922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on review of documentation, it could not be verified that the provider (DOH:02/20/23) was free from active tuberculosis. The presented documentation was read 09/29/22. Therefore, the documentation was no longer current.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation, it could not be verified that the provider (DOH: 02/20/23) had current Pediatric Abusive Head Trauma (PAHT) training. The presented document showed a completion date of 06/17/19 which surpasses the five year renewal date.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation, it could not be verified that an assistant (DOH: 08/07/24) completed six (6) hours of cabinet approved orientation. Programming In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on review of documentation, it could not be verified that one (1) child (DOH: 04/28/23) had current immunizations.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on review of documentation, it could not be verified that the provider had current liability insurance. The presented documentation had an expiration date of 11/21/24.

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:Review of the Kentucky Applicant Registry and Employment Screening (KARES) database revealed that a background check for the provider (DOH 02/20/23) had last been completed on 05/29/19 and was, therefore, expired as of 05/19/24. Further review of KARES revealed that, while the process for obtaining an updated background check had been initiated by the provider, an eligibility status was not available. Supervision In Compliance General Administration In Compliance Provider Requirements In Compliance Provider Records In Compliance Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, multiple plastic bags were stored on various surfaces throughout the programming space, at a height where they were accessible to the children in care.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, one (1) electrical outlet near the restroom sink was not covered. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on review of documentation, the enrollment information presented for a child (DOE 06/10/24) failed to contain that name of the family's preferred physician. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on review of documentation, observation of the presented attendance record revealed that the arrival time of one (1) child had not been documented on the day of the inspection. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Posted/Available Documentation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 20. Certified Family Child-Care Home Program.

General: Based on interview and review of documentation, the staff-to-child ratios, described in Section 10 of the administrative regulation, were not presented or made available for inspection. Animals Not Applicable Posted Requirements In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview, observation, and review of documentation, an assistant acted as the sole caregiver to five (5) children, ranging in age from four (4) months old to four (4) years old from 10:27 am until 10:50 am. Review of the (KARES) database revealed that the assistant did not have a completed background check with eligible employment status. Supervision In Compliance General Administration In Compliance Provider Requirements In Compliance Provider Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on review of documentation, the assistant's personnel record did not contain verification that he/she was certified by a cabinet- approved agency in infant, child, and adult cardiopulmonary resuscitation (CPR) and first aid. The assistant was observed working alone with children. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation of the nursey, there was a crib located adjacent to a window that contained broken plastic slats and strings were dangling. The slats and strings on the window blind were located next to the crib that would make them accessible to a child if he/she was placed in the crib. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on interview and review of documentation, During the review of the children’s records, the following was found: 1) The enrollment record for a child (DOE: 12/27/23) contained an immunization certificate that expired on 07/16/23. 2) Two children's enrollment records (DOE: 12/09/23) each contained a Declaration of Exempt for immunization verification. However, the Declaration of Exempt document that was presented contained another child’s name on it; therefore, the document was not valid.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on interview and review of documentation, During the review of the children’s records, the following was found: 1) There were fourteen enrollment records (DOE: 04/06/23, 09/20/23, 09/20/23, 01/27/24, 01/27/24, 01/27/24, 04/25/24, 06/26/23, 06/26/23, 05/09/23, 04/01/23, 04/01/23, 09/26/23, and 04/24/24) that did not contain a preferred hospital on the day of the inspection. 2) There were two enrollment records (DOE: 04/01/23 and 06/26/23) that did not contain the name of a family physician on the day of the inspection. 3) There were seven enrollment records (DOE: 04/01/23, 04/01/23, 09/20/23, 01/27/24, 04/06/23, 04/25/24, and 05/09/23) that did not contain permission for authorization to seek medical treatment when the parent is absent. 4) There were two enrollment records (DOE: 05/09/23 and 04/01/23) that did not contain the name and telephone number to contact in case of an emergency impacting the child. 5) There were seven enrollment records (DOE: 04/06/23, 04/01/23, 08/07/23, 04/25/24, 04/01/23, 06/26/23, and 05/09/23) that did not contain the general health status and medical history for each of the aforementioned children on the day of the inspection. 6) There were three enrollment records (DOE: 04/06/23, 05/09/23, and 04/01/23) that did not contain name in writing of the individuals that are designated to pick the child up from care. 7) There were two enrollment records (DOE: 05/09/23 and 04/01/23) that did not contain the parent’s contact information. 8) There were two enrollment records (DOE: 05/09/23 and 04/01/23) that did not contain information ID documentation. 9) There were two enrollment records (DOE: 05/09/23 and 04/01/23) that did not contain a signature from the parent. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Written Documentation In Compliance Posted/Available Documentation In Compliance Animals Not Applicable Posted Requirements In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, a crib was located immediately adjacent to a window with window blinds. The slats and strings in the blinds were located in a position to the crib that would make them accessible to a child if he/she was placed in the crib. Additionally, a large flatscreen television was sitting on a low shelf in the programming area. The television was not anchored and moved easily went touched, creating a risk of falling.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, a gallon bottle of Pool Shock was sitting on a cooler, next to the front door in the enclosed porch. Interview confirmed children enter the home through the enclosed porch area. 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 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, two (2) electrical outlets located above the sink in the restroom were uncovered.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, a glass front electic fireplace located in the programming area was in use at the time of the inspection. The metal surface around the glass was hot to touch. Interview with the provider revealed there was no safety feature on the fireplace. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on review of documentation, the enrollment forms for two (2) enrolled children (DOE: 12/09/2023) failed to include authorization from the parent for the provider to seek emergency medical care. The signed form presented for the referenced children failed to include the name of the person or entity for whom the authorization was intended. That portion of the form was left blank. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 2. Certification Process.

