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

General: Based on interview and review of documentation, a staff member (DOH: 02/13/25) determination date was 02/26/25 on the center's Kentucky Applicant Registry and Employment (KARES) report. Upon interview with the director, it was determined the staff member worked with children prior to the determination date.

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, a toddler was unsupervised for approximately six (6) minutes from 9:59 am until 10:05 am, when a staff member transitioned six (6) children from the restrooms in the hallway to the two-year-olds’ front room. During the transition, the toddler walked away from the group of children unnoticed. Approximately six (6) minutes later, a second staff member transitioned four (4) children from the restrooms in the hallway to the two-year-olds’ front room. The unsupervised child walked back into the multi-purpose room to the two (2) staff members, who stood in the doorway of the two-year-olds’ front room. One staff member asked the other where the child had been. The other staff member replied she was unsure where the child had been.

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, two (2) staff members supervised fifteen (15) children, aged one to three (3) years old, in the two-year-olds' front room. Therefore, group size was not maintained.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation and interview, the staff member did not follow the posted program of activities in the one-year-olds' room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, fifteen (15) children were present in the two-year-olds' front room. The two-year-olds' front room measured three hundred thirty (330) square feet, which allowed nine (9) children thirty-five (35) square feet of space. Therefore, six (6) children were not provided thirty-five (35) square feet of space.

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, three (3) toddlers did not wash their hands with liquid soap and warm running water after being diapered in the one-year-olds' back room. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 17 of 32 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a staff member did not wash her hands with liquid soap and warm running water each time after she diapered two (2) children in the hallway next to the restrooms.

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 following was found: 1) A staff member failed to disinfect the diaper changing surface each time after she diapered three (3) children in the one-year-olds' back room. 2) A staff member failed to disinfect the diaper changing surface each time after she diapered two (2) children in the hallway next to the restrooms.

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, no protective surface was underneath two (2) blue swings on the large playground.

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, the personnel files were not available for review on 08/26/24. The personnel files were not present at the center. Programming 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 interviews and review of documentation, a two-year-old child received an approximate one (1) inch long laceration on his chin while present at the center on 08/21/24. The child's mother discovered the laceration upon arrival to the center at approximately 12:30 pm on 08/21/24. The child was taken for medical treatment and the laceration was glued. Staff members could not determine when, where, or how the child received the laceration; therefore, the child's safety and comfort were compromised. Programming 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 and review of documentation, a staff member (DOH: 03/27/24) did not have educational documentation on file.

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 and review of documentation, a staff member (DOH: 07/28/23) had TB documentation dated 08/02/23, which was after the hire date.

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 and review of documentation, a staff member (DOH: 09/01/23) had not completed CPR/First aid training. 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

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation and review of documentation, the following was found: 1) A staff member (DOH: 02/22/23) completed eight (8) hours of annual training between July 1st and the following June 30th. 2) A staff member (DOH: 05/23/22) completed zero (0) hours of annual training between July 1st and the following June 30th. 3) A staff member (DOH: 07/29/22) completed twelve and a half (12 ½) hours of annual training between July 1st and the following June 30th. 4) A staff member (DOH: 01/19/23) had not completed orientation training within three (3) months of employment and had not completed pediatric abusive head trauma training within the first (1st) year of employment. 5) A staff member (DOH: 01/03/23) completed pediatric abusive head trauma training on 05/01/24, which was not within the first year of employment. 6) A staff member (DOH: 07/28/23) completed orientation training on 02/29/24, which was not within the first three (3) months of employment. 7) A staff member (DOH: 09/01/23) had not completed orientation training within the first (1st) three (3) months of employment. 8) A staff member (DOH: 10/02/23) completed orientation training on 05/20/24, which was not within the first three (3) months of employment. 9) A staff member (DOH: 01/08/24) completed orientation training on 05/19/24, which was not 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 following was found: 1) A staff member’ can soft drink was stored on the sign-in table in the dining room. 2) Great value disinfectant spray and Glade deodorant spray were stored on a cabinet in the children in the one (1) year-old room. 3) A staff member's black purse was stored on the floor beside the closet in the one (1) year-old room. 4) A staff member’s plastic cup with a green lid and cell phone were stored on a child-size table on the one (1) year-old’s playground. These items were accessible to children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the following was found: 1) The ceiling around the first light fixture bulged downward in the dining room. 2) The ceiling over the exit sign at the entrance of the center bulged downward.

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 hot water temperature registered seventy-eight (78) degrees Fahrenheit in the one (1) year-old room. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 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, four (4) children did not wash their hands with liquid soap and running water after being diapered in the one (1) year-old room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a staff member did not wash her hands with liquid soap and running water before and after diapering four (4) children in the one (1) year-old room.

