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

General: Based on review of documentation, in staff member's personnel files and ECE-TRIS, the surveyor discovered the following: 1. A staff member (DOH:03/01/2016) completed thirteen (13) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/2023 through 06/30/2024. 2. A staff member (DOH: 07/29/2021) completed thirteen (13) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/2023 through 06/30/2024. 3. A staff member (DOH:08/08/2022) completed thirteen (13) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/2023 through 06/30/2024. Staff-in-charge reported that she would let the director know.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered a brown substance on the ceiling tile located in the boys' restroom. Staff-in-charge stated that she would have the ceiling tile replaced.

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 surveyor discovered the first toilet seat was not tightly secured to the toilet bowl. Staff-in-charge reported that she would have Maintenace fix the toilet seat. Hygienic Practices 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, the surveyor discovered the following: 1. A child's file (DOE:02/28/2024) contained a list of immunizations received. 2. A child's file (DOE:02/11/2024) contained a list of immunizations received. 3. A child's file (DOE:02/10/2024) contained a list of immunizations received. The lists did not contain an expiration dates for the immunization records. Staff-in-charge stated that those three (3) children's immunizations are from Tennessee and she does not know why good until dates are not placed on them.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on interview and a review of ECE-TRIS, the surveyor found: 1. A staff member (DOH: 03/01/16) completed two (2) hours of the required fifteen (15) hours of cabinet-approved early care and education training during the review period 07/01/22- 06/30/23. 2. A staff member (DOH: 07/29/21) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training during the review period 07/30/22-06/30/23. 3. A staff member (DOH: 08/08/22) completed seven (7) hours of the required fifteen (15) hours of cabinet-approved early care and education training during the review period 08/08/22-08/08/23. Staff reported the staff members would complete their trainings. Programming In Compliance 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

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found a glass window had one (1) broken pane; therefore, the window was not in good repair. Staff reported the window would be repaired.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found: Boys' Restroom: 1. Broken wall tile behind the toilet. Girls' Restroom: 1. Broken wall tile underneath the sink. Staff reported the broken tiles would be repaired. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found a child’s (DOE: 08/21/23) file did not contain a current immunization certificate. Staff reported the child's immunization certificate would be obtained. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following staff's (DOH: 03/01/16 and 08/01/18) files did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A staff’s (DOH: 03/01/16) file contained documentation of a background check submitted through the Kentucky Applicant Registry and Employment System (KARES) that verified the staff’s eligibility date as 09/12/18. During interview with staff-in-charge, she stated that she had moved to Tennessee four (4) years ago and had not completed an out of Child Abuse/Neglect Background Check (CAN) or a check of the state’s sex offender registry. During interview, staff-in-charge stated she was not aware that she needed to complete these additional background checks since she was entered into KARES prior to being hired and moved to Tennessee after being hired. Staff-in-charge stated she would complete the additional background checks as soon as possible. 2. A staff’s (DOH: 08/26/21) file contained documentation of a background check submitted through the Kentucky Applicant Registry and Employment System (KARES) that verified the staff’s eligibility date as 07/29/21. During interview with staff-in-charge, she stated that the staff (DOH: 08/26/21) had moved to Tennessee in the last year. The staff’s file did not contain a completed out of state Child Abuse/Neglect Background Check (CAN) or a check of the state’s sex offender registry. The surveyor observed the staff person to be working alone with children in Nap Room One Classroom on the day of the surveyor's of visit. Staff-in-charge called the surveyor on 03/08/23 to let her know that she had spoken with her child-care aware coach and thought she had found the CAN check for staff (DOH: 08/26/21) but stated it was the wrong documentation. Staff-in-charge stated that she would complete the correct documentation as soon as possible. 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 review of documentation, a staff’s (DOH: 08/26/21) file contained documentation of a background check submitted through the Kentucky Applicant Registry and Employment System (KARES) that verified the staff’s eligibility date as 07/29/21. During interview with staff-in-charge, she stated that the staff (DOH: 08/26/21) had moved to Tennessee in the last year. The staff’s file did not contain a completed out of state Child Abuse/Neglect Background Check (CAN) or a check of the state’s sex offender registry. The surveyor observed the staff person to be working alone with children in the Nap Room One Classroom on the day of the surveyor's of visit. 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 ECE-TRIS, the surveyor found the following: 1. A staff (DOH: 03/01/16) obtained one and one-half (1 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/01/21 – 06/30/22. 2. A staff (DOH: 08/01/18) obtained zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/01/21 – 06/30/22. 3. A staff (DOH: 07/29/21) obtained seven and a one-half (7 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/29/21 – 07/28/22. 4. A staff (DOH: 08/26/21) obtained seven and one-half (7 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 08/26/21 – 08/25/22. 5. A staff (DOH: 12/03/21) obtained six (six) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 12/03/21 – 12/02/22. 6. A staff (DOH: 02/01/22) obtained six (6) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 02/01/22 – 01/31/23. 7. A staff’s (DOH: 12/03/21) file did not contain documentation of one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training; therefore, the training was not completed within the staff's first year of employment. 8. A staff’s (DOH: 02/01/22) file did not contain documentation of one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training; therefore, the training was not completed within the staff's 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 In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a staff’s (DOH: 02/01/2022) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. Staff reported she would inform the director that the staff does not have education documentation in their file. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. Staff's (DOH: 12/03/2021) file did not contain a copy of a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative tuberculin result; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. 2. Staff's (DOH: 03/01/2016) file contained a negative tuberculin result dated 10/23/2018; therefore, the result was no longer current. Based on this documentation, the surveyor was unable to verify if the staff person was free of active tuberculosis. Staff reported she would inform the director that the staff needs to update their negative tuberculin results.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS, the surveyor found the following: 1. Staff (DOH: 03/01/2016) completed one (1) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/2020 through 6/30/2021. 2. Staff (DOH: 08/01/2018) completed zero (0) the required fifteen (15) hours of cabinet-approved early care and education training completed between 7/1/2020 through 6/30/2021. Staff reported that the director has had issues getting training hours to reflect in ECE-TRIS. 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

