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Home › KY › Pippa Passes › June Buchanan School/Alice Lloyd College Dev Center
100 Purpose Road, Pippa Passes KY 41844 · License #L352885 · Center · Licensed
When they operate
Schedule type not published.
Ages served
922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.
General: Based on review of documentation and KARES, the surveyor discovered a staff member (DOH: 01/29/20) was listed on the child-care center's KARES report as "eligible- expired". The staff member was not working with children at the time of the survey.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:280 · 922 KAR 2:280. Section 11. Status of Employment.
General: Based on review of documentation on the child-care center's KARES report, the surveyor discovered the following: 1. There were eighteen (18) "current employees" listed on KARES that were no longer employed by the child-care center. 2. There were seven (7) "eligible not employed" listed on KARES that were currently working at the child-care center. Supervision In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 15. Statement of Deficiency and Corrective Action Plans.
A PLAN OF CORRECTION WAS DUE ON 12/23/2025 AND AS OF 01/15/2026, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Findings: A PLAN OF CORRECTION WAS DUE ON 01/30/2026 AND AS OF 02/17/2026, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED.
Open Not marked corrected in the state record
Open / not marked corrected.
Generated from this facility's specific inspection record
Data synced from Kentucky Cabinet for Health and Family Services, Division of Child Care on Jul 11, 2026 · Source records · Report an error
922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.
General: Based on review of documentation, the surveyor discovered the following: 1. A staff member's (DOH: 10/24/23) file contained a staff evaluation dated for 08/20/24; therefore, the staff evaluation was not completed yearly. 2. A staff member's (DOH: 10/03/23) file contained a staff evaluation dated for 08/14/23; therefore, the staff evaluation was not completed yearly. 3. A staff member's (DOH: 10/03/23) file contained a staff evaluation dated for 08/20/24; therefore, the staff evaluation was not completed yearly. 4. A staff member's (DOH: 10/03/23) file contained a staff evaluation dated for 08/20/24; therefore, the staff evaluation was not completed yearly. 5. A staff member's (DOH: 08/20/24) file contained a staff evaluation dated for 08/20/23; therefore, the staff evaluation was not completed yearly.
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation, the surveyor discovered that a staff member's (DOH: 08/20/25) file did not contain proof of education documentation; therefore, the surveyor could not determine if the staff member's education was qualifying. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 11 of 34 Inspection Report
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation, the surveyor discovered the following: 1. A staff member's (DOH: 08/20/25) 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 (TB skin test) result for the staff person; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. 2. A staff member's (DOH: 08/19/25) 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 TB skin test result for the staff person; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis.
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 discovered the following: 1. A staff member (DOH: 08/21/18) completed zero (0) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/24 through 06/30/25. 2. A staff member (DOH: 10/24/23) completed zero (0) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/24/24 through 6/30/25. 3. A staff member (DOH: 10/03/24) completed zero (0) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/03/24 through 10/02/25. 4. A staff member (DOH: 10/03/23) completed zero (0) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/03/24 through 06/30/25.
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor discovered that a child's (DOE: 05/07/25) immunization certificate was current until 12/01/2024; therefore, the surveyor could not determine if the child was up-to-date on their immunizations.
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor discovered the following: 1. A staff member's (DOH: 10/24/23) file contained a professional development dated for 08/10/24; therefore, the professional development was not completed yearly. 2. A staff member's (DOH: 10/03/23) file contained a professional development dated for 08/13/24; therefore, the professional development was not completed yearly. 3. A staff member's (DOH: 10/03/23) file contained a professional development dated for 08/14/24; therefore, the professional development was not completed yearly. 4. A staff member's (DOH: 10/03/23) file contained a professional development dated for 08/13/24; therefore, the professional development was not completed yearly. 5. A staff member's (DOH: 08/20/24) file contained a professional development dated for 08/20/24; therefore, the professional development was not completed yearly.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.
