatory requirements. Review of video documentation on 4/11/19 revealed on 4/10/19 a staff member striking a child in the head with the palm of their hand during naptime. Continued review of video revealed the same staff member making a striking motion with their hand towards another child. Interview with director revealed she acknowledged the deficiency.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 4. Procedures and Payments.

General: Based on review of documentation, interview, and observation, the child care center failed to maintain background checks in accordance with regulatory requirements. Upon request, the child care director did not present verification that the employees with the hire dates of 04/09/2018, 04/23/2018,04/24/2018 and 04/28/2018, had completed fingerprint checks to obtain their background checks. The above mentioned employee were not observed working alone. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance Director Requirements In Compliance Employee Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to comply with regulatory programming requirements. Upon request, the child care director did not present verification that the daily activity of programming was posted in writing that had been updated to reflect the current week that included the activities that are individualized and developmentally appropriate for each child for the children in two (2) of the nine (9) classrooms. 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 child care center failed to maintain premises in accordance with regulatory requirements. The blue wall located in the one-year-old classroom had a large circle area near the bottom of the wall where the paint was flaking and the drywall was exposed. The area was accessiable to children.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain the premises in accordance with regulatory requirements. Observation of the bathroom located in the K-4-B and three-year-old classrooms revealed there was dust, dirt and hair strands located on the base of the toilet underneath the toilet tank. 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 and interview, the child care center failed to comply with hygienic practices in accordance with regulatory requirements. Upon observation in the one- year-old- classroom, the children were not assisted or prompted in hand-washing procures prior to the lunch meal. Interview with the staff revealed that hand-sanitizer is utilized throughout the day, in place of warm running water and soap. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain equipment in accordance with regulatory requirements. Various toys located throughout the classrooms revealed a number of battery-operated toys that were not maintained and used according to the manufacturer's specifications; the batteries were non-operational. Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to maintain written documentation in accordance with regulatory requirements. Upon request, the child care director did not provide verification that the daily attendance record for 05/16/2018 had been maintained to accurately report the number of children in attendance. The record indicated eighty-eight (88) children had been signed in. Observation revealed one hundred and eleven (111) in attendance. Continued review revealed the daily attendance record for the week of 05/14/2018 was verified in advance as evidenced by the signature of the parent or designated person for nine (9) of the children listed on the DCC -94E form. 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 and interview, the child care center failed to post documentation in accordance with regulatory requirements. Upon request, the child care director did not provide verification that the information on the Kentucky Consumer Product Safety Program and the program's website as specified in KRS 199.897 was posted in a conspicuous place and available for public inspection. Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the child care center failed to comply with regulations regarding Staffing Requirements. In the Three's room there were thirteen (13) three-year-old children in the classroom with staff member with hire date 08/20/2012 at the initial start of the survey (8:30am). The aforementioned staff member did admit to the HSS that she was aware she was out of ratio and needed to call the director to notify she needed more staff assistance in her classroom. When the HSS returned at 8:37am, there were then fourteen (14), three-year-old children with the same aforementioned staff member being the only teacher in the classroom. At 8:37am, it was then observed that the staff member with hire date 09/20/2013 entered the classroom, making the classroom within child to staff ratio. Interview with the director indicated she was not aware the classroom was out of ratio at that time. General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 7 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to comply with regulatory requirements. The documented staff meeting from April 2017 was not available with staff members' signatures. When asked, the director indicated she does not keep record of who attends the staff meetings.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to comply with regulations for Director Requirements. An annual written performance evaluation was not presented for a staff member with hire date 04/04/2016.

