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

General: Based on interview and review of documentation, the last Fire Marshal report was dated 9/16/2019. The staff in charge stated that she has sent request by email but could not provide proof of contact at the time of review. Director Requirements 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 10. Director Requirements and Responsibilities.

General: Based on review of documentation, a staff member with hire date of 1/4/2021 did not have record of a current annual written performance evaluation on file for 2022 or 2023 at the time of review. 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 An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, children with enrollment dates of 8/5/2022 and 7/5/2022 did not have contact information for the family physician or preferred hospital on enrollment form at the time of review. A child with enrollment date of 5/20/2019 did not have contact information for the preferred hospital on the enrollment form at the time of review. 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, a staff member with hire date of 1/4/2021 did not have a written annual plan for child-care staff professional development for 2022 or 2023 at the time of review. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, the staff in charge 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 for the infant and three-year-old classrooms.

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 four-month-old and a five-month-old was observed sleeping in separate cribs with pacifiers that contained a long strap as an attachment. 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 beige area carpet in the two-year-old classroom contained numerous dark stains. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. 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 provide verification that the center had documented the names of the children who had participated in the fire and disaster drills for the last twelve (12) months. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Observation of the baby room revealed there was on infant sleeping in a bouncy seat that was sitting inside of a crib. Interview with the staff member revealed the infant was four (4) months old. Continued observation of the baby room revealed an infant asleep in a crib with a blanket and a pacifier attached to clip which was attached to the child's shirt. Interview with the staff member revealed the infant was ten (10) months old.

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 with a hire date of 4/5/2021 did not have the following in his/her file: 1. High school diploma; 2. GED or qualifying documentation from a comparable educational entity; or 3. Commonwealth Child Care Credential as described in 922 KAR 2:250. 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 in the classroom known as the Three-Year-Old room, the corners of the ceilings had a thick collection of dust and cobwebs. 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 Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable Emergency Regulation 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 10. Director Requirements and Responsibilities.

General: Based on observation and interview, the child care center failed to assure compliance with regulatory requirements. Observation of the Three’s room revealed an outlet uncovered under the television. Interview with the staff in charge revealed the outlet was uncovered. Employee Records In Compliance Programming In Compliance Premises In Compliance Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the child care center failed to comply with hygienic practices in accordance with regulatory requirements. Observation of the baby changing room revealed the container in which the diapers are disposed in the changing room did not have a cover or lid on it. An interview with the staff in charge revealed that there is a lid for the container, it was just not on it. First Aid/Medication In Compliance Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable Emergency Regulation 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 10. Director Requirements and Responsibilities.

General: Based on interview and review of documentation, the child care center director failed to assure compliance with regulatory requirements. Upon request, a staff evaluation was not presented for review for a staff member with the hire date 3/30/15.

Open Not marked corrected in the state record

Category: recordkeeping. 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, the child care center director failed to assure compliance with regulatory requirements. Review of staff files revealed a Mantoux Tuberculin Skin Test Record Form that had been altered to the date 4/7/18 as to when the test was read for a staff member with the hire date 5/30/18. Continued review of staff files revealed a PPD Skin Test form that had been altered to the date of 3/30/18 as to when the test was read for a staff member with the hire date 3/30/17. Interview with the child care center director revealed she did not confirm nor deny that the two (2) aforementioned TB form had been altered. Interview with the health care provider on 5/1/19 revealed they could not authenticate the Mantoux Tuberculin Skin Test Record Form with the date 4/7/18. Interview with a staff member from the Little Clinic on 5/1/19 verified that the date on the PPD Skin Test form had been altered to read 3/30/18. Continued interview with the staff member revealed the original date on the form was 3/30/17. 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

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, the child care center failed to maintain employee records in accordance with regulatory requirements. Upon request, a high school diploma, GED or Commonwealth Child Care Credential was not presented for review for a staff member with the hire date 4/17/19.