General: Based on review of documentation of KARES, the surveyor discovered the following: 1. A staff member (DOH: 08/21/2018) was listed twice on the KAREs report as "eligible- expired" and "closed-fingerprints not taken"; therefore, the staff member did not have an up- to-date eligible background check completed. Staff-in-charge stated that she was not aware the background check was not completed or that fingerprints were not taken. 2. A staff member (DOH: 08/09/2023) was listed on the KAREs report as "eligible-expired"; therefore, the staff member did not have an up-to-date eligible background check completed. 3. A staff member (DOH: 08/20/2024) was listed as "In Process", while working at the child-care center. During interview, staff-in-charge reported that the staff member has been working at the child-care center; however, she has not been working alone. The surveyor did not see the staff member working at the time of the survey. 4. A staff member (DOH: 01/29/2020) was listed on the KAREs report as "eligible- expired"; therefore, the staff member did not have an up-to-date eligible background check completed. Staff-in-charge reported that she would make sure staff members have an eligible background check completed. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:280 · 922 KAR 2:280. Section 11. Status of Employment.
General: Based on review of documentation, the surveyor discovered that the child-care center failed to maintain an up-to-date KAREs report. Staff-in-charge did not realize the KAREs report listed multiple staff members that are no longer employed. Supervision In Compliance Staffing Requirements In Compliance General Administration Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 15. Statement of Deficiency and Corrective Action Plans.
A PLAN OF CORRECTION WAS DUE ON 06/17/2025 AND AS OF 07/01/2025, THE PLAN OF CORRECTION HAS NOT BEEN RECEIVED. Director Requirements In Compliance Employee Records Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation, the surveyor discovered that a staff member's (DOH: 08/18/2020) personnel file contained a negative Tuberculosis skin test dated for 12/6/2021; therefore, the TB verification was no longer current. The surveyor was unable to verify if the staff person was free of active tuberculosis. Staff-in-charge stated that she did not realize the staff member did not have a current negative TB skin test.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 7. First Aid and Medicine.
General: Based on review of documentation in staff personnel files and ECE-TRIS, the surveyor discovered there were three (3) staff members (DOH: 08/20/2024) who did not receive training on first aid and cardiopulmonary resuscitation (CPR). Staff-in-charge reported that she would have all trainings completed. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation in staff personnel files and ECE-TRIS, the surveyor discovered the following: 1. There were six (6) staff members (DOH: 08/20/2024) who did not complete the required six (6) hours of cabinet-approved orientation within the first three (3) months of employment in a child-care program. 2. A staff member (DOH: 08/18/2020) did not complete the required fifteen (15) hours of cabinet-approved early care and education training between July 1 and the following June 30. 3. A staff member (DOH: 09/28/2022) did not complete the required fifteen (15) hours of cabinet-approved early care and education training between July 1 and the following June 30. 4. A staff member (DOH: 10/03/2023) completed nine and one half (9.5) of the required fifteen (15) hours of cabinet-approved early care and education training between October 03 and the following October 02. 5. A staff member (DOH: 09/28/2022) completed one and one half (1 1/2) of the required fifteen (15) hours of cabinet-approved early care and education training between October 03 and the following October 02. Staff-in-charge reported that she would have staff members complete all required trainings. 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 Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation in the children's files, the surveyor discovered a child's (DOE: 08/14/2024) file contained a list of immunizations that were given to the child; therefore, the surveyor could not determine if the list was up-to-date and still in good standing. Staff-in-charge reported that she would have the parents bring in an immunization record. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 8. General.
General: Based on observation, the surveyor found the following on a corner shelf in restroom located off from the hallway: 1. A bottle of hand sanitizer that had a label on the back that stated, "Keep Out of Reach of Children" was located on a shelf. 2. On the bottom shelf, there was an open brown box that had thirty-two (32) bottles of hand sanitizer. All the bottles had a label on the back that stated, "Keep Out of Reach of Children". 3. A scrub brush and a plunger was on the floor located beside the toilet. During interview with staff-in-charge, she stated that the restroom was only used by staff. The surveyor showed the staff member that the restroom was approved licensed space. Staff-in-charge stated that she would remove all the items from the restroom. Therefore, the health, safety and comfort of children was compromised. 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, the surveyor found two (2) staff member’s (DOH: 11/11/19 and 10/03/23) files did not contain documentation of a current TB skin test or a statement from a health professional stating that the staff members are free from active tuberculosis.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation, the surveyor found the following: 1. Based on review of ECE-TRIS, one (1) staff member (DOH: 09/29/22) completed thirteen and one-half (13 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 09/29/22 - 09/29/23. 2. Based on review of ECE-TRIS, one (1) staff member (DOH: 10/21/22) completed one and one-half (1 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/21/22 - 06/30/23. 3. Based on review of ECE-TRIS, one (1) staff member (DOH: 08/16/21) completed ten (10) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 08/16/22 - 06/30/23. 4. Based on review of ECE-TRIS, one (1) staff member (DOH: 08/18/20) completed zero (0) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 08/18/22 - 06/30/23. 5. Based on review of ECE-TRIS, one (1) staff person (DOH: 08/21/18) completed six and one-half (6 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/22 - 06/30/23. 6. Based on review of ECE-TRIS, one (1) staff member (DOH: 10/21/22) did not have documentation that Orientation was completed within the first three (3) months of hire. Programming In Compliance Premises Not In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.