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, the child care center failed to comply with regulations regarding Director Requirements/Health, Safety, and Comfort as follows: 1) The Three's bathroom, Infant bathroom, K-4B bathroom, and Men's bathroom contained a plunger in the bathrooms next to the toilet. 2) The K-3B bathroom contained a toilet brush next to the toilet. 3) The child care center's hallway had three (3) electrical outlets that had no cover. 4) The K-4A room had a bottle of Hand Sanitizer indicating "keep out of reach of children" on the label. 5) In the Infant room there was an electrical extension cord that was hanging above a crib, making it accessible to a child's reach. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to comply with regulations for employee records. The following three (3) staff members with the hire dates 02/21/2017, 05/29/2017, and 03/13/2017, did not have a personnel file which contained proof of a criminal record check or child abuse and neglect check. None of the aforementioned staff members were observed to be alone with children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 7 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to comply with regulations for employee records. The staff member with the hire date 03/13/2017, did not have a personnel file which contained proof of a statement from a health professional that the individual is free of active tuberculosis, a criminal records check, or a child abuse and neglect check. Interview with the director revealed there was no documentation or a personnel file at the time of survey.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to maintain employee records in accordance with regulations. Review of staff files revealed staff members with the hire date of 05/29/2017 and 03/13/2017 failed to have records of a negative tuberculin result.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to maintain employee records in accordance with regulations. Review of staff files and ECE-TRIS report revealed that fifteen (15) hours of cabinet approved training was not presented for review at the time of survey for staff members with hire dates 08/19/2014 and 09/20/2013. 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, the child care center failed to comply with regulations regarding Programming. In the Toddler A room there were four (4) children seated in highchairs at the initial start of the survey (8:30am). When the HSS returned to the classroom (9:05am), those same four (4) children were still seated in the same highchairs causing the children to be restricted for a long period of time from 8:30am-9:05am. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 7 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to comply with regulations regarding Premises as follows: 1) In the Infant room bathroom, there were four (4) bottles of toxic cleaning supplies (shower cleaner, Glade air freshener, odor eliminator, carpet fresh) and three (3) bottles of personal belongings that indicate "keep out of reach or children" on the label (hair spray, firm hold hair spray, and baby powder). 2) There were also several plastic bags on the bathroom floor, accessible to a child's reach.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to comply with regulations regarding Premises. In the 2B room the window screen had a hole opening to the outside, preventing protection against the entrance of vermin into 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, the child care center failed to comply with regulations regarding Premises as follows: 1) Baseboards were separating away from the wall in the K-4A and 2B classrooms. 2) In the K-4A room there was a torn baseboard exposing the wall insulation. 3) In the Toddler A room the carpet was torn around the edges, exposing fabric at the seams. 4) In the K3-B room and Toddler B room there were several areas of paint chipping on the book shelves. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the child care center failed to comply with regulations regarding Hygienic Practices. In the Infant room there was debris underneath the changing pad on top of the diaper changing table. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 7 Inspection Report 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, the child care center failed to comply with regulations regarding medication. In the 2B room there was a bottle of "A&D" ointment and "Max Strength diaper cream" on the top shelf by the supply of diapers, that were not in a locked place. Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, the child care center failed to comply with regulations regarding Equipment. In the Toddler A room there were three (3) high chairs torn with fabric exposed at the seams. There was also a high chair with duct tape completely surrounding the height back of the chair, with a toddler observed to be seated in the highchair. Transportation Not Applicable 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, the child care center failed to comply with regulations regarding Food Service. The Infant Room freezer thermometer registered thirty-two (32) degrees Fahrenheit.

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 and interview, the child care center failed to comply with regulations regarding Food Service. In the Infant room there was debris in the microwave on the counter top. Interview with staff member with date of hire 08/10/2015 did indicate that the microwave is used to prepare infant meals. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 7 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to maintain children’s records in accordance with regulatory requirements. The record for a child with the enrollment date of 08/17/2015 did not contain information for an emergency contact. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to comply with regulations regarding Written Documentation. The attendance records and interview with the director revealed sixty-three (63) children were present during time of survey and only sixty-one (61) signed into the daily attendance record for that day. Posted Documentation Not In Compliance

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 review of documentation and interview, the child care center failed to comply with regulations regarding Posted Documentation. The Statement of Deficiencies issued by the cabinet during the current licensure year and Plan of Correction submitted to the cabinet were not posted in a conspicuous place. Interview with the director indicated the Statement of Deficiencies and Plan of Correction were posted in the director’s office behind the desk, hanging on a bulletin board. When further interviewed, the directed indicated that parents were not allowed into the director’s office to review any documentation without the director's permission.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the child care center failed to post documentation in accordance with regulations. The Infant room and 2A room had no daily activities 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, the child care center failed to post documentation in accordance with regulations. The 2A room had no diaper changing procedure posted near the diaper changing area. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 6 of 7 Inspection Report Animals Not Applicable

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.