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 interview and review of documentation, the child care center failed to maintain employee records in accordance with regulatory requirements. Upon request, written documentation from a health care professional was not presented for review to verify that a staff member with the hire date 4/17/19 was free from active TB. Upon request written documentation for two (2) TB test was presented for review for two (2) staff members with the hire dates 3/30/17 and 5/30/18, review of the documents revealed numbers that appeared to be altered. Interview with the health care professional revealed one could not be authenticated and the other document had dates that had been altered.

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, documentation to verify that two (2) staff members with the hire dates 3/30/15 and 3/30/17 had completed fifteen (15) hours of cabinet-approved early care and education training was not presented for review. Review of the ECE TRIS report did not verify that the training hours had been completed. Interview with the director revealed she was not able to verify that the training hours were completed. Upon request, documentation was not presented to verify that two (2) staff members with the hire dates 3/30/15 and 10/5/18 had completed six (6) hours of cabinet-approved orientation within ninety (90) days of employment. Interview with the director revealed she was not able to verify that the orientation training was completed within ninety (90) days of employment for the two (2) aforementioned staff members. Upon request, documentation was not presented to verify that a staff member with the hire date 3/30/17 had completed pediatric abusive head trauma training. Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain the premises in accordance with regulatory requirements. Observation of the infant room revealed the purple and green walls were soiled. Observation of the two-year-old room revealed the green walls and the door on the left was soiled. Continued observation of the two-year-old room revealed a section of carpeting that was wrinkled up. Observation of the school age room revealed the green wall was soiled and the purple wall had a sticky residue on it. Observation of the three-year-old room revealed the yellow wall by the table was soiled. Observation of the four-and-five-year-old room revealed fraying carpeting with exposed fibers. Continued observation of the four-and-five-year-old room revealed a section of carpeting that was wrinkled up and a child tripped over it. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the child care center failed to maintain an outdoor play area in accordance with regulatory requirements. Observation of the outdoor play ground revealed a section of wooden edging that was decayed and splintered, exposing a metal spike located by the green railing. 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 6. Sleeping and Napping Requirements.

General: Based on observation, the child care center failed to maintain equipment in accordance with regulatory requirements. Observation of the infant room revealed a crib with two (2) mattresses. Observation of room 3 revealed a crib with two (2) mattresses.

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. Observation of the bathroom located off the infant room revealed the faucet was loose and not secured to the sink. Observation of the outdoor playground revealed a Razor scooter that was missing a handle, exposing sharp edges. Transportation Not Applicable 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 interview, the child care center failed to maintain food service in accordance with regulatory requirements. Review of the posted menu revealed snacks consisting of only one food component; therefore, the food requirements for snack were not met.

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 interview and review of documentation, the child care center failed to maintain food service in accordance with regulatory requirements. Review of the posted menu for 4/22/19 revealed baked beans, salad and pineapple were served for lunch; therefore, two (2) food components (bread and milk) were not listed as being served. Interview with a staff member revealed she could not recall what was served for lunch on 4/22/19. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report 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 interview and review of documentation, the child care center failed to maintain children’s records in accordance with regulatory requirements. Review of ten (10) children’s files revealed two (2) files did not contain the information for the parents' preferred hospital. Continued review of the children’s files revealed one (1) file that did not contain authorization by the parent for the child care center to seek emergency medical care for the child in the parent’s absence. Interview with the director revealed an acknowledgment that the information was not contained in the aforementioned children’s files at the time of the survey. 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, the child care center failed to maintain written documentation in accordance with regulatory requirements. Upon request, the director did not provide a written annual plan for child care staff professional development for a staff member with the hire date 3/30/15. 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 3. Implementation and Enforcement.

General: Based on observation, interview and review of documentation, the child care center failed to assure compliance with regulatory background check requirements. Observation of the child care center on 03/21/19 revealed an individual, alone, with supervisory control of children, in the Two-Year-Old classroom. Interview with staff-in-charge revealed the individual was a volunteer. Review of the KARES Surveyor Report revealed the individual failed to complete background checks in accordance with administrative regulations. Further review of documents provided by the staff-in-charge revealed background checks were conducted in the year 2015, which was prior to January 1, 2018. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, interview and review of documentation, the child care center failed to assure compliance with regulatory background check requirements. Observation of the child care center on 03/21/19 revealed an individual, alone, with supervisory control of children, in the Two-Year-Old classroom. Interview with staff-in-charge revealed the individual was a volunteer. Review of the KARES Surveyor Report revealed the individual failed to initiate background checks, in accordance with administrative regulations.