General: Based on interview and review of documentation, the insurance documentation presented for review revealed the liability insurance policy for the provider expired on 11/21/2023. When asked for current information regarding insurance, the provider stated, 'It's in the works'.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on observation and review of documentation, six (6) children were present at the time of the inspection; however, only four (4) of the six (6) were documented on the daily attendance record with a time of arrival noted. Interview with the provider revealed that she failed to create an attendance record to include the two (2) additional children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Posted/Available Documentation In Compliance Animals Not Applicable Posted Requirements In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, bottles of Febreeze fabric cleaner and Glade air freshener were stored on the changing table's lower shelf where they were accessible to the children in care. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

General: Based on observation, the provider failed to ensure that the children in care washed their hands before and after eating morning snack. First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 16. Medication and First Aid.

General:Review of the presented first aid supplies revealed that medical tape was not present. The provider stated that they had not yet obtained medical tape. Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: A current immunization certificate for a child enrolled on 06/26/23 was not presented for review upon request. The immunization certificate presented for the child contained an expiration date of 09/16/23. 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 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Review of presented enrollment information revealed that all of the enrollment forms failed to contain the name of the family's preferred hospital. Additionally, a written record of enrollment information for a child enrolled on 10/03/23 was not presented for review. Therefore, the child's enrollment information was not retained on the child's first day of attendance. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General:Upon request, documentation verifying that fire drills had been conducted during August and September of 2023 was not presented for review.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General:Documentation verifying that earthquake and tornado drills had been conducted was presented for review, however, a list of those who participated in the drills was not included.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Documentation verifying that fire drills had been conducted March through July of 2023 was presented for review, however, a list of those who participated in the drills was not included.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: A written evacuation plan was not presented for review upon request. The provider stated that they needed to update the plan before presenting it. Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. 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 employment status of the provider's assistant was not maintained in accordance with regulations. Review of the KARES database revealed the assistant with a hire date of 6/13/2023 had a completed background check, but his/her employment status was listed as "eligible not employed." The aforementioned staff member was observed working with children on the date of the inspection. The provider acknowledged that the assistant's employment status in the KARES database was not changed from "eligible not employed" to "current employee" upon hire. Supervision In Compliance General Administration Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 16. Medication and First Aid.