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, two (2) tears, approximately one (1) inch long, were in the surface of the changing mat in the hallway outside the director's office.

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 following was found: 1) A staff member diapered four (4) children and did not disinfect the diapering surface after each diaper change in the one (1) year-old room. 2) A staff member diapered two (2) children and did not disinfect the diapering surface after each diaper change in the older two (2) year-old room. 3) A staff member diapered four (4) children and did not disinfect the diapering surface after each diaper change in the younger two (2) year-old room. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation and review of documentation, a child enrolled on 10/17/23, did not have a preferred hospital documented on the enrollment information. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and review of documentation, the center did not have a written plan for evacuation in accordance with KRS 199.895, which includes being updated yearly by December 31st. The center's disaster plan was last updated 12/29/20.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and review of documentation, the following was found: 1) A staff member (DOH: 05/23/22) had a professional development plan dated 2022. 2) A staff member (DOH: 01/19/23) did not have a professional development plan on file. 3) A staff member (DOH: 01/03/23) had a professional development plan dated 04/25/23. Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and review of documentation, the proper methods of diapering were not posted at the diaper changing area in the one (1) year-old room and in the hallway outside the director’s office. Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 14. Transportation.

General: Based on interview, the center is not licensed to transport children, however, a one-year-old child was transported in a car seat in a staff's personal vehicle to the hospital. The provider stated that a child's finger was smashed in a classroom door and was bleeding quite a bit. The provider stated that she received approval over the phone from the parent to transport the child. The provider stated that she transported the child to the hospital because she did not feel the ambulance could get there fast enough.

Open Not marked corrected in the state record

Category: transportation. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 15. Statement of Deficiency and Corrective Action Plans.

A PLAN OF CORRECTION WAS DUE ON 11/17/2023 AND AS OF 12/28/2023, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Findings: A PLAN OF CORRECTION WAS DUE ON 01/12/2024 AND AS OF 01/25/2024, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on interview and record review, the facility reported that on 9/20/2023 a child's eyes were cleaned with wet wipes and she had an allergic reaction. Eyes became puffy and medical attention was sought by the child's parent. Director Requirements In Compliance Employee Records 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 and interview, a caregiver hired on 4/19/23, did not have an Illinois criminal records check, child abuse/neglect check and sex offender registry check on file. The caregiver was present at the center and supervised children alone during diapering at the diaper changing table in the hallway.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 5. Checks of Other States.

General: Based on observation, a caregiver hired on 4/19/23, did not have an Illinois criminal records check, child abuse/neglect check and sex offender check on file. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, a caregiver hired on 4/19/23, did not have an Illinois criminal records check, child abuse/neglect check and sex offender registry check on file. The caregiver was present at the center and supervised children alone during diapering at the diaper changing table in the hallway. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, two (2) caregivers hired on 1/3/23 and 1/19/23, did not have education documentation on file.

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 and interview, caregiver hired 1/19/23, was not first aid/CPR trained.

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 and interview, a caregiver hired 1/19/23, did not completed six (6) hours of orientation training within the first three (3) months. A caregiver hired 5/23/22, completed six (6) hours of training during the first year of employment and did not complete one and a half (1 1/2) hours of Pediatric Abusive Head Trauma (PAHT) within the first year of employment. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance 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 Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on interview and record review, the facility reported that on 9/27/2022, center staff missed a step while climbing stairs and fell backwards while holding a child. The child hit his head on the concrete which resulted in the child suffering a concussion. 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation and interview, a blue diaper changing pad was torn on the corners, and exposed foam in the one/two-year-olds' classroom. A staff member's cell phone, craft supplies and a blanket were stored on the diaper changing surface in the one/two-year-olds’ classroom. 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 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 and interview, fabric weed block was raised three (3) inches above the mulch under a swing and created a tripping hazard on the older children's outdoor playground. 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 and interview, a large yellow and a large blue pillow were heavily soiled with brown stains in the three-year-olds' classroom.

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 and interview, the plastic on a Fisher-Price ride-on toy was cracked in several areas on the one-year-olds’ outdoor playground. A metal truck with two (2) steering wheels, a blue three (3) steering wheel driving apparatus and a red merry-go-round each had chipped paint and showed signs of rust on the older children's outdoor playground. 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 In Compliance 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 8. General.

General: Based on interview and review of documentation, a child had a documented allergy to peanuts on file at the center, and staff served the child a peanut based granola bar on 8/13/21 and chocolate covered peanuts on 10/20/21. Benadryl was administered as a result of both incidents.