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 interview and review of documentation, the child care center failed to assure compliance with regulatory background check requirements. Review of the child care center staff schedule revealed several staff listed on the KARES Surveyor report are no longer employees with the child care center. The director failed to change the status of staff who were no longer employees. Supervision Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the child care center failed to maintain adequate supervision of children in accordance with regulatory requirements. Review of a written statement provided by the child care center director on 03/21/19 revealed children were left unsupervised and out of the range of sight and sound of the teacher, for an undetermined amount of time, in the Three-Year-Old classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 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, the child care center failed to maintain adequate staffing in accordance with regulatory requirements. Observation of the Preschool classroom and the Three-Year-old classroom on 03/20/19 revealed the classrooms failed to meet minimum staff to child ratios based on the youngest child in the class. The Preschool classroom was observed with one (1) staff and sixteen (16) children. Interview with the staff revealed the youngest child in the classroom was three (3) years old. The Three-Year-Old classroom was observed with one (1) staff and fifteen (15) children for less than three (3) minutes. Interview with the staff revealed the youngest child in the classroom was two (2) years old. 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 and interview, the child care center director failed to assure compliance with regulatory requirements regarding the health, safety and comfort of children in care. Observation on 03/20/19 revealed children were asleep at nap upon arrival of the surveyor at 12:30 PM. Interview with the CPS worker revealed she was present at 12:15 PM. Cups of milk and snacks were observed placed on tables throughout the child care center. Interview with the child care center director revealed the milk and snack was placed on the tables at 11:00 AM and the children were scheduled to have snack at 1:40. The uncovered milk and opened snack sat on the tables for approximately two (2) hours and forty (40) minutes. The snack and drink was not protected from contamination. Interview with the director revealed this was common practice when the child care center was short in staff. In addition, the director was observed to grab a child by one arm in an aggressive manner to lift him/her from the cot. Additionally, observation of the Preschool classroom revealed a very chaotic atmosphere for play. Children threw plastic blocks at other children, which caused them to cry.

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, interview and review of documentation, the child care center director failed to assure compliance with regulatory requirements with regard to caregiver alone. Observation of the child care center on 03/21/19 revealed an individual, alone, with supervisory control of children in the Two-Year-Old classroom. Interview with staff-in-charge revealed the individual was a volunteer. Review of the KARES Surveyor Report revealed the individual failed to complete background checks in accordance with administrative regulations. Further review of documents provided by the staff-in-charge revealed background checks were conducted in the year 2015, which was prior to January 1, 2018.

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, the child care center director failed to assure compliance with regulatory requirements with regard to altered/falsified records for an individual who was observed to have supervisory control of children in care. Interview with staff-in-charge revealed the individual was a volunteer. Upon request, the staff-in-charge provided an altered/falsified PPD Skin Test statement. Furthermore, written documentation received from the Little Clinic by email, indicated the document did not match their records. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 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 observation, interview and review of documentation, the child care center failed to maintain employee records in accordance with regulatory requirements. Observation revealed an individual with supervisory control of children, alone, in the Two-Year-Old classroom. Although the individual was observed in the role of a staff member, interview revealed the individual was identified as a volunteer. Upon request, the staff-in-charge failed to provide documented evidence of a current statement from a health professional that the individual is free of active tuberculosis. Programming Discussed 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, interview and review of documentation, the child care center failed to maintain premises in accordance with regulatory requirements with reference to thirty-five (35) square feet per child. Observation of the child care center on 03/20/19 revealed the Preschool classroom exceeded capacity by eight (8) children, based on thirty-five (35) square feet per child, throughout the inspection. An additional observation of the child care center on 03/21/19 revealed the Two’s classroom exceeded capacity by one (1) child and the Preschool classroom exceeded capacity by six (6) children, based on thirty-five square feet per child, throughout the inspection. Interview with staff revealed the number of children in the Preschool classroom may sometimes be twenty (20) children. 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 child care center failed to maintain food service in accordance with regulatory requirements. Observation of the child care on 03/20/19 and interviews revealed uncovered milk and opened snacks sat on tables in the classrooms from 11:00 AM until snack at 2:00 PM. The snack was not protected from contamination. Written Documentation 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 observation, interview and review of documentation, the child care center failed to maintain written documentation in accordance with regulatory requirements. Observation, review of child care attendance records and interviews with staff revealed on 03/20/19 and 03/21/19, each child in attendance was not documented upon their arrival and departure from the child care center.

