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

General: Based on observation, the surveyor discovered that the first aid kits were missing sterile gauze. Staff-in-charge stated that the main first aid kit had previously been stocked with sterile gauze; however, she did not know where the gauze was on the day of the surveyor's visit. Staff-in-charge stated that more gauze would be obtained and added to the first aid supply kit. 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 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: health medication. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered the following: 1. Two (2) holes in the wall near the bathroom sink in the downstairs restroom. 2. A section of drywall was peeled off in the School Age Room; therefore, the wall was not kept in good repair. 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 In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Written Documentation In Compliance Posted Documentation In Compliance Animals 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 8. General.

General: Based on observation, the surveyor found the following: 1. One (1) missing outlet cover on a power strip located in the floor beside a small refrigerator in the Infant Classroom. The power strip was observed to be accessible to the children. 2. Three (3) missing outlet covers on a power strip located on a small brown shelf beside a fish tank in the Three Year Old Classroom. 3. A turtle tank placed on top of a metal stand that appeared unsteady as it moved when pushed on located in the School Age Classroom. The items mentioned were observed to be accessible to the children. 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

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: 09/09/20) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 03/17/12; therefore, the training was not completed within the last five years. 2. A staff (DOH: 09/09/20) obtained twelve (12) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 09/09/20 - 09/09/21. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area 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 surveyor found an empty pack of Jack Links Beef and Mild Cheddar placed on the ground beside the building and fence roll located on the side of the School Age 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 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. Tree branches with pointy ends placed on the ground by a tree and climbing structure on the School Age Playground. Staff-in-charge stated that they had stormy weather recently. 2. Short green metal poles placed on the ground by the fence roll located on the side of the School Age Playground. 3. One (1) swing seat on a swing set located on the Toddler/Preschool Playground that appeared rip/torn; therefore, the swing seat was not in good repair. 4. One (1) swing seat that was wrapped around the top pole of the swing set located on the Toddler/Preschool Playground. The chains attached to the swing seat were observed to be hanging down and the swing seat appeared to be rip/torn. 5. Water was observed to be standing underneath the swing seats and in different areas of the Toddler/Preschool Playground; therefore, the playground was not well drained. 6. A pink car with a purple seat that was no longer attached and exposing cables/wires underneath the seat on the Toddler/Preschool Playground. 7. Two (2) nails sticking up from a wooden sand box top located in front of the porch on the Toddler/Preschool Playground. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found that the protective surface around a gray climbing structure on the School Age Playground was depleted and 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 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on observation in the School Age Classroom, the surveyor found the lesson plan was dated for December. Staff reported that she did not realize there was an outdated lesson plan hanging in the classroom. 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 4. Premises Requirements.

General: Based on observation in the School Age Classroom, the surveyor found candy wrappers located on the floor. During interview, staff stated that she did not know there were candy wrappers on the floor but she would have them picked up. 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, the surveyor found the following: 1. Inside the Younger Children's Playground, there was a child's jacket and sock left on the playground. 2. Inside the Younger Children's Playground, there was a paper substance located on the playground. 3. Inside the Older Children's Playground, there was a paper substance along with candy wrappers on the playground. Staff stated she would make sure the playgrounds are clean. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service 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 8. Kitchen Requirements.

General: Based on observation in the Infant Classroom, there was not a thermometer located in the refrigerator; therefore, the refrigerator temperature could not be determined. During interview, staff stated that she would ensure a thermometer was placed in the refrigerator. Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance Emergency Regulation 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 that a safety plug was missing from an electrical outlet located in the Two Year Old Classroom, under the window facing the playground; therefore, the safety of the children was at risk. During interview, staff stated they were not aware of the missing safety plug and that the plug would be replaced as soon as possible. Employee Records In Compliance Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found rust and debris on the bowl of the toilet located in the Two Year Old Classroom. During interview, staff reported that the toilet would be repaired and cleaned. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area 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, the surveyor found the following: 1. A mop was laying across the fence on the playground. Therefore, the mop was accessible to the children. 2. A deflated plastic football was laying on the playground. Upon interview, staff stated that they were not aware of the mop or the deflated football being on the playground and that both items would be removed immediately. Equipment In Compliance 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