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, a caregiver told two (2), two-year-old children to sit against the wall, grabbed the children underneath their arms and pulled the children across the floor to the wall at approximately 5:30 p.m. on 03/17/2021. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, the center’s inappropriate interaction with children policy stated an inappropriate tone and discipline of children will not be tolerated. Children are not to be spoken to with angry voices and in manners that are not calm. Staff must exhibit patience at all times or take a break when necessary. If incidents of inappropriate interaction between a child and a staff member are reported to the director by staff or parent, staff will receive a written warning. The policy was not followed when a caregiver told two (2), two-year-old children to sit against the wall, grabbed the children underneath their arms and pulled the children across the floor to the wall at approximately 5:30 p.m. on 03/17/2021. In addition, the caregiver received verbal warnings for loudness with children and rudeness to staff but the caregiver never received written warnings.

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on observation, five (5) nap mats were torn and exposed foam in the two-year-old's room. Four (4) nap mats were torn and exposed foam in the three-year-old's room. Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, there was no documentation for monthly, practiced fire drills conducted in January and February 2021. Posted Documentation In Compliance Animals In Compliance Emergency Regulation In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, a back wheel was detacted from a tricycle in the large outdoor play area. 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 and interview, a child enrolled 6/15/20, did not have information on file to enable the person in charge to contact the child’s preferred hospital. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview, eight (8), two-year-old toddlers were grouped together, daily, with two (2) three-year-old children for more than an hour in the two and three-year-olds' room. The two-year-old children did not have a transition plan. 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, a staff, hired on 08/18/15, had an annual professional devleopment plan on file that was dated 08/09/18. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

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 interview, a two-year-old child played on a large piece of climbing equipment on 11/1/19 when she slid down the swirl pole. The two-year-old child lost her grip, fell and landed on a toy truck left directly under the swirl pole. The two year-old child received a cut on the back right side of her head, which required two (2) staples to close. Interview determined a staff member was present and did not foresee the hazard of the toys being under the climbing equipment. As a result, the child received an injury to her head, which required medical treatment.

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, interview and review of documentation, a child was not offered an alternative activity during rest period. Observation of the recorded video for 08/28/19 showed the caregiver in the one-year-olds' room use her left hand to push downward on the lower back of the one-year-old child who attempted to raise up on her nap cot. Instead, the supervising caregiver pushed the child on her back to stay on her cot. The video displayed a date and time stamp of 08/28/19 13:17:01. Children's Records In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a caregiver hired 07/30/18, completed six (6) hours of orientation training on 12/15/18; which was not within the first three months of employment. A caregiver hired 08/13/18, had no proof she completed six (6) hours of orientation training within the first three (3) months of her employment. A caregiver hired 08/18/15, completed six (6) of the required fifteen (15) hours of cabinet approved annual training during their subsequent year of employment. In addition, a caregiver hired 07/14/15 completed twelve (12) of the required fifteen (15) hours of cabinet approved annual training during their subsequent year of employment. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report 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 storm door screen leading from the one-year-olds' classroom to the outside playground was torn in several areas.

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 brown carpet had several dark stains in the three-year-olds' room. The blue carpet had dark stains in the two-year-olds' room. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, fabric weed block protruded approximately three (3) to four (4) inches above the mulch on the two-year-olds' and three-years-olds' outdoor playground area. Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, two (2) benches attached to the 6-foot plastic picnic table were busted on the two-year-olds' and three-years-olds' outdoor playground. Also, four (4) swing chains were rusty in the two-year-olds' and three-years-olds' outdoor playground area. 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 2 of 3 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a child, first day of attendance 04/09/18, did not have the physician's phone number on file. 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 observation, the posted schedule of daily activities was not dated in the one-year-olds' room. 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 a review of centers written policies and procedures on reporting suspected abuse and on discipline, a staff member observed another staff member slap a one- year-old child across her face at 11:10 am on 04/23/19. The caregiver completed her shift at 12:00 pm and did not report her observations until the morning of 04/24/19 at 7:30 am. The center's policy stated anyone would immediately report to the proper authorities. Programming In Compliance Hygienic Practices 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, a review of a video recording of the one-year olds' classroom on 04/23/19 determined a caregiver wiped a child’s face and arms with a cloth wipe. The caregiver then used the same cloth wipe on another one-year olds child’s face and arms.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 12. Reports.

General: Based on Review of Documentation and interview, a child received an injury, which required medical care on 03/01/18. The cabinet was notified on 03/08/18, which was not within twenty-four (24) hours from the time of discovery.

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 Review of Documentation, a caregiver hired on 2/1/18, had no completed background checks but was not left alone supervising children.