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 presented, the surveyor found the following: 1. A child’s (DOE: 09/02/20) file contained an immunization certificate with no expiration date. 2. A child’s (DOE: 05/27/20) file contained an immunization certificate with no expiration date. 3. A child’s (DOE: 09/04/20) file contained an immunization certificate with no expiration date. 4. A child’s (DOE: 09/03/20) file contained an immunization certificate that was no longer current as of 02/13/21. 5. A child’s (DOE: 08/20/20) file contained an immunization certificate that was no longer current as of 03/16/21. During interview, staff did not realize that out of state immunizations for three (3) children did not have expiration dates nor did staff realize that two (2) immunizations were no longer current. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance Emergency Regulation In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: (1.) Staff's (DOH: 9/6/11) file contained a copy of a negative tuberculin result that was read on 10/13/17; therefore, the tuberculin result is no longer current. Staff confirmed through interview that this is the most recent tuberculin result for the staff's file. (2.) Staff's (DOH: 10/21/19) file did not contain a statement from a health professional stating that the individual is free of active tuberculosis or a copy of a negative tuberculin result. Staff confirmed through interview that the documentation had not been obtained for the staff's file. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, and ECE - TRIS, the surveyor found the following: (1.) Staff (DOH: 9/1/18) obtained thirteen and one-half (13 1/2) of the required fifteen (15) hours of cabinet-approved early care and education training. (2.) Staff (DOH: 8/1/18) obtained seven and one-half (7 1/2) of the required fifteen (15) hours of cabinet-approved early care and education training. During interview, staff confirmed that fifteen (15) hours of training were not obtained by the two (2) staff. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals 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 6. License Issuance.