Based on observation, record review and interview, the child care center director failed to assure compliance with regulatory requirements with regard to staff management and supervision. Observation of the Older two (2) to three (3) year old classroom revealed staff on a personal cell phone while caring for children in the classroom. Review of the child care center’s “Supervision of Children” policy and procedures for cell phone usage revealed “cell phone calls or texting are not allowed while staff are at work. The exception is if staff are on break and out of the room.” Interview with the child care center director revealed staff were instructed not to use their cell phones in the classrooms.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on Review of Documentation, and interview, the child care center director failed to assure compliance with regulatory requirements as it related to the health, safety and comfort of a child in care. Review of written documentation, review of video surveillance and interviews of staff revealed a three (3) year-old child received an eye injury that required medical treatment. Although staff were present, interviews revealed no one seemed to be aware of the incident until the video surveillance documentation was reviewed. Exit interview with the child care center director revealed acknowledgement of deficient practice. 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, and interview, the child care center failed to maintain employee records in accordance with regulatory requirements. Review of record for staff with a hire date 05/31/16 revealed no documented evidence of a high school diploma, GED or qualifying documentation from a comparable educational entity or Commonwealth Child Care Credential as described in 922 KAR 2:250. Interview with the child care center director revealed staff was still a high school student. There was no evidence of a letter from the high school which indicated the staff was in good standing. Programming

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, the child care center failed to comply with regulatory programming requirements. Observation of the Infant room revealed an infant asleep in the crib with a loose blanket over his head. Interview with staff revealed the child was six (6) months old. Equipment

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, the child care center failed to maintain equipment in accordance with regulatory requirements. Observation of the Toddlers classroom revealed five (5) cribs. Further observation revealed five (5) toddlers who slept in the cribs. Interview with staff revealed the youngest child in the classroom was fifteen (15) months and the oldest was twenty-four months. Additional interview revealed there were no appropriate developmental reasons for the toddlers who slept in the five (5) cribs. Written Documentation

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the child care center failed to assure compliance with regulatory requirements. Based on a review of documentation, staff members with hire dates of: 06/11/10, 12/08/08, 02/01/13, 10/08/10, 12/03/14, and 03/01/13 failed to have documentation showing an assessment of each person's interaction with children in care and classroom performance through an annual written performance evaluation.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Review of Documentation, the child care center failed to maintain employee records in accordance with regulatory requirements. Based on a review of all staff files, staff members with hire dates of 08/10/15, 06/25/15, 05/30/16, 05/23/16, 03/17/16, 05/16/16, 10/27/14, and 05/10/16 failed to have written documentation revealing a high school diploma, GED, or qualifying documentation from a comparable educational entity, or a letter from a school official verifying their current enrollment.

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 child care center failed to maintain the premises in accordance with regulatory requirements. Based on observation of the large kitchen, numerous 5 gallon buckets, 1 gallon jugs, and various other containers containing chemicals, cleaners, strippers, and bleach, with warnings of Keep Out of the Reach of Children on all of the aforementioned containers, were on the floor, and accessible to the school age children, whose classroom was directly across the hall from the kitchen, where both doors to the kitchen were propped open when observed, both before and after lunch.

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 child care center failed to maintain the premises in accordance with regulatory requirements. Based on observation, the vents in the bathrooms were clogged with dust and dirt, failing to be maintained and kept clean.

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 maintain the premises in accordance with regulatory requirements. Based on observation, numerous light fixtures in the Toddler room, Tiger room, and 3 year old room had broken pieces of plastic in the bulb coverings.

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 child care center failed to maintain the premises in accordance with regulatory requirements. Based on observation in the Toddler Room, three (3) of the ceiling tiles showed evidence of water damage.