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, a caregiver hired on 3/23/18, had an application of a submitted child abuse and neglect check on file. However, there was no documentation by the caregiver of a completed and signed DCC-500. Supervision In Compliance Staffing Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 6 Inspection Report General Administration Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

A PLAN OF CORRECTION WAS DUE ON 05/14/2018 AND AS OF 05/17/2018, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, five (5) caregivers hired on 4/25/05, 6/25/15, 7/14/15, 8/18/15, 9/26/16, had an evaluation on file dated 11/8/16. 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 9. Records.

General: Based on Review of Documentation, a caregiver was rehired on 8/16/17, and had a child abuse and neglect check dated 4/2/15, a criminal records check dated 3/27/15, and a North Carolina and Florida criminal records check dated 3/27/15. Also, a caregiver hired on 11/19/13, documentation of education was not maintained on file.

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, five (5) caregivers hired on 12/14/17, 11/29/17, 2/1/18, 8/16/17, 11/14/17, had no documentation of education on file.

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, five (5) caregivers hired on 3/23/18, 2/1/18, 8/16/17, 11/14/17, and 11/19/13, each had no documentation of a TB skin test on file. A caregiver hired on 11/29/17, had TB documentation dated 11/8/17.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation, a substitute caregiver hired on 8/16/17, did not have documentation of education, TB skin test, and had a child abuse/neglect check on file dated 4/2/15, a criminal records check dated 3/27/15, and a North Carolina and Florida background check dated 3/27/15. Also, a substitute hired on 11/14/17, did not have documentation of education and TB documentation on file. Therefore, the substitutes did not meet qualifications. 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 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.

General: Based on Review of Documentation, two (2) caregivers hired on 4/25/05 and 7/14/15, lacked three (3) hours of training. A caregiver hired on 11/19/13, lacked fifteen (15) hours of training. Also, five (5) caregivers hired on 12/14/17, 11/29/17, 8/16/17, 11/14/17, 11/19/13, had not completed six (6) hours of orientation. Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on Observation, there was no posted daily planned program of activities in the one-year-olds' and two-year-olds' rooms. A posted daily planned program of activities in the three-year-olds' room was dated February 2017. 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, a caregiver's silver and black drinking cup was on a lower shelf in the two-year-olds' room. The cup was accessible to the children in care.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, a window was open and not screened in the three-year-olds' room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, the brown carpet had several dark stains in the three-year-olds' room. Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 6 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, there was no medical tape and gauze in the first aid supplies in building #2.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Observation, two (2) bottles of Coppertone Water Babies were not labeled to indicate for whom each was intended. These were located in a brown wall cabinet in the three-year-olds' room. A bottle of Banana Boat Ultra Defense Sheer Protect Sunscreen Lotion was not labeled to indicate for whom it was intended. This sunscreen was in a blue tote in a locked closet in the kitchen. Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Observation, red tape held a gate closed to the fence located in the younger children's outdoor play area. The director stated a part had been ordered to repair the gate. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 6 Inspection Report Equipment Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, a sandbox was partially covered with a blue tarp in the older children's outdoor play area.

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, there was an accumulation of dust on a ceiling vent and tile in the two-year-olds' room. Transportation Not Applicable 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 2:090 · 922 KAR 2:090. Section 9. Records.

General: Based on Review of Documentation, a child enrolled on 8/1/17, had an immunization certificate valid until 10/30/17; a child enrolled on 5/29/17, had an immunization certificate valid until 8/21/17, and a child enrolled on 4/12/17, had an immunization certificate valid until 11/30/17. Also, three (3) children enrolled on 2/26/18, 10/10/16, and 7/7/17, each did not have an immunization certificate on file.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on Review of Documentation, two (2) children enrolled on 8/1/17 and 2/26/18, did not include the following on their enrollment form: a name of a person who was designated in writing to pick-up the child; a name and phone number of an individual to be contacted in an emergency situation involving the child; a preferred hospital; a name of physician and contact information; authorization by the parent for the center to seek emergency medical care for the child in the parent’s absence, and a parent's signature. A child enrolled on 3/7/18, did not include on their enrollment form a preferred hospital, and a name of physician and the physician's contact information. Also, a child enrolled on 7/7/17, did not include a physician's phone number on the enrollment information. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 6 Inspection Report 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, three (3) caregivers hired on 4/25/05, 7/14/15, and 9/26/16, did not have a professional development plan on file. Two (2) caregivers hired on 6/25/15 and 8/18/15, had a professional development plan on file dated 11/8/16.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on a Review of Documentation, there was no documented for earthquake and tornado drills for the third and fourth quarters of 2017. Interview with the director determined the earthquake and tornado drills were conducted, but staff failed to document the information. Also, fire drills were not conducted; therefore, not documented August through December 2017 and January through February 2018.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on a Review of Documentation, there was no quarterly documentation for earthquake and tornado drills for the third and fourth quarters of 2017. Interview with the director confirmed the information was not document. Also, fire drills were not conducted; therefore, not documented August through December 2017 and January through February 2018. 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 4. Premises Requirements.