General: Based on review of documentation, the surveyor found that the center’s liability insurance was no longer current as of 1/12/18. During interview with a staff, the surveyor was informed that the center's insurance is current; however, verification was not presented during the renewal survey. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A plunger was stored beside the commode located in the girls’ restroom located in the lower building. 2. An extension cord dangled from an approximately twelve (12) foot wall and onto the floor in the dining area. The staff-in-charge identified that children, whose ages ranged from one to three-years-old, eat lunch in this area. The extension cord was within reach and accessible to the children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a staff’s (DOH: 3/1/16) negative tuberculin result was no longer current as of 2/26/18. 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 3. General Requirements.

General: Based on observation, the surveyor found the following: 1. Sanitizing hand wipes were on the sink located in the classroom for the three and four-year-old children. The wipes label indicated the wipes should be kept out of the reach of children. The wipes were within reach and accessible to the children. 2. Sanitizing hand wipes and a staff’s purse were on the desk located in the classroom for the four-year-old children. The items were within reach and accessible to the children. 3. A can of Zenatize Disinfectant Spray was on the bottom shelf of a metal cart located in the dining area. The disinfectant was within reach and accessible to the children. 4. Two bottles of hand sanitizer were sticking out of a side pocket located on a diaper bag. The diaper bag was located in the hallway that children walk through to the dining area. The hand sanitizer was within reach and accessible to the children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of Building #2, the surveyor found a thick coat of dust on the ceiling air vents in the girls' and boys' restrooms. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation of the preschool-age children during lunch, the surveyor found that two (2) children were drinking Kool-Aid and one (1) child was drinking juice. Staff did not serve the children pasteurized low fat one (1) percent or fat free skim milk. 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, the surveyor found the following: 1. A child’s (DOE: 8/26/18) enrollment file contained an immunization certificate that was no longer current as of 1/16/19. 2. Three (3) of the children’s (DOE: 8/26/18) enrollment files contained immunization certificates that had no expiration date. The children’s immunization status could not be determined. 3. A child’s (DOE: 6/8/16) enrollment file contained an immunization certificate that had no expiration date. The child’s immunization status could not be determined. 4. A child’s (DOE: 6/20/16) enrollment file contained an immunization certificate that had no expiration date. The child’s immunization status could not be determined. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found no written verification that staff reviewed or revised the emergency preparedness plan during 2018.

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, the surveyor found the following: 1. The surveyor found that only one (1) time of day and date were recorded for both, tornado and earthquake drills, for the first, second, third and fourth quarters of 2018. 2. The surveyor found that the day was not recorded on which the staff and children practiced the July 2018 fire drill. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and interview, the following were found: 1. A staff file (DOH: 11/8/17) presented for review did not contain results of a child abuse and neglect background check or documentation showing that the child abuse and neglect background check had been submitted timely. The staff member was not observed working alone. The Director reported that the only proof of submission that she had kept was her mail receipt. 2. A volunteer file (Start Date: 9/25/17) presented for review did not contain results of criminal records background check for previous state of residence or documentation showing that the criminal records background check for previous state of residence had been submitted timely. The staff member was not observed working alone. The Director reported that the only proof of submission she had kept was the mail receipt. 3. A volunteer file (Start Date: 11/8/17) presented for review did not contain results of criminal records background check or a child abuse and neglect background check. There was no documentation showing that the background checks had been submitted timely. The staff member was not observed working alone. The Director reported that the only proof of submission she had kept was the mail receipt. 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 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation, review of ECE-TRIS, and interview, the surveyor found that a staff member (DOH: 1/28/09) had not completed fifteen (15) hours of annual traing for 1/28/16 - 1/27/17 at required. Review of ECE-TRIS and the staff file revealed that the staff member had only completed six (6) hours of annual training. Upon interview, the Director was aware that the staff member had not completed the required annual training hours. 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 and interview, the surveyor found that the lesson plan posted in the second Nursery Classroom was dated for 11/10/17; therefore, it was not current. Staff reported that the lesson plan was the one they were following for the day but she had forgot to change the date.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found that there were six (6) children between eighteen-months and two-years-old combined in the Toddler Classroom. Staff reported that the oldest two (2) children had just turned two (2) around 11/13/17 and were getting ready to start transitioning to the Two's Classroom. Staff stated that at this time the two-year-old children were combined with the toddlers all day. Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, a child's file (DOE: 8/30/17) presented for review contained an immunization certificate that was no longer current after 11/7/17. Upon interview, the Director was not aware that the immunization certificate was no longer current. Written Documentation In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, during a tour of the six (6) to twelve (12) month old children's classroom, the surveyor observed cords dangling from a TV. The cords were not connected and were hanging low enough for a child to grab and pull; thus, creating a safety hazard to the children. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A staff member (DOH: 08/28/13) had not completed fifteen (15) hours of approved training as required. A review of ECE-TRIS found that the staff member had obtained thirteen (13) hours of training during the annual training year of 08/23/15-08/23/16. There was no additional training documentation in the staff members file. 2. A staff member (DOH: 08/20/14) had not completed fifteen (15) hours of approved training as required. A review of ECE-TRIS found that the staff member had obtained thirteen (13) hours of training during the annual training year of 08/20/15-08/20/16. There was no additional training documentation in the staff members file. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, during a tour of a six (6) to twelve (12) month old children's classroom, the surveyor found a quart jar of milk in the refrigerator. In an interview with staff, the surveyor was informed that the parent had changed their eleven (11) month old child’s milk to whole milk. There was no written notification of the change from the parent in the child’s file and staff confirmed that the parent had not submitted a written request for the change. Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found that an infant child was sleeping in a crib while wearing a bib. Through interview, staff reported that they were unaware that the bibs posed a safety threat. 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

Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS, the surveyor found the following: 1. A staff (DOH: 09/27/13) had obtained only fourteen (14) hours of cabinet-approved early care and education annual training. 2. A staff (DOH: 06/18/08) had obtained only thirteen and a half (13 ½) hours of cabinet-approved early care and education annual training. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found that the paint was chipped on the toilet seats located in the boys' and girls' restrooms. The chipped paint allows for the underlying surface to become absorbent; therefore, they cannot be properly cleaned and sanitized. Hygienic Practices

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview with two (2) staff, the surveyor learned that the mouth contact toys are sanitized by mixing bleach into the water used to wash the mouth contact toys or by spraying the toys with bleach water. The proper method for sanitizing mouth contact toys is to wash in warm soapy water using a brush to reach into crevices, rinse in clean water, submerge in a sanitizing solution for a least two (2) minutes and air dried. First Aid/Medication

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that there was no thermometer in the refrigerator located in the Infant Room; therefore, the interior temperature could not be determined. The staff reported that they were unaware the thermometer had been removed. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 20 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a substitute staff’s (DOH: 08/26/94) file did not contain a written plan for professional development. Through interview with a staff, the surveyor learned that as the substitute is seldom needed, the plan for professional development was overlooked. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 24 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview with the director at the time of the renewal visit, the surveyor was unable to verify to that an earthquake drill had been conducted during the fourth quarter of 2015.

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 with the director at the time of the renewal visit, the surveyor was unable to verify to that an earthquake drill had been conducted during the fourth quarter of 2015. Posted Documentation

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, only thirteen (13) hours of cabinet-approved early care and education training obtained from 1/28/13 to 1/27/14 was presented for review for a staff member (date of hire - 1/28/09).

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, landscape fabric installed under mulch on the smaller children's playground was exposed through the mulch in two (2) areas and created a hazard to children.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, contact information to enable a person in charge to contact a child's preferred hospital was not presented for three (3) children (dates of enrollment - 8/23/13, 10/21/13 and 3/17/14).