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 child care center failed to maintain the premises in accordance with regulatory requirements. Based on observation, the hot water in the Toddler room exceeded the maximum of 120 degrees Fahrenheit. Based on interview with staff in charge, she acknowledged the water exceeded the acceptable maximum temperature by touch.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the child care center failed to maintain the premises in accordance with regulatory requirements. Based on observation, the bathroom in the Tiger room, failed to contain ventilation to outside air. Based on continued observation, a bathroom in the hallway designated as Ladies, failed to have a working ventilation system within the room also. Hygienic Practices

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a large blue shelving unit in the Tiger Room, and a large red shelving unit in the Sweet Peas room, revealed bare wood where paint had been worn off of the edges of the shelves. Continued observation revealed in the Toddler Room, three (3) plastic riding toys which were missing handles, on which to hold, while riding were observed.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the child care center failed to maintain the food service in accordance with regulatory requirements. Based on observation, all seven (7) of the children in the Tiger Room failed to be served a breakfast snack which meets regulatory requirements. Based on observation, the children were served milk, and chocolate donuts which did not meet the requirements of a grain product. Additionally, one (1) female child was observed eating a bag of Doritos and milk for her breakfast snack. Based on interview with staff, the parent had sent in the Doritos as the snack. Based on further interview with staff in charge, food is brought into the center by parents and is not evaluated for meeting requirements by staff members.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the child care center failed to maintain children's records in accordance with regulatory requirements. Based on a review of documentation, a child's file failed to reveal contact information to enable a person in charge to contact the child's preferred hospital.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the child care center failed to maintain written documentation in accordance with regulatory requirements. Based on a review of all staff files, staff members with hire dates of: 06/11/10, 12/08/08, 02/01/13, 10/08/10, 12/03/14, 03/01/13 failed to have a written, annual plan for professional development contained in the file.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the child care center failed to maintain a written documentation in accordance with regulatory requirements. Based on a review of documentation, a policy stating that the procedures taught at orientation training would be implemented by each child care center staff member failed to be contained in the file.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of records and interview, the child care center failed to maintain adequate supervision in accordance with regulatory requirements. Review of a video recording from 2/19/16 revealed a staff member supervising twelve (12) four-year-old children at approximately 9:40 a.m.. Continued review of the recording revealed that the staff member removed a cell phone from her pocket and directed her attention to the cell phone device from 9:40 a.m. until 9:44 a.m.. Ongoing review of the recording revealed that while the staff member was distracted by cell phone usage, two (2) children left their seats and proceeded under a cluster of desks, out of the scope of vision of the staff member for approximately three (3) minutes, prior to returning to their respective seats. Continued review of the recording reviewed that while under the table, one (1) of the children was observed lying on the floor on his back, lifted his buttocks off the floor and pushed his waist band down. Interview with the director revealed that a child viewed in the video, and identified as one (1) of the children under the table, had reported to his mother that he was under a table with another child and contact was made with exposed genitalia. Interview with the staff member on 3/2/16 revealed that the staff member was unaware that the children had been under cluster of desks engaged in inappropriate behavior. Staffing Requirements

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on Review of Documentation, and interview, the child care center director failed to assure compliance with regulatory requirements. Review of a video recording from 2/19/16 revealed a staff member supervising a room of twelve (12) four-year-old children. Continued review of the video recording revealed the staff member removed a cell phone from her pocket and engaged in cell phone activities from 9:40 a.m. until 9:44 a.m.. Interview with the director revealed that a staff meeting on 2/17/16 included documentation that each staff member signed off on to include a policy regarding the supervision of children which prohibited the use of cell phones in the classroom. Review of records revealed the policy regarding cell phones which read, “Cell phone calls or texting are not allowed while you are at work”. Continued review of records revealed that the identified staff member had signed off on the policy on 2/17/16. 265 - Health, Safety, Comfort Discussed 922 KAR 2:110. Section 4. Director Requirements and Responsibilities. (1) Effective with the adoption of this administrative regulation, a director shall: (l) Provide for the health, safety, and comfort of each child;

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on Observation, review of documentation and interview the child care center director failed to comply with director regulatory requirements. Observation of the school age classroom at 10:50am and at 11:15am revealed one (1) staff member (DOH: 1/26/15) supervising eleven (11) children ages six-years-old to twelve-years-old. Observation of the hallway near the entrance of the building at 12:35 pm revealed the aforementioned staff member (DOH: 1/26/15) supervising ten (10) children alone ages six-years-old to twelve- years-old. Review of the central registry document for the aforementioned staff member revealed she lived in Utah and California within the last five (5) years. Continued review of documentation revealed the aforementioned staff member did not have an out of state criminal records check on file. Interview with staff (DOH: 1/26/15) revealed she lived in Utah and California within the last five years. Interview with staff in charge revealed an out of state criminal records check has not been processed for the aforementioned staff member.

