Smart Start Early Learning Academy 2 daycare inspections in Middlesboro, KY

922 KAR 2:090. Section 8. General.

General: Based on observation upon entering the Glowworms room at approximately 11:56am to do a walk-through, the surveyor found the room to be so dark that the surveyor was unable to view the room's interior and children napping within without using a flashlight; therefore, the health, safety and comfort of the children was compromised. During interview, staff-in-charge stated she would obtain nightlights or other lighting source for staff to utilize during naptime.

922 KAR 2:090 · Correction status not published

922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: 1. One (1) child’s (DOE: 08/07/25) file did not contain a physician’s name or contact number to enable a person in charge to contact the child’s physician. 2. One (1) child’s (DOE: 04/16/25) file did not contain a contact number to enable a person in charge to contact the child’s preferred hospital. During interview, staff-in-charge stated she would obtain this information from the children’s parents to complete the enrollment forms.

922 KAR 2:090 · Correction status not published

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

General: Based on review of documentation, and review of KY-TRIS, the surveyor found that one (1) staff (DOH: 09/10/25) completed four and one-half (4.50) of the required fifteen (15) hours for the second year review period of 08/25/24-06/30/25. Staff-in-charge stated this staff person left employment with the center in March 2025 and was rehired in September 2025; therefore the center was not aware that this staff had not met all of the training requirements for the second year review period.

922 KAR 2:090 · Correction status not published

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

General: Based on observation, the surveyor found dirt and debris on the blue rectangular alphabet rug in the Fireflies classroom; therefore, the rug was not kept clean. Staff-in- charge stated classroom staff clean their rooms at the end of each day, and that she would have staff clean the rug.

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor observed multiple areas on the older children’s playground where the blue rubber mulch was depleted, exposing the black underlayment; therefore, the playground was not well maintained and safe from foreseeable hazards. During interview, staff-in-charge stated that the childcare center had obtained extra mulch that they planned to spread once the weather had cleared.

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor observed a section of the chain-link fence separating the older children’s and younger children’s playgrounds had become separated from the top rail, leaving a gap at the top of the chain link fencing. Staff-in-charge stated she would have maintenance fix that section of the fence.

922 KAR 2:120 · Correction status not published

922 KAR 2:120. Section 9. Food and Drink Requirements for All Child-Care Centers.

General: Based on observation in the Wiggleworms classroom, the surveyor observed stains of dried liquids on the shelves inside the refrigerator door as well as on the bottom shelf of the refrigerator, which staff stated was used to store drinks for the children. Therefore, the shelves in the classroom refrigerator were not kept clean. Staff-in-charge stated she would have staff clean the classroom refrigerator.

922 KAR 2:120 · Correction status not published

922 KAR 2:090. Section 8. General.

General: Based on interview and review of documentation, a 2-year-old's finger was smashed in the door while a staff member was changing diapers. It was determined that the other staff member had taken the children whose diapers had already been changed outside, leaving a staff member with seven (7) two-year-old children in the classroom. During this transition the child’s fingers were closed in the door and he sustained a broken pinky finger. It was also found that the incident occurred around 2:56pm. The child’s parents work in jobs that do not allow them to check the app for incident reports. The parents did not receive information that the child was injured until the evening pick up. Once the child was taken to seek medical care, it was determined that the child stayed at the center for several hours with a broken pinky finger. The center did not reach out to the parents via phone call or attempt to contact other individuals listed on the emergency contact list. Noted by pictures the child’s finger continued to swell while waiting to be picked up by the parent. Director Requirements In Compliance

922 KAR 2:090 · Correction status not published

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

General: Based on observation, the surveyor discovered multiple areas of plastic tarp showing on the playground; therefore, the playground was not in good repair. Staff-in-charge reported that there has been a lot of rain that has moved the mulch around. Equipment In Compliance 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 In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

922 KAR 2:120 · Correction status not published

922 KAR 2:090. Section 13. Reports.

General: Based on observation, the surveyor attempted a visit on 12/26/2024 and discovered a sign posted on the door stating the child-care center was closed. There was no history note entered stating the child-care center would be closed. Staff-in-charge reported that she did not realize the closure was not reported to the cabinet. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Employee Records Not In Compliance

922 KAR 2:090 · Correction status not published

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

General: Based on review of documentation in personnel files and ECE-TRIS, the surveyor discovered the following: 1. A staff member (DOH: 03/22/2024) completed the required six (6) hours of cabinet-approved orientation on 06/25/2024; therefore, the required orientation was not completed within the first three (3) months of employment in a child-care program. 2. A staff member (DOH: 05/20/2024) completed the required six (6) hours of cabinet-approved orientation on 10/01/2024; therefore, the required orientation was not completed within the first three (3) months of employment in a child-care program. 3. A staff member (DOH: 04/18/2024) completed the required six (6) hours of cabinet-approved orientation on 10/16/2024; therefore, the required orientation was not completed within the first three (3) months of employment in a child-care program. 4. A staff member (DOH: 09/20/2024) completed the required six (6) hours of cabinet-approved orientation on 01/08/2025; therefore, the required orientation was not completed within the first three (3) months of employment in a child-care program. 5. A staff member (DOH:09/25/2024) completed the required six (6) hours of cabinet-approved orientation on 01/22/2025; therefore, the required orientation was not completed within the first three (3) months of employment in a child-care program. 6. A staff member (DOH: 08/14/2018) completed fourteen (14) of the required fifteen (15) hours of cabinet-approved early care and education training completed between July 1 and the following June 30. Staff-in-charge reported that she would inform the director of the trainings that were late or missing. Programming In Compliance Premises Not In Compliance