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation provided to the surveyor, the surveyor was not presented with an immunization certificate for one (1) child (DOE: 08/12/2020). During interview, staff stated they were not aware that the child’s file did not contain an immunization certificate. 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on interview with multiple individuals, the surveyor determined the following: 1. A three-year-old child was out of scope of vision of daycare staff when the three-year-old child was loaded onto a county school bus by center staff on 8/14/19. The child was taken to the elementary school; however, the child was not due to start preschool until 8/26/19. Staff stated they did not realize the preschool started on a later date than the rest of the school system. 2. A three-year-old child exited the front door of the child care center alone without staff supervision. A staff person quickly retrieved the child and returned with him, inside the center. Staffing Requirements In Compliance Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. 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 surveyor determined that the health, safety, and comfort of a three-year-old child was compromised on 9/4/19 when the child sustained significant abrasions/scratches to his back after falling out of a swing on the playground. Per staff and collateral interview, staff failed to inform other supervising staff as well as the parents of the child's accident and sebsequent injuries thus preventing them from monitoring the child for discomfort or additional injury to the effected area. Staff stated they did not inform staff taking over supervision of the child of the accident and supervising staff stated they could not remember if the parents were informed of the accident or injuries. 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 2. Child Care Services.

General: Based on interview and review of documentation, the surveyor found that center staff are not providing adequate supervision of children as follows: Staff are not following the center's "Use of Telephone and Mail System" policy in regards to personal cell phone use. The policy states cell phones are not to be used in the classroom or on the playground and should only be used while staff are on breaks and off the clock. The policy further states that this includes no texting with a cell phone while in the classroom or when children are in your care. Per interview with multiple parents and staff, the surveyor was able to confirm that staff are utilizing their cell phones while in the classroom and while supervising children. The Director reported she allows staff to have their cell phone when on the playground so that they can call inside the center for emergency purposes if needed. Staffing Requirements In Compliance General Administration Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on interview and review of documentation, the surveyor found that the center did not cooperate with the state agency in regards to a report of abuse or neglect. On 8/20/19 the Director was informed of suspected abuse or neglect by a parent in regards to a staff member yanking their child up by the arms and shaking them. The Director failed to report the incident to CHFS or DRCC and proceeded to conduct an in house investigation. The Director stated that she interviewed multiple staff in regards to the incident before she found that she could not confirm the incident occurred. 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 12. Reports.

General: Based on interview and review of documentation, the surveyor determined that the staff failed to report multiple incidents of alleged child abuse/neglect to appropriate authorities as follows: 1. A parent informed the Director on 8/20/19 that they had observed a staff member yank a child up by their arms and shake the child two (2) times. The Director reported that she investigated the incident in house by interviewing staff and did not report the incident to CHFS or DRCC as she could not confirm the incident had occurred and did not suspect abuse/neglect. 2. Per parent and staff interview, it was determined that a pre-school age child was loaded onto a county school bus by center staff and transported to the local elementary school on 8/14/19 despite the fact that the child was not due to start preschool until 8/26/19. Staff reported the parent had been discussing school with the child when dropping the child off at the center and they thought the child started school that day. The child was reportedly found by school staff in the hallway crying. The Director reported she did not report this incident to CHFS or DRCC as she did not view it as possible abuse/neglect. 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 surveyor found that center staff are not following the center's "Use of Telephone and Mail System" policy in regards to personal cell phone use. The policy states cell phones are not to be used in the classroom or on the playground and should only be used while staff are on breaks and off the clock. The policy further states that this includes no texting with a cell phone while in the classroom or when children are in your care. Per interview with multiple parents and staff, the surveyor was able to confirm that staff are utilizing their cell phones while in the classroom and while supervising children. The Director reported she allows staff to have their cell phone when on the playground so that they can call inside the center for emergency purposes if needed.