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, review of documentation and interview the child care center failed to comply with employee records regulatory requirements. Observation of the school age classroom at 10:50am and at 11:15am revealed one (1) staff member (DOH: 1/26/15) supervising eleven (11) children ages six-years-old to twelve-years-old. Observation of the hallway near the entrance of the building at 12:35pm revealed the aforementioned staff member (DOH: 1/26/15) supervising ten (10) children alone ages six- years-old to twelve-years-old. Review of the central registry document for the aforementioned staff member revealed she lived in Utah and California within the last five (5) years. Continued review of documentation revealed the aforementioned staff member did not have an out of state criminal records check on file. Interview with staff (DOH: 1/26/15) revealed she lived in Utah and California within the last five years. Interview with staff in charge revealed an out of state criminal records check has not been processed for the aforementioned staff member.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, the child care center failed to comply with employee records regulatory requirements. Review of staff files revealed an employee with the hire date of 3/1/13 did not have documentation from a health professional to verify that the individual was free from active Tuberculosis.

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 child care center failed to keep their premises clean. Observation of classroom 103, 104, 105, and 106 revealed vents in each classroom with dust build-up. Continued observation of the aforementioned vents revealed the dust from the vents had spread to the ceiling tiles.

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 comply with premises regulatory requirements. Observation of the floor near the bathroom in room 102 revealed two (2) floor tiles were missing near the exit of the restroom. Further observation of the facility revealed classroom 103 to have a brown stain on the ceiling tile, near the door entrance.

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, the child care center failed to comply with equipment regulatory requirements. Observation of the sink used for children, in room 102 revealed the base of the faucet was missing near the hot water knob.

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 child care center failed to comply with food service regulatory requirements. Observation of the refrigerator revealed a gallon of 2% reduced fat milk. Interview with staff revealed the aforementioned milk is served to everyone besides the infants and toddlers.

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, it was determined the center failed to comply with regulatory requirements regarding supervision, specifically ensuring the children are within scope of vision and range of voice. At approximately 3:00 p.m. on 11/12/14 an infant was observed sleeping in a crib located in an area along a half-wall which divides the infant classroom. Further observation revealed two (2) supervising staff members sitting in rocking chairs located in the area on the opposite side of the half-wall; the sleeping infant was out of the scope of vision of both staff members. Interview revealed the infant had been sleeping for approximately one (1) hour and both staff members had been feeding other infants for approximately five (5)-ten (10) minutes. Additionally, interview revealed that it is normal practice for children to sleep on one side of the classroom while the staff members care for children on the opposite side of the classroom because the children are "checked on" occasionally. Staffing Requirements

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on Review of Documentation, and interview, the child care center failed to maintain employee records in accordance with regulatory requirements. Review of staff files revealed that staff with the hire date of 6/7/12 did not have verification of nine of the required fifteen hours of cabinet approved training available for review at the time of the survey. Interview with the director revealed that this staff person was summer help and did not complete the additional nine hours.

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 maintain the premises in accordance with regulatory requirements. Observation revealed a fluorescent light bulb located in room #106 and four fluorescent light bulbs located in room #100 that were not shielded or shatterproof. Additional observation revealed that these were classrooms used by the children in care at the time of the survey.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the child care center failed to comply with regulatory requirements regarding medication. Observation revealed a bottle of refrigerated Cephalexin that failed to be in a locked place, located in the refrigerator of the one year old room #104. 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 6. Sleeping and Napping Requirements.