General: Based on Observation, an opening, approximately a foot in length and a foot in height, exposed three (3) pipes, in the kitchen wall. An interview revealed a hole was cut into the wall as a result of a leaky pipe being repaired and pipes had remained exposed for approximately a week and a half post repair.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, a brown stain was on two (2) ceiling tiles in the preschool room. An interview revealed the ceiling leaked and was in need of repair. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and interview, a caregiver hired 03/27/17, and a caregiver hired 01/02/17, did not have proof a criminal records check was submitted timely. In addition, a caregiver hired 02/27/17, did not have proof of a criminal records check and child abuse neglect check were submitted timely. 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 and interview, a ceiling tile in the hallway was bowed and left a two (2) gap in the ceiling. Nine (9) celing tiles in the preschool room were brown and interview confirmed the center had repaired a leak but not replaced the ceiling tiles. In addition, ceiling tiles above the entrance door were brown and interview determined a new water leak had developed which had not been repaired. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation and interview, the changing bench, which pulled down from the wall, was not padded in the restroom. Surveyor observed a caregiver changed a child's diaper on the hard surface. Interview determined the director was not aware the changing bench had to have a padded durface. 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 review of documentation, there was no written record of the caregiver who administered a child's medication on the following dates; 01/24/17,01/25/17, 02/03/17, 03/14/17, 03/15/17, 03/16/17, 03/20/17, 03/23/17, 03/27/17 and 03/28/17.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation and interview, two (2) tubes of Destin diaper cream, a tube of A&D ointment and a jar of Balmex cream were stored in an unlocked hallway cabinet, across from the hall restrooms. Three (3) tubes of Destin diaper cream and two (2) tubes of Boudreaux's cream were stored in a drawer, not in a place located in the toddler room. Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation and interview, protective surface material was not available for a toddler slide on the outdoor playground. The slide set directly on the grass. 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 4. Premises Requirements.

General: Based on observation, a large square wooden sandbox was not covered when not in use nor constructed to allow drainage. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Transportation Not Applicable Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the statement of deficiencies and plan of correction for the current licensure year, Kentucky Consumer Product Safety Program and the program's website were not posted. Animals Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

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

A PLAN OF CORRECTION WAS DUE ON 03 Mar 17 AND AS OF 07 Mar 17, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Interview, a two-year-old child was taken to the local emergency room to have a thumbtack removed from his right nostril on 12/11/16. Interviews determined the child possibly obtained the thumbtack from the two-year-olds' classroom. The staff used this particular type of thumbtack to decorate a corkboard, in the two-year-olds' room, approximately two (2) weeks prior to the thumbtack being discovered in the child's nose. No one was aware the thumbtack was in the child's nose. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Interview, a child obtained a thumbtack while at the center and put it in his nose. The child received medical treatment on 12/11/16 to have the thumbtack removed from the right nostril. Interviews determined the thumbtack may have been in the child's nose from around the end of November 2016 until 12/11/16.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a staff, hired on 07/14/15, did not have education verification on file.

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 roll of clear trash bags, and two (2) bottles of Neutron concentrated citrus spray labeled, “Keep out of reach of children,” were stored in an unlocked cabinet under the sink in the toddlers’ room. Three (3) caregivers’ purses were stored in the blue wooden cubbies in the multipurpose room. These items were accessible to children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, an accumulation of dust was on a light shield and brown stains were on a light shield in the multipurpose room. An accumulation of dust was on the light shield in the boys’ and girls’ restrooms.

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, a triangular section was missing from the toilet tank lid in the girls’ restroom. The missing area measured approximately five (5) inches by (5) inches by three (3) inches. Hygienic Practices

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a caregiver failed to wash her hands before putting on gloves and diapering a child in the two and three year olds’ room.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, two (2), four ounce tubes of A and D ointment, a four (4) ounce tube of Desitin and a four (4) ounce tube of Boudreaux paste were stored unlocked in a container beside the diapering station in the toddlers’ room. A four (4) ounce tube of Calmoseptine ointment was stored unlocked in a box above the wooden cubbies in the hallway. Outdoor Play Area

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, two (2) feet of white rope dangled from the fence and was accessible to children on the outdoor 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 11. Toys and Furnishings.