Open Not marked corrected in the state record

Category: supervision. 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 surveyor determined that the health, safety, & comfort of the children was compromised as follows: 1. Per interview with multiple parents and staff, the surveyor was able to confirm that staff are utilizing their cell phones while in the classroom and while supervising children. 2. A parent informed the Director on 8/20/19 that they had observed a staff member yank a child up by their arms and shake the child two (2) times. The Director reported that she investigated the incident in house by interviewing staff and did not report the incident to CHFS or DRCC as she could not confirm the incident had occurred and did not suspect abuse/neglect. 3. Per parent and staff interview it was determined that a pre-school age child was loaded onto a county school bus by center staff and transported to the local elementary school on 8/14/19 despite the fact that the child was not due to start preschool until 8/26/19. Staff reported the parent had been discussing school with the child when dropping the child off at the center and they thought the child started school that day. The child was reportedly found by school staff in the hallway crying. Written Documentation 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, the surveyor found the following: (1.) A blue square rug located in the corner of the Infant / Toddler Classroom contained debris. (2.) Two (2) square rugs located in the Two Year Old Room contained debris. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 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, the surveyor found there was debris on the diaper changing table underneath the diaper changing pad. Staff reported the area needed to be wiped down. 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: physical safety. 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 two (2) uncovered electrical outlets located on the outside wall of the childcare building. The outlets are accessible as the children pass them on their way to the playground. Employee Records In Compliance Programming In Compliance Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the childcare center, the surveyor found that a pair of sharp pointed scissors were in an unlocked drawer on the sink located in the classroom for the one and two-year-old children. The scissors were within reach and accessible to the children. 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 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation during a tour of the childcare center, the surveyor found an approximate two and one-half to three (2 ½ - 3) inch hole in the wooden flooring of the deck. The children use the deck when going to the playground located at the rear of the childcare center. The deck was not in good repair. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area 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 during a tour of the playground, the surveyor found that a wooden pallet was leaned against the outside wall next to the steps leading to the deck. The pallet was accessible to the children. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation 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 during a tour of the childcare center, the surveyor found that a child’s medical information was posted on the wall in the Infant Classroom. The child’s confidential information was not protected. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. Verification that the monthly practiced fire drills were conducted. However, the times that the drills were practiced was not documented. 2. Verification that a quarterly practiced tornado drill was conducted on 01/08/18; however, the time that the drill was practiced was not recorded. Posted Documentation In Compliance 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 2. Child Care Services.

General: Based on observation of video footage from 8/29/17, it was found that the staff member (DOH: 7/22/16) in the two-year-old classroom stepped out of the classroom area and into the hallway at 12:46pm and did not return to the classroom area until 12:57pm. Based on interview, it was reported that the staff member was doing laundry and was sitting on the floor of the hallway during this time. Further interviews determined that the staff member was unable to physically see all of the children in the classroom at this time. Therefore, the children were left unsupervised for a total of eleven (11) minutes. Staffing Requirements In Compliance Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: Based on review of documentation, it was found that a staff’s (DOH: 8/1/11) file contained a copy of a negative tuberculin results dated 8/19/15; therefore, the result was no longer current.

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 of the two-year-old classroom, the following things were found: 1) There was one (1) unprotected outlet in the kitchen area of the classroom. 2) There was a fire extinguisher located on the floor of an unlocked closet. The closet had a safety lock on top; however, the safety lock was broken. The fire extinguisher was accessible and within reach of the children. Employee Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Programming Not In Compliance

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 of the pre-school classroom, there was no lesson plan posted. Based on interview with the director, she acknowledged and confirmed there was not a current lesson plan posted in this classroom. 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 Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview with staff, some of the parents provide the canisters of formula and staff measure and prepare the bottles for the children. 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: ratio. Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found the following: (1) One (1) electrical outlet by the changing area in the One's classroom that did not have a protective covering and one (1) electrical outlet by the days of the week poster in the Three's classroom that did not have a protective covering, upon interview staff were not aware the protective coverings were missing. (2) There was some unsecured wiring connected to the camera that was hanging from the ceiling in the Four's classroom, the wiring was at eye level with the surveyor and therefore could pose as a strangulation risk if accessed by a child. Upon interview staff reported the Four's classroom is not currently being utilized by children.

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 and interview, one (1) staff file presented for review (DOH: 3/8/16) did not contain a criminal records check for their previous state of residence, staff was not observed alone with the children at the time of the survey. Upon interview the director stated they were not aware the staff member had resided outside the state of Kentucky.