General: Based on Observation, and interview, the child care center failed to maintain equipment in accordance with regulatory requirements. Observation revealed a sheet on a crib mattress used in room #104 failed to be in poor repair. Additional observation revealed the sheet to have a hole in the fabric approximately the size of a silver dollar at the time of the survey. Interview with the staff revealed that the crib was currently being used for rest time for a child in care.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the child care center failed to maintain food service in accordance with regulatory requirements. Observation revealed an unlabeled bottle located in the refrigerator of the infant room in room #105 at the time of the survey.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, observation and interview, the child care center failed to maintain written documentation in accordance with regulatory requirements. Review of attendance records revealed five children signed in on June 9, 2014. Observation revealed sixty-seven children in attendance. Interview with the director revealed that the center staff have a difficult time getting the parents to sign their children in on the attendance sheet.

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, the child care center did not maintain with regulatory programming requirements. Observation of the Infants' Room revealed a six-month-old infant was sleeping in a crib with the bedding not properly tucked. Food Service

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 child care center did not maintain food service in accordance with regulatory requirements. Observation of the afternoon snack being served to the children revealed only one component (cheerios, pretzels, or graham crackers) was being served along with water. Interview with the center's director revealed she was unaware the afternoon snack had to have at least two of the required components.

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, two staff with hire dates 1-8-13 and 6-3-13 failed to have documentation on file varifying education requirements at the time of the survey.

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, three cribs in the infant classroom contained toys hanging from the rails inside of the crib.

Open Not marked corrected in the state record

Open / not marked corrected.

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

One year old room: Based on observation, no alternate activity was provided during television viewing.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infant Room: Based on observation, cribs were placed less than twelve (12) inches apart.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 4 (18)

General: Based on observation, a metal post was jutting out, at an approximate three (3) foot height, into the playground.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 6

Infant Room: Based on observation, Cribs were not 12 inches apart.

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, Observation of the Three-year-old room at 9:00 a.m. revealed one (1) staff member was the sole caregiver assigned to care for thirteen (13) children. During interview the director acknowledged that staff-to-child ratio was not maintained in the Three-year-old room and stated that the facility was short staffed and a substitute had not yet arrived. 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 (1)

General: Based on Observation, Observation of the Infant room revealed two (2) infants were sitting in infant carriers that had been placed inside of the infant cribs. During interview the director stated she was unaware that staff had allowed infants to remain in their carriers after being placed inside the cribs. 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 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: Infant room: Based on Observation, Observation of the Three-year-old room revealed staff did not instruct the children to wash their hands after eating the morning snack. Observation of the Infant room revealed a staff member failed to wash an infant's hands after a diaper changing process. During interview the director stated she was unaware that staff failed to wash the three-year-old children's hands and the infant's hands. 189 - Staff Hygiene/Hand Washing 922 KAR 2:120 - Section 3 (5) Staff shall: (a) Maintain personal cleanliness; (b) Conform to hygienic practices while on duty; and (c) Wash their hands with liquid soap and running water: 1. Upon arrival at the center; 2. After toileting or assisting a child in toileting; 3. Before and after diapering each child; 4. After wiping or blowing a child's or own nose; 5. After handling animals; 6. After caring for a sick child; 7. Before and after feeding a child or eating; 8. Before dispensing medication; and 9. If possible, before administering first aid. 4) Handwashing after toileting or assisting child Not In Compliance Findings: Infant room: Based on Observation, Observation revealed a staff member in the infant room failed to wash her hands after changing a child's diaper. During interview the director stated she was unaware that staff failed to wash her hands after changing a child's diaper.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infant room: Based on Observation, Observation revealed a staff member in the Infant room failed to disinfect the diaper changing surface after changing a child's diaper. During interview the director stated she was unaware that staff failed to disinfect the diaper changing surface. Food Service 265 - Menu 922 KAR 2:120 - Section 9 (4) A weekly menu shall be: (a) Prepared; (b) Dated; (c) Posted in advance in a conspicuous place; (d) Kept on file for thirty (30) days; and (e) Substitutions to a posted weekly menu shall be noted on the day the meal is served. 5) Substitutions noted Not In Compliance Findings: General: Based on Review of Documentation, Review of the posted menu revealed it was labeled "Breakfast Nov. 2011" and cereal and milk was noted as being served daily. Observation revealed the children were served a snack of applesauce and water. During interview the director confirmed that a breakfast meal was not served that it was only a morning snack. The director acknowledged that substitutions had not been made to the posted menu. 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 267 - Snack Requirements 922 KAR 2:120 - Section 9 (6) A snack shall include two (2) of the following: (a) Milk; (b) Protein; (c) Bread; or (d)1. Fruit; 2. Vegetable; or 3. 100 percent juice. 1) Milk ** Must select two from the list Not In Compliance Findings: General: Based on Observation, Observation revealed the children were served applesauce and water for a morning snack which did not meet the minimum standards for a snack meal. During interview the director acknowledged that the morning snack failed to meet minimum standards and that she had not had time to purchase milk for the children.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

