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.

922 KAR 2:120 · Correction status not published

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.

922 KAR 2:090 · Correction status not published

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

922 KAR 2:120 · Correction status not published

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.

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.

922 KAR 2:120 · Correction status not published

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

922 KAR 2:120 · Correction status not published

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

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

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

922 KAR 2:090 · Correction status not published

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.

922 KAR 2:090 · Correction status not published

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

922 KAR 2:090 · Correction status not published

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

922 KAR 2:090 · Correction status not published

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

922 KAR 2:090 · Correction status not published

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.

922 KAR 2:090 · Correction status not published

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

922 KAR 2:120 · Correction status not published

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.

922 KAR 2:120 · Correction status not published

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.

922 KAR 2:120 · Correction status not published

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

922 KAR 2:120 · Correction status not published

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

922 KAR 2:110 · Correction status not published

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

922 KAR 2:120 · Correction status not published

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

922 KAR 2:110 · Correction status not published

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

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.

922 KAR 2:110 · Correction status not published

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

922 KAR 2:110 · Correction status not published

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

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).

922 KAR 2:110 · Correction status not published

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).

922 KAR 2:110 · Correction status not published

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.

922 KAR 2:120 · Correction status not published

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.

922 KAR 2:110 · Correction status not published

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

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

922 KAR 2:110 · Correction status not published

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.

922 KAR 2:120 · Correction status not published

922 KAR 2:110 - Section 4 (1)

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

922 KAR 2:110 · Correction status not published

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.

922 KAR 2:110 · Correction status not published

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

922 KAR 2:120 · Correction status not published