922 KAR 2:090. Section 9. Records.

General: Based on review of documentation, the surveyor found the following: 1. The following children’s (DOE: 08/02/23, 07/06/23, 08/02/23, 08/22/23, and 08/07/23) files did not contain the contact telephone number for the child’s preferred hospital. 2. A child’s (DOE: 08/02/23) file did not contain the name and contact telephone number for the child’s preferred hospital. The document read, “Closest.” Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

922 KAR 2:090 · Correction status not published

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

General: Based on observation, the surveyor found that the sink in the restroom in the Wiggleworms Classroom was not draining properly and was holding water. The drain plug was observed to be loose and easily pulled out of the sink. Therefore, the sink was not kept in good repair. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor found the following: 1. The surveyor found blue storage bins placed on two (2) open shelves under the diaper changing table in the restroom in the Wiggleworms Classroom. The second shelf contained one (1) bin with a tube of Parent's Choice Diaper Rash Ointment and one (1) bin with a bottle of Studio Selection Sunscreen Spray. The bottom shelf contained one (1) bin with a bottle of Neutrogena Beach Defense Sunscreen Spray, one (1) bin with Coppertone Sunscreen and Desitin Diaper Rash Paste, one (1) bin with Equate Sunscreen and Parent's Choice Diaper Rash Ointment, and one (1) bin with Banana Boat Sunscreen and Calmoseptine Ointment. The items mentioned read, "Keep Out of the Reach of Children," and were observed to be accessible to the children. 2. The surveyor found blue storage bins placed on two (2) open shelves under the diaper changing table in the restroom in the Caterpillars Classroom. The second shelf contained one (1) bin with a tube of Aquaphor Healing Ointment, one (1) bin with a tube of Parent's Choice Diaper Rash Ointment, and one (1) bin with a box containing Aquaphor Diaper Rash Cream, one (1) tube of Aquaphor Diaper Rash Cream, and one (1) spray bottle of Boogie Diaper Rash Spray. The bottom shelf contained one (1) bin with a tube of A+D Prevent Diaper Rash Ointment, one (1) bin with a tube of A+D Prevent Diaper Rash Ointment and tube of Parent's Choice diaper Rash Ointment, and one (1) bin with a tube of Desitin and Triple Paste Diaper Rash Ointment. The items mentioned read, "Keep Out of the Reach of Children," and were observed to be accessible to the children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Outdoor Play Area Not In Compliance

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

General: Based on observation, the survey discovered the following: Fireflies: 1. There was dirt debris on the alphabet rug; therefore, the rug was not kept clean. Wiggleworm: 1. There was dirt debris on the number rug; therefore, the rug was not kept clean. Bookworm Restroom: 1. There was a layer of dust on the exhaust fan. Staff-in-charge reported that she would have the areas cleaned.

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor discovered drywall exposed approximately three (3) inches long in the Wiggleworm Classroom. Staff-in-charge stated that there is normally a shelf in front of the exposed drywall. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Outdoor Play Area Not In Compliance

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor found a small green stationary climber located in the corner fence roll on the grassy area of the side playground; therefore, the stationary climber did not have an adequate fall zone. Equipment In Compliance 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 An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Children's Records Not In Compliance