General: Based on observation, an accumulation of gray dust was on a white oscillating fan in the kitchen. A three (3) inch by five (5) inch section of seat was missing from a pink child-size folding chair in the three and four year olds’ room. A bench seat was missing and two (2) screws protruded approximately two (2) inches downward on the frame of a metal house on the outdoor playground.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Review of documentation, a child, first date of attendance on 09/30/15, had an immunization certificate on file that was valid until 03/01/16. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 26 Web site: http://chfs.ky.gov/ 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, two (2) children, first dates of attendance on 08/05/15, did not have the name and phone number of each person to be contacted in an emergency situation.

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 attendance records dated for the week of 02/15/16, did not include a documented departure time and initials from a parent or authorized person, in accordance with Child Care Assistance Program. Also, a review of attendance records dated for the week of 02/08/16, did not include initials from a parent or authorized person and a signature from a parent to verify accuracy of the weekly attendance for each child, in accordance with the Child Care Assistance Program.

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, a staff, hired on 02/01/88, did not have a professional development plan on file.

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 review of documentation, the proper methods of hand-washing were not posted at the diapering station in the toddlers’ room. Animals

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, an employee hired on 06/08/12 had an evaluation dated 01/16/13, which was not updated annually.

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, an employee hired on 03/19/15 had no TB documentation on file.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, employee hired 09/21/92 had 10.5 accumulative hours of annual training failing to meet the requirements of 15 accumulative hours of annual training.

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, two (2) knives were in the pantry drawers located in the pantry room. The knives were accessible to children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, two (2) ceiling light fixtures had an accumulation of bugs in the light cover. Another light fixture cover had a brown substance on the outside of the light cover. Also, a light bulb was not working in the three (3) to five (5) year olds' classroom. Interview determined the bulb had burned out.

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, eight (8) ceiling tiles had brown stains located in the three (3) to five (5) year old classroom. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 11 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, one (1) sink located in the girls' restroom and one (1) sink located in the boys' restroom had a water temperature of seventy (70) degrees. These restrooms were located near the entrance of the center. Another sink had water temperatures reading eighty-four (84) degrees. This sink was located near the entrance to the kitchen area. Also, a sink had water temperatures reading eighty-four (84) degrees. This sink was located near the pantry entrance.

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, a caregiver used bleach water and a wet wash cloth to sanitize/disinfect the changing area. Interview determined the caregiver used the same wash cloth with a bottle of bleach water each time she sanitized the changing table in the infant room.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, an eight (8) foot section was missing from the top rail of the fence. Also, an eight (8) inch by four (48) inch opening of fence was located at the side of the playhouse. Also, a five (5) inch fence rod was exposed in front of the playhouse.

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 four (4) by eight (8) foot rug had four (4), six inch black stains located in the all purpose room. Also, two (2) rusty bolts were protruding on a metal frame house with a wooden roof on the playground area, and one (1) glass window was cracked eight (8) inches long in the playhouse located on the playground.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, it was determined the last years statement of deficiencies/plan of correction was not posted.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview, no consent was obtained from parents for children to be in the presence of fish in a tank.

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, the center's liability insurance was valid until 06/01/13.

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, a staff (hired on 06/08/12) had an annual written performance evaluaton on file dated 01/16/13. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 5 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, an electrical outlet was not covered in the center room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, an accumulation of dust was on the vent in the boys' restroom.

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, dead bugs were in a light fixture in the multipurpose room. An accumulation of dust was in a light fixture in the multipurpose room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a ceiling tile in the multipurpose room was bubbled and buldged downwards approximately twelve (12) inches from the ceiling.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, a bottle of children's ibuprofen and a bottle of amoxicillin were in an unlocked container in the kitchen refrigerator. Outdoor Play Area

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, a car shaped piece of climbing equipment did not have a protective surface on the playground.

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, chalking paint was on two (2), two (2) foot tall multi-colored tables in the preschool room. Flaking paint was on a cork board in the music room.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, ten (10) children, enrolled on 07/17/13, 08/01/13, 08/05/13, 09/04/13, 09/16/13, 10/04/13, 10/15/13, 11/01/13, 01/30/14, and 02/24/14, did not have the name of each person who was designated to pick-up each child. 1080 - Documentation for Off Premise Trip Not Applicable 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 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