General: Based on observation, the surveyor found the following on a corner shelf in the restroom located off from the hallway: 1. Placed on the top shelf, there was a spray bottle of All Purpose Cleaner and a spray bottle of glass cleaner, both that had labels on the back that stated, "Keep Out of Reach of Children." Therefore, the child-care center failed to keep toxic cleaning supplies inaccessible to children. Staff-in-charge stated that she would remove all the items in the restroom.
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. In the Nursery, there was a ceiling tile over the entrance door that had discoloration. 2. In the Nursery, two (2) ceiling tiles over the sink had water discoloration. Therefore, the child-care center failed to keep the ceiling in good repair. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 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
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 a long green slide connected to a large play structure. The slide's edge landed on a sidewalk area that had depleted mulch around the side of the slide and no mulch surrounding the base of the slide; therefore, the protective surface was not equal height of the equipment. 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 Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor found the following: 1. A child’s (DOE: 03/17/23) file contained an immunization certificate that was no longer current as of 09/24/23. 2. A child’s (DOE: 05/01/23) file contained an immunization certificate that was no longer current as of 09/04/23. 3. A child's (DOE: 10/24/23) file contained an immunization certificate that was no longer current as of 11/01/23. 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 2:280 · 922 KAR 2:280. Section 4. Procedures and Payments.
General: Based on review of documentation, the surveyor discovered the following: 1. Based on review of the Kentucky National Background Check Service, background checks for five (5) staff (DOH: 8/15/22, 8/16/22, 8/15/22, 8/16/22, & 8/15/22) had not been completed through the Kentucky National Background Check Service and a determination status of “In Process” is indicated on the report. The employee’s personnel file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. None of the employee’s personnel files contained a completed Child Abuse/Neglect Background Check or completed Criminal Records Background Check. 2. Based on review of the Kentucky National Background Check Service, background checks for four (4) staff (DOH: 1/11/22, 8/15/22, 8/16/22, & 8/15/22) had not been submitted through the Kentucky National Background Check Service. The employee’s personnel file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. None of the employee’s personnel files contained a completed Child Abuse/Neglect Background Check or completed Criminal Records Background Check. The surveyor did not observe staff working alone with children. Staff-in-charge stated that staff had been working at the child-care center; however, the employees had not worked alone with children. Supervision In Compliance Staffing Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report General Administration Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 6. License Issuance.
General: Based on review of documentation, the surveyor discovered that the Fire Marshal report was dated 1/23/2020. Staff-in-charge stated that the fire marshal had not returned since the 1/23/2020 visit due to the Covid-19 shut down and restrictions; therefore, the child-care center failed to provide documentation that they are in compliance. Director Requirements In Compliance Employee 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 11. Staff Requirements.
General: Based on interview, with the staff-in-charge, the surveyor discovered that the personnel file of one (1) staff (DOH: 12/1/2021) did not contain documentation of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential. Staff-in-charge stated that the employee had requested her diploma from California; however, she had not received the diploma yet.
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 interview, with the staff-in-charge, the surveyor discovered the following: 1. The personnel file of five (5) staff (DOH: 8/16/22, 8/15/22, 1/11/22, 8/16/22 and 8/15/22) did not contain a statement from a health professional that they are free of active tuberculosis or a copy of negative tuberculin results. 2. A staff’s personnel file (DOH: 8/20/19) contained a negative tuberculin result that was no longer current after 8/20/20.