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 and interview, the child care center failed to comply with staffing requirements. Observation revealed that one staff member was the sole caregiver of eight (8) children in the two (2) year old room at 9:10am. Interview with the staff member revealed that the youngest child present was one (1) year old. Upon the surveyor's reentry into the classroom at 9:20am, a second staff member was present and assisting the aforementioned staff member. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report General Administration In Compliance Director Requirements In Compliance 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 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 11. Toys and Furnishings.

General: Based on observation, the child care center failed to maintain equipment in accordance with regulatory requirements. Observation of the four (4) and five (5) year old classroom revealed the vinyl covering of a red bench was torn in several places. Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the child care center failed to maintain food service in accordance with regulatory requirements. Observation of the infant room revealed a staff member held a bottle and fed it to an infant while he laid in his crib. Interview with the staff member revealed the infant was five (5) months old. 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 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.

General: Based on review of documentation, the child care center failed to post documentation in accordance with regulatory requirements. Review of posted documentation in the two (2) year old room revealed the daily schedule of activities listed the month, but not specific dates. Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 6. Reports.

General: Based on Review of Documentation, and interviews, the child care center failed to comply with regulatory requirements with regard to reporting information to the Cabinet within twenty-four (24) hours. Review of written documentation revealed a child was injured on May 15, 2017 in which medical care was required. The child broke his/her arm and surgery was required. Interviews revealed the child care center was notified on May 15, 2017, that the child required medical attention and received physician’s care. The child care center notified DRCC on May 17, 2017 which was more than twenty-four (24) hours from the time of discovery. Director Requirements 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 Review of Documentation and Interview, the child care center director failed to assure compliance with regulatory requirements. An annual written performance evaluation was not presented for review at the time of survey for five (5) staff members with hire dates of: 7/17/05, 6/10/08, 9/7/10, 5/22/14, and 11/2/15. The owner/director revealed a current evaluation was not completed for these staff members.

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 and Interview, the child care center director failed to assure compliance with regulatory requirements. The immunization certificate presented for review at the time of survey for one (1) child appeared to be altered. The aforementioned certificate was a photocopy; however, part of the expiration date was written in black ink. The owner/director acknowledged the document appeared to be altered. 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

Category: recordkeeping. 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 regulations. Review of staff files and ECE- TRIS report revealed documentation of fifteen (15) hours of cabinet approved training was not presented for review at the time of survey for one (1) staff member hired 5/22/14. The owner/director revealed this staff member did not complete the annual training hours. The documentation of pediatric abusive head trauma training (PAHT) presented for review at the time of survey for a staff member hired 6/10/08 failed to include the name of the staff member; therefore, the document failed to verify that the aforementioned staff member had completed the PAHT. The owner/director revealed the staff member has completed the PAHT; however, she acknowledged the staff member’s name was not included on the documentation presented for review at the time of survey. Programming In Compliance Premises In Compliance Hygienic Practices 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on Observation and Interview, the child care center failed to maintain hygienic practices in accordance with regulations. In the Extra Room, the diaper changing pad was torn, exposing the inner padding. The owner/director revealed the diapering surface was maintained in the room in case it is needed to be used for diapering children. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on Review of Documentation and Interview, the child care center failed to maintain food service in accordance with regulations. The posted menu was not dated. The owner/director acknowledged the menu was not dated. Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation and Interview, the child care center failed to maintain children’s records in accordance with regulations. Review of ten (10) children’s files revealed a current immunization certificate was not presented for review at the time of survey for one (1) child. The owner/director revealed this documentation was not on file at the time of survey. The immunization certificate presented for review at the time of survey for another child appeared to be altered. The aforementioned certificate was a photocopy; however, part of the expiration date was written in black ink. The owner/director acknowledged the document appeared to be altered. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Review of Documentation and Interview, the child care center failed to maintain children’s records in accordance with regulations. Review of ten (10) children’s files revealed the written record for one (1) child failed to contain contact information to enable a person in charge to contact the child’s family physician and the written record for two (2) children failed to contain contact information to enable a person in charge to contact the child’s preferred hospital. The owner/director revealed this documentation was not on file at the time of survey. 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, the child care center failed to maintain written documentation in accordance with regulations. Attendance records for 4/12/17 revealed the week’s attendance had been verified in advance for six (6) children on the DCC-94E form.