General: Based on observation and interview, two bottles of prescription medication, which were located in the refrigerator, were not stored in a locked container. The provider acknowledged that the medication belonged to an enrolled child. Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

General: Based on observation, the health, safety, and comfort of a one-year-old toddler was jeopardized when the assistant lifted the child by placing his/her hand under a child's armpits and lifted the child from the ground. The child was dangling precariously as he/she was picked up by one side and placed in a high chair. The child's body was not supported as it was lifted from the ground. Additionally, the provider gave a five-month-old infant a bottle as he/she sat in a bouncer seat; however, the infant was unable to hold the bottle and feed him/herself. The infant cried and appeared to be distressed about not being about the access the bottle as it lay next to him/her. This compromised the infant's comfort. Provider Requirements In Compliance Provider Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

General: Based on interview and observation, six children ages one to nine-years-old watched a television program that was not scheduled as a part of the daily planned program. Additionally, the program was designed for younger children, and was not developmentally appropriate for the six and nine-year-old children present. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, an air conditioning window unit was covered by curtains, both of which were accessible from a crib that was against a wall.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, six children were present in an area of the home that was secured by a child gate. The area where the children were contained measured for thirty- five square feet of space for only three children.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 14. Toilet and Diapering Requirements.

General: Based on observation, the temperature of the sink in the bathroom exceeded 120 degrees Fahrenheit. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

General: Based on observation, six children did not wash their hands before or after eating a snack. 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 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

General: Based on observation, the provider failed to wash her hands after wiping one child's nose and another child's face. The provider then fed an infant a bottle. First Aid/Medication Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 15. Food Requirements.

General: Based on interview and review of documentation, the menu was not dated. The provider acknowledged this deficiency.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 15. Food Requirements.

General: Based on observation, two children were not held when they drank from their bottles. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on interview and review of documentation, the name of each person who is designated in writing to pick up the child, authorization by the parent for the provider to seek emergency medical care for the child in the parent’s absence, and a preferred hospital were not listed in the enrollment records for three children with enrollment dates of 4/21/2023, 5/8/2023, 5/9/2023. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 10. Standards for the Provider.

General: Based on interview and review of documentation, five children were signed in and out for the day prior to those dates and times occurring on attendance records for the week of 6/12/2023 through 6/16/2023. Additionally, the attendance records for the aforementioned week were signed by the parents of ten children prior to the week ending.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on interview and review of documentation, fire drills were not conducted or documented in April and May of 2023. The provider acknowledged that she had not conducted fire drills.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 19. Records.

General: Based on interview and review of documentation, fire drills were not conducted or documented in April and May of 2023. The provider acknowleged that she had not conducted fire drills. Posted/Available Documentation In Compliance Animals In Compliance Posted Requirements In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the family child care home failed to accurately maintain the status of the provider's employment on the Kentucky Applicant Registry and Employment Screening (KARES) database. The employment status of the provider was listed as "Eligible, but not employed" on the report obtained from the KARES database. The provider stated that she had not yet updated her employment status. Supervision Discussed General Administration In Compliance Provider Requirements In Compliance Provider Records In Compliance Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, the kitchen wall, near the stove, contained a hole from which uncapped, electrical wires were protruding.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 12. The General Requirements of the Family Child-Care Home Environment.

General: Based on observation, a wall-mounted radiator/heater, located on the wall that separates the kitchen from the programming space, was not protected with a safety guard. The heater was installed at a height where it would be accessible to children in care. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report 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: physical safety. Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 13. Care Requirements for a Provider.

General: Based on observation, the sole crib within the family child care home's programming space contained a loose-fitting sheet. Transportation Not Applicable Food Service/Food Program Discussed Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:100 · 922 KAR 2:100 - Section 15. Food Requirements.

General: The provider stated that her hours of operation are 6:30AM-10:00PM, Monday through Friday, however, the presented menu did not include a plan for what will be served for dinner. Children's Records Discussed Written Documentation In Compliance Posted/Available Documentation In Compliance Animals Not Applicable Posted Requirements In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.