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the following were found: 1) One (1) infant child was eating lunch at a feeding table in the Infant Room and the safety straps were not secured. 2) One (1) infant child was eating lunch in a high chair in the Infant Room and the safety straps were not secured. 3) Six (6) toddler children were eating lunch at a feeding table in the cafeteria and the safety straps were not secured. 4) Five (5) toddler children were eating lunch in high chairs in the cafeteria and the safety straps were not secured.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the files presented for four (4) child care staff revealed that they had not obtained fifteen (15) hours of cabinet-approved early care and education training each subsequent year of employment. 1) A staff (hire date: 8/20/2005) had obtained zero (0) hours of annual training during the most recent subsequent year of employment. 2) A staff (hire date: 9/16/211) had obtained only seven and one-half (7.5) hours of annual training during the most recent subsequent year of employment. 3) A staff (hire date: 1/28/2009) had obtained only six (6) hours of annual training during the most recent subsequent year of employment. 4) A staff (hire date: 2/9/2009) had obtained zero (0) hours of annual training during the most recent subsequent year of employment. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the portable sink in the Toddler Room was not equipped with hot water as required.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the following was found: (1) The most recent completed professional development plans presented for surveyor review for fourteen (14) staff members were dated October 2011 and were no longer current. (2) The most recent completed professional development plan presented for surveyor review for one (1) staff member (DOH: 1/28/09) was dated September 2010 and was no longer current. 107 - Maintenance of Background check/Out of State 922 KAR 2:110 - Section 3 (12) For the director, employee, volunteer, or any person with supervisory or disciplinary control over, or having direct contact with a child, results of the: (a) Criminal records check in accordance with KRS 17.165; (b) Child abuse and neglect check in accordance with 922 KAR 1:470; and (c) Background check from: 1. Previous state of residence, if the individual has been a resident outside of Kentucky in the previous five (5) years; or 2. Current state of residence, if other than Kentucky; 1) Criminal Records Check In Compliance 2) Child Abuse/Neglect Check In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 7 of 40 Web site: http://chfs.ky.gov/ Inspection Report 3) Previous State of Residence In Compliance 4) Current State other than KY In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

Nursery II: Based on observation upon entry into the classroom at approximately 12:38 p.m., the surveyor observed a male child and a female child sleeping in swings. Through interview with the staff, it was learned that the male child had just fallen asleep. Staff stated that the female child (7 months old) had been sleeping in the swing since approximately 11:00 a.m. (1 and 1/2 hours). Staff further stated that they did not have any medical documentation that permitted the child to sleep in the swing.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, there was landscaping fabric exposed in multiple areas on the big playground.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the immunization certificate presented for surveyor review for one (1) child (DOE: 8/19/12) was no longer valid after 11/22/12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

Based on observation during a tour of the infant room, the surveyor found that a staff member was supervising six (6) children. The youngest child was ten weeks old; therefore, the staff-to-child ratio was exceeded by one (1) child. 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 4 (1)

Based on review of documentation, the surveor found only (1) documented staff meeting during the past year.

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.

Based on review of documentation and staff interview, the surveyor found the following: (1) There was no evidence of a high school diploma, GED, or Commonwealth Child Care Credential on file for a staff member hired on 02/21/11. (2) There was no evidence of a high school diploma, GED, or Commonwealth Child Care Credential on file for a staff member hired on 08/09/11. (3)There was no evidence of a high school diploma, GED, or Commonwealth Child Care Credential on file for a staff member hired on 08/17/11. (4) There was no evidence of a high school diploma, GED, or Commonwealth Child Care Credential on file for a staff member hired on 09/02/11. (5) Interview with the director found that a staff member (DOH: 09/16/11) does not have a high school diploma, GED, or Commonwealth Child Care Credential. This staff member works as an assistant in the classroom and has supervisory power over children.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 9 Food Requirements.

Based on review of documentation, the surveyor found that the posted daily schedules for the two-, three-, and four-year-old daycare children indicated that lunch is served from 11:45 a.m. to 12:15 p.m. and afternoon snack is served from 3:30 p.m. to 3:50 p.m. Therefore, there is a three (3) hour and fifteen (15) minute lapse between lunch and afternoon snack. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 35 of 44 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.