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor found the following: 1. An opened box of several long metal stakes placed by the exit door that leads to the Glowworms Classroom on the side playground. The box read, "Name: Stake-electric Zinc Plated." 2. Tiny staples that contained a sharp end were observed sticking out in areas of the front part of the lattice that surrounded the air units on the side playground. 3. Loose black landscape fabric was placed on the ground at the end of the mulched area on the side playground. 4. Seven (7) tall metal stakes were observed sticking up and out of the ground along the side and back edge of the border around the mulched area next to the fence on the side playground. 5. Two (2) plastic bags containing rubber mulch were placed on the ground at the end of the mulched area on the side playground. 6. Unsecured black cables that appeared to be coming from a gray box attached to the child-care center building on the back playground by the exit door that leads into the Fireflies Classroom. One (1) cable had an exposed end. Staff-in-charge stated that the cables were not live wires. 7. Two (2) plastic bags containing rubber mulch and one (1) tall metal stake that was sticking up and out of the ground located at the end of the mulched area between the exit doors that leads to the Bookworms and Wiggleworms Classrooms on the back playground. 8. A tall wooden board was observed standing upright and leaned on the child-care center building on the back playground located between the exit doors that lead to the Bookworms and Wiggleworms Classrooms. 9. A gap was observed at the bottom of the side fence roll on the back playground. The fence was observed to not be secured at the bottom and to push outward when pushed; therefore, creating a bigger gap. 10. Loose landscape fabric, one (1) small wooden board, one (1) tall metal stake, one (1) Hanson Measuring Wheel, and several pieces of plastic playground border were placed on the ground by the back corner fence roll on the back playground. 11. Approximately three (3) loose chunks of concrete placed on the ground on the grassy area of the back playground. During interview, staff-in-charge stated this was due to concrete being busted up when leveling the area. 12. A Bulldog Farm Jack Tool leaned on the back fence roll located at the end of the mulched area on the back playground. 13. The playground border located on the side of the mulched area by the Bookworm and Wiggleworm Classrooms on the back playground was observed to have a drop off to the grassy area from the mulched area of approximately ten (10) inches; therefore, this created a tripping hazard and safety hazard for the children. During interview, staff-in-charge stated that they had just added the playground border and she would see if it could be taken further down the grassy area to eliminate the drop off. 14. Approximately twenty-one (21) plastic bags containing rubber mulch were lined along the fence roll that separates the side and back playgrounds and were observed on the back playground side of the fence. Therefore, the playgrounds were not safe from foreseeable hazards or well maintained. During interview, staff-in-charge stated that she would have the items mentioned removed off the playground.

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor found while getting a head count of the classrooms that the Glowworms Classroom was on the playground. The surveyor went to the playground and found one (1) staff member with eight (8) children at approximately 10:41 a.m.. Through interview with staff, the surveyor learned that the children were one-years-old and two-years-old; therefore, the staff-to-child ratio was exceeded by two (2) children based on the age of the youngest child. Within seconds, the surveyor observed another staff member to go to the playground. Through interview with staff, the surveyor learned the one (1) staff member was on the playground "not even one (1) minute" with the children. Staff- in-charge stated that the other staff member had to run to the restroom. Staff-in-charge stated the staff member was a new staff member. General Administration Not 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 found the following: 1. A child’s (DOE: 08/22/23) file contained an immunization certificate that read, “This child has been examined: 02/08/23,” and “Date of issue 08/23/23.” However, the certificate did not contain an expiration date. 2. A child’s (DOE: 08/07/23) file contained an immunization certificate that read, “This child has been examined: 05/16/23,” and “Date of Issue 08/29/23.” However, the certificate did not contain an expiration date. Based on review of the immunization certificates, the surveyor was unable to determine if the children's immunizations were current. During interview, staff-in-charge stated that the Tennessee immunizations do not contain expiration dates and they have been accepted in the past.

922 KAR 2:090 · Correction status not published

922 KAR 2:090. Section 8. General.

General: Based on observation, the surveyor found the following: 1. An unsecured cord to a CD player that was placed on a shelf in the Fireflies Classroom and one (1) unsecured white charging cable coming down the wall from an electrical outlet. The cords were observed to be accessible to the children. 2. Four (4) electrical outlets in the Bookworms Classroom that were missing one (1) outlet cover each. One (1) outlet was located beside blue/red storage bins, one (1) beside a wooden canopy, one (1) by the exit door to the playground, and one (1) under the bulletin board. 3. The bottom corner of an electrical outlet face plate located under the bulletin board in the Wiggleworms Classroom was broken. The broken edge was observed to be sharp/rough. Therefore, the health, safety, and comfort of the children was compromised. Director Requirements In Compliance Employee Records In Compliance Programming In Compliance Premises Not In Compliance

922 KAR 2:090 · Correction status not published

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

General: Based on observation, the surveyor found a small long hole along the top of an electrical outlet located at the bottom of the wall under the bulletin board in the Wiggleworms Classroom; therefore, the wall was not in good repair. Hygienic Practices Not In Compliance

922 KAR 2:120 · Correction status not published

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

General: Based on observation, the surveyor found the following: 1. There was debris on the diaper changing table around and under the diaper changing pad and a red/orange substance that appeared to be paint on the diaper changing pad in the Wiggleworms Classroom; therefore, the diaper changing surface was not clean. 2. There was a rip/tear in the diaper changing pad in the Glowworms Classroom; therefore, the diaper changing surface was not free from rips or tears. First Aid/Medication Not In Compliance

922 KAR 2:120 · Correction status not published

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922 KAR 2:090. Section 8. General.

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922 KAR 2:090. Section 9. Records.

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

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

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

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

922 KAR 2:120. Section 9. Food and Drink Requirements for All Child-Care Centers.

922 KAR 2:090. Section 8. General.

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

922 KAR 2:090. Section 13. Reports.

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

922 KAR 2:090. Section 9. Records.

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

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

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

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

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

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

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

922 KAR 2:090. Section 9. Records.

922 KAR 2:090. Section 8. General.

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

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