General: Based on review of documentation, the posted daily schedule of activities was dated 07/2012 through 06/2013 in the multipurpose room. The posted daily schedule of activities was dated 07/2012 through 06/2013 in the center's room. The posted daily schedule of activities was dated 07/2012 through 06/2013 in the music room. The posted daily schedule of activities was not dated in the one year olds' room.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 4

music room - room 2: Based on observation, record review, and interview, there were seventeen (17) children present with two (2) caregivers on 03/16/12. A paper was posted on the classroom wall which stated the classroom capacity was fourteen (14) children. The room measured 336 square feet of space which allowed for nine (9) children to be in the classroom at a time. all purpose room 1: Based on observation, record review, and interview, twenty-three (23) children and two (2) caregivers were present from 7:50 a.m. until 8:00 a.m. on 03/16/12. A paper was posted on the classroom wall which stated the classroom capacity was twenty-one (21) children. The room measured to be 547 square feet of space which allowed for no more than fifteen (15) children in the classroom at a time. 205 - Floors, walls, Ceilings 922 KAR 2:120 - Section 4 (8) Floors, walls, and ceilings shall be smooth, in good repair, and constructed to be easily cleaned. 1) Floors smooth/good repair In Compliance 2) Walls smooth/good repair In Compliance 3) Ceilings smooth/good repair In Compliance 4) Floors easily cleaned In Compliance 5) Walls easily cleaned In Compliance 6) Ceilings easily cleaned In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 40 Web site: http://chfs.ky.gov/ Inspection Report 212 - Building Temperature 922 KAR 2:120 - Section 4 (15) The temperature of the inside area of the premises shall be: (a) Sixty-five (65) to seventy-five (75) degrees Fahrenheit during the winter; or (b) Sixty-eight (68) to eighty-two (82) degrees Fahrenheit during the summer months. 1) Winter Temperature sixty-five to seventy-five In Compliance 2) Summer Temperature sixty-eight to eighty-two In Compliance 233 - Infant/Toddler indoor space 922 KAR 2:120 - Section 5 Infant and Toddler Play Requirements. (1) Infant and toddler inside areas shall: (a) Be separate from an area used by an older child; (b) Not be an exit or entrance; and (c) Have adequate crawling space for an infant or toddler away from general traffic patterns of the center. 1) Separate from older children In Compliance 2) Not Exit/ Entrance In Compliance 3) Adequate crawling space In Compliance 4) Traffic Pattern In Compliance 239 - Cots/ Mats Location Restrictions 922 KAR 2:120 - Section 6 (4) If cots or mats are used, floors shall be free from: (a) Drafts; (b) Liquid substances; (c) Dirt; and (d) Dampness. 1) No drafts In Compliance 2) No liquid substances In Compliance 3) No dirt In Compliance 4) Not damp In Compliance 279 - Toilet Room 922 KAR 2:120 - Section 10 (2) A toilet room shall: (a) 1. Be provided for each gender; or 2. A plan shall be implemented to use the same toilet room at separate times; (b) Have a supply of toilet paper; and (c) Be cleaned and sanitized daily. 1) Provided for each gender/plan to use separately In Compliance 2) Toilet Paper In Compliance 3) Clean/Sanitized In Compliance 280 - Sink 922 KAR 2:120 - Section 10 (3) A sink shall be; (a) Located in or immediately adjacent to toilet rooms; (b) Equipped with hot and cold running water that allows for hand washing; (c) Equipped with hot water no more than 110 degrees Fahrenheit; (d) Equipped with liquid soap and single use disposable hand drying material; (e) Equipped with an easily cleanable, covered waste receptacle; and (f) Immediately adjacent to a changing area used for infants and toddlers. 1) Located in or immediately adjacent to toilet rooms In Compliance 2) Equipped with hot running water that allows for hand washing In Compliance 3) Equipped with cold running water that allows for hand washing In Compliance 4) Equipped with hot water no more than 110 degrees Fahrenheit In Compliance 5) Equipped with liquid soap and single use disposable hand drying material In Compliance 7) Immediately adjacent to a changing area used for infants and toddlers In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 40 Web site: http://chfs.ky.gov/ Inspection Report 280 - Sink 922 KAR 2:120 - Section 10 (3) A sink shall be; (a) Located in or immediately adjacent to toilet rooms; (b) Equipped with hot and cold running water that allows for hand washing; (c) Equipped with hot water no more than 110 degrees Fahrenheit; (d) Equipped with liquid soap and single use disposable hand drying material; (e) Equipped with an easily cleanable, covered waste receptacle; and (f) Immediately adjacent to a changing area used for infants and toddlers. 6) Equipped with an easily cleanable, covered waste receptacle Not In Compliance Findings: all purpose, room 1: Based on observation and interview, there was no covered waste receptacle at the handwashing sink. 281 - Toilet 922 KAR 2:120 - Section 10 (4) Each toilet shall: (a) Be kept in clean condition; (b) Be kept in good repair; (c) Be in a lighted room; and (d) Have ventilation to outside air. 1) Clean In Compliance 2) Good repair In Compliance 3) Lighted Room In Compliance 4) Ventilated In Compliance General Premises 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 1) Toxic cleaning supplies, poisons, and insecticides In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff In Compliance 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 2) Knives and sharp objects Not In Compliance Findings: General: Based on observation, a paper shredder was on the floor, behind a door, in the storage room. The toddler children walked through this room to get to the toddlers' room. 4) Plastic bags Not In Compliance Findings: General: Based on observation, three (3) large garbage bags were on the floor and a plastic sack was on a chair in the storage room, accessible to children. The toddler children walked through the storage to access the toddlers' room. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 14 of 40 Web site: http://chfs.ky.gov/ Inspection Report 192 - Guns/Ammunition storage 922 KAR 2:120 - Section 3 (8) Guns and ammunition shall be stored separately in a locked area outside of the designated child care area. 1) Separate storage In Compliance 2) Locked In Compliance 193 - Smoking Protocol 922 KAR 2:120 - Section 3 (9) Smoking shall: (a) Be permitted in accordance with local ordinances; (b) Be allowed only in outside designated areas; and (c) Not be permitted in the presence of a child. 1) Local Ordinance In Compliance 2) Outdoor Designated Area In Compliance 3) Not in the presence of children In Compliance 197 - Premises Requirements 922 KAR 2:120 - Section 4 Premises Requirements. (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with a land-line telephone accessible to a room used by a child. 1) Suitable In Compliance 2) Clean In Compliance 3) Good repair In Compliance 4) Land-line phone accessible In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