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 training website, and interview, one (1) staff file presented for review (DOH: 8/1/11) did not contain proof of completing the required one and one half hours (1 1/2) of Pediatric Abusive Head Trauma within the past five (5) years, upon interview the staff member and director reported the training had been completed and they had previously had documentation of it's completion.

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 and interview, the following were found: (1) In the hall bathroom, staff's personal items (hair pick, hair straightener, feminine hygiene products) were located in three different unlocked drawers under the sink, upon interview staff acknowledged the items belonged to staff members. (2) In the One's classroom, a pair of non-safety scissors were located on the changing table where they would be within reach of a child during a diaper change, upon interview staff reported the One's classroom is not used every day and therefore they were not aware of the scissors being there. (3) In the Two's classroom, a can of disinfectant spray and a staff member's purse were located in the unlocked cabinet under the sink, the cabinet did have a child lock in place but it was not functional at the time of the survey. Upon interview staff was not aware that the lock was no longer functional. (4) In the Four's classroom located in the basement, there was an unlocked closet which contained what appeared to be a jug of bleach, upon interview staff reported the Four's classroom was not currently in use and they were not aware bleach was located in the closet. (5) In the School Age classroom, an unlocked closet in the back corner of the room contained loose insulation, upon interview staff was not aware the insulation was present in the closet.

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, the surveyor observed a significant amount of beatles surrounding the window as well as covering the ceiling around the window in the Four's classroom located in the basement, beatles were not observed in any other area of the center. Upon interview, staff acknowledged the presence of the beatles but did not report any measures being in place to control the beatle infestation.

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, the surveyor observed a doorway to the outside located in the storage area of the basement which had some significant cracks/openings to the outside around the edges, therefore the door was not effectively protected to prevent the entrance of vermin. Upon interview, staff acknowledged the door was in need of repair.

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, the surveyor found the sink located in the bathroom off the the Two's classroom did not have disposable towels or a dryer for drying of hands. Upon interview, staff was not aware there were not disposable towels available. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found that one (1) toilet located in the basement bathroom was not maintained in a clean condition as there was dried urine located on the seat. Upon interview, staff reported the bathroom is only used by school-age children in the afternoons. Hygienic Practices

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found nap mats located in the Infant, Two's, Three's, and Four's classrooms that were not in good repair as evidenced by them having tears/holes in them exposing the foam filling. Upon interview staff reported there should not be any mats with holes in them as they had recently purchased new mats and disposed of the old mats.

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 and interview, the surveyor found an individual tricycle located on the younger children's playground that had both pedals broken off and a cracked/broken seat creating sharp edges that could be hazardous to children, upon interview staff was not aware of the tricycle being damaged.

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 and interview, the surveyor found that the thermometer in the refrigerator located next to the microwave to read fifty five (55) degrees fahrenheit rather than the required forty (40) degrees fahrenheit or below, upon interview staff was not aware of the current temperature reading.

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, the surveyor found the hand washing steps were not posted by the sink/diaper changing area in the Infant classroom, upon interview staff was not aware the hand washing procedures were missing. Animals

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, the sink located in the Two Year-Old Room was not equipped with a hand-drying blower or single-use, disposable hand-drying materials.

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, an employee (DOH 09/13/13) record presented for review contained a performance evaluation dated 12/09/13 which had not been updated annually as required by regulations.

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, an employee (DOH 08/21/14) record presented for review did not contain a criminal record check. During an interview, the director stated that the criminal record check was completed upon the employee's date of hire and had apparently been misplaced at the time of the inspection. The director stated that the employee was a co-op student and had never worked alone in supervision of children.

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 following issues were found: 1) An employee (DOH 03/27/13) file contained only twelve (12) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. 2) An employee (DOH 09/13/13) file contained only thirteeen (13) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. 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 3. General Requirements.

General: Based on observation of the downstairs restroom used by Preschool and School Age children, the following inaccessible items were placed beside the sink: a mop bucket full of mop water containing a soiled mop, a broom, and a dustpan.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the posted weekly menu was dated January 5-9, 2015; therefore, the menu was not updated weekly as required by regulations.