Based on observation the three-year-old room did not maintain appropriate staff-to-child ratio as there one (1) caregiver was assigned to care for thirteen (13) children. During interview the director acknowledged the finding and stated she was short staffed on the day of the survey. 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 (1)

Based on observation infant room staff allowed two (2) infants to sleep in infant carriers that had been placed inside infant cribs. During interview the director stated she was unaware that staff allowed infants to sleep in the carriers. 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 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: Based on observation the staff in the three-year-old room failed to have the children wash their hands after finishing the snack meal. During interview the director stated she was unaware that staff failed to wash the children's hands. 4) Handwashing after toileting or diaper change Not In Compliance Findings: Based on observation a staff member in the infant room failed to wash a child's hands after a diaper changing process. During interview the director stated she was unaware that the staff member failed to wash the child's hands. 189 - Staff Hygiene/Hand Washing 922 KAR 2:120 - Section 3 (5) Staff shall: (a) Maintain personal cleanliness; (b) Conform to hygienic practices while on duty; and (c) Wash their hands with liquid soap and running water: 1. Upon arrival at the center; 2. After toileting or assisting a child in toileting; 3. Before and after diapering each child; 4. After wiping or blowing a child's or own nose; 5. After handling animals; 6. After caring for a sick child; 7. Before and after feeding a child or eating; 8. Before dispensing medication; and 9. If possible, before administering first aid. 5) Handwashing before/after diapering Not In Compliance Findings: Based on observation the staff member in the infant room failed to wash her hands after changing a child's diaper. Further observation revealed the same staff member then proceeded to pick up a child's food and began to feed the infant. During interview the director stated she was unaware that a staff member failed to wash her hands after diapering a child and then proceeded to feed a child.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on observation a staff member in the infant room failed to disinfect the diaper changing surface after changing a child's diaper. During interview the director stated she was unaware that a staff member failed to disinfect the diaper changing surface. Food Service 264 - Meals Required 922 KAR 2:120 - Section 9 (3) The child-care center shall serve: (a) 1. Breakfast; or 2. A mid-morning snack; (b) Lunch; (c) A mid-afternoon snack; and (d) Dinner. 2) Mid-morning snack In Compliance 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 265 - Menu 922 KAR 2:120 - Section 9 (4) A weekly menu shall be: (a) Prepared; (b) Dated; (c) Posted in advance in a conspicuous place; (d) Kept on file for thirty (30) days; and (e) Substitutions to a posted weekly menu shall be noted on the day the meal is served. 5) Substitutions noted Not In Compliance Findings: Based on record review the menu posted on the wall in the facility's lobby revealed it was not current as it noted that children would received cereal and milk for all of the breakfast meals; however, the children were served applesauce and water. During interview the director stated that the applesauce and water was only a morning snack and that the children did not receive cereal and milk on a daily basis. 267 - Snack Requirements 922 KAR 2:120 - Section 9 (6) A snack shall include two (2) of the following: (a) Milk; (b) Protein; (c) Bread; or (d)1. Fruit; 2. Vegetable; or 3. 100 percent juice. 4) Fruit/Vegetable/Juice ** Must select two from the list Not In Compliance Findings: Based on observation in the one-year-old classroom and the three-year-old classroom the children were only served applesauce and water which did not meet minimum standards. During interview the director acknowledged that the snack did not meet minimum standards. The director stated further that the facility had run out of milk on the day of the survey.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.