all purpose room 1: Based on observation and interview, a caregiver hired 08/15/11, and a caregiver hired 10/02/01, supervised twenty-three (23) children from 7:50 a.m. until 8:00 a.m. The age of the youngest child was a two year old. 163 - Defined Groups 922 KAR 2:120 - Section 2 (2) (a) In a Type I center, a group size shall: 1. Be separately maintained in a defined area unique to the group; and 2. Have specific staff assigned to, and responsible for, the group. 1) Separate/Defined Area In Compliance 2) Specific Staff 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 5 (1)

General: Based on record review and interview, a caregiver hired 05/11/10, did not have TB documentation on file. 128 - CPR/First Aid Coverage 922 KAR 2:110 - Section 5 (3) At least one (1) person on duty and present with the children shall be currently certified by a cabinet-approved training agency in the following skills: (a)Infant and child cardiopulmonary resuscitation; and (b) Infant and child first aid. 1) CPR In Compliance 2) First Aid In Compliance 131 - Adequate Substitute(s) 922 KAR 2:110 - Section 5 (6) Child-care centers shall have available in case of need: (a) One (1) qualified substitute staff person for a Type II child-care center; or (b) Two (2) qualified substitute staff persons for a Type I child-care center 1) Type I In Compliance 131 - Adequate Substitute(s) 922 KAR 2:110 - Section 5 (6) Child-care centers shall have available in case of need: (a) One (1) qualified substitute staff person for a Type II child-care center; or (b) Two (2) qualified substitute staff persons for a Type I child-care center 2) Type II Not Applicable 139 - Training 922 KAR 2:110 - Section 5 (14) A staff person with supervisory authority over a child shall complete the following: (a) Six (6) hours of cabinet-approved orientation within the first three (3) months of employment; (b) Nine (9) hours cabinet-approved child development training within the first year of employment; and (c) Fifteen (15) hours of cabinet-approved training during each subsequent year of employment. 1) Orientation In Compliance 2) 9 hours-first year In Compliance 3) 15 hours annually In Compliance 317 - Driver requirements Not Applicable 922 KAR 2:120 - Section 12 (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty one (21) years old; (b) Complete the background checks as described in 922 KAR 2:110; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; (d) Not have had any convictions concerning vehicle operation in the past twelve (12) months; and (e) Not caused an accident which resulted in the death of a person. 1) Be 21 years old or over Not Applicable 2) Background checks Not Applicable 3) Drivers license Not Applicable 4) No convictions for vehicle operation Not Applicable 5) No accident causing death Not Applicable An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 8 of 40 Web site: http://chfs.ky.gov/ Inspection Report Programming 169 - Program of Activities Followed 922 KAR 2:120 - Section 2 (4) The child-care center shall provide a daily planned program of activities: (a) Posted in writing in a conspicuous location with each age group and followed; 1) Posted In Compliance 2) Followed In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 3

General: Based on record review and interview, a child enrolled 01/23/12, had an immunization certificate valid until 02/29/12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.