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, the child care center failed to maintain written documentation in accordance with regulations. A written annual plan for child-care staff professional development was not presented for review at the time of survey for five (5) staff members with hire dates of: 7/17/05, 6/10/08, 9/7/10, 5/22/14, and 11/2/15. The owner/director revealed a professional development plan was not completed for these staff members. 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 4. Director Requirements and Responsibilities.

General: Based on Review of Documentation and Interview, the child care center failed to post documentation in accordance with regulations. A daily schedule of activities was not posted in the Before and After School Room. The owner/director acknowledged this documentation was not posted. Animals Not Applicable

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. Observation of the two-year-old room revealed cobwebs on the ceiling and frayed carpet with fibers exposed. Observation of the school age room revealed frayed carpet with fibers exposed.

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, and Interview, the child care center failed to maintain the premises in accordance with regulatory requirements. Observation of the three-year-old room revealed a light flickering; causing a portion of the room to be dimly lit. Interview with the director revealed the child care center was in the process of addressing the flickering light.

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 failed to maintain the premises in accordance with regulatory requirements. Observation at approximately 11:00 am of the two-year-old room revealed ten (10) children to be present. Review of the child care center’s floor plan on file with DRCC revealed the two-year-old room has space for eight (8) children. Observation at approximately 11:15 am of the art room revealed twelve (12) children to be present. Review of the child care center’s floor plan on file with DRCC revealed the art room has space for five (5) children; therefore the child care center exceeded the minimum of thirty-five (35) square feet of space per child.

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 maintain children’s records in accordance with regulatory requirements. Review of ten (10) children’s files revealed the following: 1. One (1) file did not have authorization by the parent for the child-care center to seek emergency medical care for the child in the parent’s absence presented for review at the time of the survey. 2. Ten (10) files did not have the parents preferred hospital on file. Interview with the director revealed an inability to locate the documents at the time of the survey. 1080 - Documentation for Off Premise Trip Not Applicable An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 25 Web site: http://chfs.ky.gov/ Inspection Report 922 KAR 2:110. Section 3. Records. (1) A child-care center shall maintain: (b) A written record for each child: 3. To contain: g. A permission form for each trip off the premises signed by the child’s parent in accordance with 922 KAR 2:120, Section 12; Written Documentation

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, one staff member was observed with sixteen children ages two thru eleven for approximately ten minutes.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, the center does not have a current copy of this administrative regulation including 922 KAR 2:090, 922 2:110 and KAR 2:120.

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 in the bathroom near the infant room, a toilet scrub brush was next to the toilet 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 6. Sleeping and Napping Requirements.

General: Based on observation, an infant was left to sleep on in a bouncy chair as opposed to being placed to sleep on her back in a crib.

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, two cribs contained stuffed animals under the mattresses.

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 bathroom near the infant room, a can of Powerhouse Air Freshener was on a towel bar with in reach of children walking into the bathroom, Air Freshener stated on the can "Keep out of Reach of Children".

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the water temperature in all bathroom sinks was determined to be 80 degrees Fahrenheit as measured with a calibrated thermometer.

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, at least ten children were not signed in or out based on review of numerous daily attendance sheets.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of posted documentation, a plan of daily activities posted in the two year old classroom was dated for 9-9-13. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 25 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.