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 review of documentation, the child care center's emergency preparedness plan presented for review was dated 12/05/13. During an interview with the director, she stated that the child care center plan was updated in calendar year 2014; however, the director had inadvertently failed to retain a copy of the emergency plan sent in to the local emergency management office.

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 review of documentation, the child care center did not have a written chain of command included in the program's policies and procedures as required by regulations.

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, an employee's (DOH 08/01/11) professional development plan presented for review was dated 08/01/13 which was not updated annually as required by regulations.

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 daily lesson plan of activities posted in the Preschool Room was dated December 8 -12; therefore, the lesson plans had not been maintained up-to-date as required by regulations.

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 the playground area, water was draining from the roof down through a drain spout onto the play area used for the older children.

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 during a tour of the center, two (2) brown circular stains were on the ceiling in the three-year-old children's classroom. Through interview with the director, it was learned that there had been an overloading of the washer upstairs and water had leaked causing the stains on the ceiling downstairs.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 5 (1)

General: Based on review of documentation, the file for a staff member (date of hire - 8/1/11) included the results of a negative tuberculin skin test that was dated 7/12/10. This certificate was no longer current after 7/12/12. 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 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 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 4 (1)

One's Room: Based on observation, mucus was under two (2) children's noses for several minutes before the children's noses were wiped. Nursery: Based on observation, a staff member changed an infant's feces soiled diaper and did not wash her hands prior to giving the infant a pacifier or prior to giving a toy to another infant. This staff member touched, played with and cared for the infants in the room and did not wash her hands after changing the diaper. 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 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 11 of 40 Web site: http://chfs.ky.gov/ Inspection Report 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 1) Windows In Compliance 2) Doors In Compliance 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 3) Stoves Not Applicable 4) Heaters Not Applicable 5) Furnaces Not Applicable 6) Pipes Not Applicable 7) Stairs Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 10

Nursery: Based on observation, a staff member changed an infant's diaper and did not disinfect the changing pad after changing the diaper.

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

Nursery: Based on interview, the toys that infants put in their mouths are cleansed and sanitized by placing the toys in a bleach/water solution to soak. The toys are then removed from the bleach/water solution and allowed to air dry. The toys are not scrubbed in warm, soapy water with a brush to reach into crevices and rinsed prior to the toys being sanitized in the bleach/water solution and air dried. First Aid/Medication 244 - First aid supplies 922 KAR 2:120 - Section 7 (3) If a child becomes ill while at the center: (a) The child shall be placed in a supervised area isolated from the rest of the children; (b) The parent shall be contacted immediately; and (c) Arrangements shall be made to remove the child from the child-care center as soon as practicable. 1) Availability In Compliance 2) Storage In Compliance 3) Inventoried In Compliance 4) Sanitized, if reusable In Compliance 5) Maintained in sanitary manner In Compliance 6) Liquid soap In Compliance 7) Adhesive bandages In Compliance 8) Sterile gauze In Compliance 9) Medical tape In Compliance 10) Scissors In Compliance 11) Thermometer In Compliance 12) Flashlight In Compliance 13) Cold pack In Compliance 14) First aid book In Compliance 15) Disposibale gloves In Compliance 16) Cardiopulmonary resuscitation mouthpiece protector In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 4 (1)

General: Based on observation, a four (4) bulb light fixture was installed over the sink in the restroom used by the children in the Two (2) Year Room. Two (2) light bulbs were missing allowing the empty sockets to be uncovered and unprotected.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 4 (1)

School Age Room: Based on observation, the downstairs basement area was used for the after school program and consisted of a large open room that was divided into three (3) separate areas by half walls and a large wooden gate. A bird was flying around in two (2) areas and a bird nest was in one (1) area at the top of the room where a clothes dryer vent had come out of the exterior wall leaving a hole to the outside and allowing the bird access to the inside of the building. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 11 of 40 Web site: http://chfs.ky.gov/ Inspection Report 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 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff 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 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 1) Windows In Compliance 2) Doors 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 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 3) Stoves Not Applicable 4) Heaters Not Applicable 5) Furnaces Not Applicable 6) Pipes Not Applicable 7) Stairs Not Applicable

Open Not marked corrected in the state record

Open / not marked corrected.