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, found in employee files and review of ECE TRIS, the surveyor discovered the following: 1. For the timeframe of 1/29/2021 thru 6/30/2022, the surveyor discovered that one (1) staff (DOH: 1/29/2020) failed to complete any of the fifteen (15) required hours of cabinet- approved early care and education training. 2. For the timeframe of 8/16/2021 thru 8/15/2022, the surveyor discovered that one (1) staff (DOH: 8/16/2021) had completed seven (7) hours of the fifteen (15) required hours of cabinet-approved early care and education training. 3. For the timeframe of 8/17/2021 thru 8/16/2022, the surveyor discovered that one (1) staff (DOH: 8/17/2021) had completed thirteen (13) hours of the fifteen (15) required hours of cabinet-approved early care and education training. 4. For the timeframe of 8/18/2021 thru 6/30/2022, the surveyor discovered that one (1) staff (DOH: 8/18/2020) had completed one (1) hour of the fifteen (15) required hours of cabinet-approved early care and education training. 5. For the timeframe of 8/17/2021 thru 8/16/2022, the surveyor discovered that one (1) staff (DOH: 8/17/2021) failed to complete any of the fifteen (15) required hours of cabinet- approved early care and education training. 6. For the timeframe of 8/18/2021 thru 6/30/2022, the surveyor discovered that one (1) staff (DOH: 8/18/2020) failed to complete any of the fifteen (15) required hours of cabinet- approved early care and education training. 7. For the timeframe of 8/17/2021 thru 8/16/2022, the surveyor discovered that one (1) staff (DOH: 8/17/2021) had completed six (6) hours of the fifteen (15) required hours of cabinet-approved early care and education training. 8. For the timeframe of 8/17/2021 thru 8/16/2022, the surveyor discovered that one (1) staff (DOH: 8/17/2021) had completed ten (10) hours of the fifteen (15) required hours of cabinet-approved early care and education training. 9. For the timeframe of 7/1/2021 thru 6/30/2022, the surveyor discovered that one (1) staff (DOH: 8/20/2019) had completed twelve (12) hours of the fifteen (15) required hours of cabinet-approved early care and education training. Therefore, the child-care center failed to ensure that training was completed as required. Programming In Compliance Premises In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report 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 Written Documentation Not In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor discovered that the monthly/quarterly drill records presented for review had “fire/tornado/earthquake drills” printed at the top of the page, with only one date and time notated. Staff-in-charge stated in interview that the drills were conducted at fifteen (15) minute intervals; however, she was unable to provide a written record indicating that the earthquake, tornado, and fire drills were performed separately, at the fifteen (15) minute intervals reported. Therefore, the child-care center failed to provide a written record indicating the date and times that the earthquake, tornado, and fire drills were conducted as required.
Open Not marked corrected in the state record
Category: physical safety. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.
General: Based on review of documentation, the surveyor discovered that records indicating that quarterly lockdown/shelter-in-place drills were conducted was not included in the documentation presented to the surveyor for review . Staff-in-charge stated that she did not know what lockdown/shelter-in-place drills were and that she was not aware that lockdown/shelter-in-place drills were a requirement. Staff-in-charge stated that the child-care center had not been conducting quarterly lockdown/shelter-in-place drills; therefore, the child-care center failed to complete quarterly lockdown/shelter-in-place drills as required. Posted Documentation In Compliance Animals In Compliance
Open Not marked corrected in the state record
Category: physical safety. Open / not marked corrected.
922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.
Based on review of documentation the surveyor found the following: 1.There were four (4) staff’s (DOH: 08/17/2021) files that did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff members did not have a completed background check; therefore, the staff persons were hired prior to clearance for employment. There was not a completed Child Abuse/Neglect Background Checks (CAN) or Criminal Records Background Checks (CRC) in the staffs’ files. During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service, CAN or a CRC was submitted for the staff members. Staff stated that the staff persons have not worked alone with children. The surveyor did not observe the staff persons working alone with children. 2. There were three (3) staff’s (DOH: 08/16/2021) files that did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff members did not have a completed background check; therefore, the staff persons were hired prior to clearance for employment. There was not a completed Child Abuse/Neglect Background Checks (CAN) or Criminal Records Background Checks (CRC) in the staffs’ files. During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service, CAN or a CRC was submitted for the staff members. Staff stated that the staff persons have not worked alone with children. The surveyor did not observe the staff persons working alone with children. 3. A staff’s (DOH: 01/17/2021) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. There was not a completed Child Abuse/Neglect Background Checks (CAN) or Criminal Records Background Checks (CRC) in the staff’s file. During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service, CAN or a CRC was submitted. Staff stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. 4. A staff’s (DOH: 08/02/2021) file that did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. There was not a completed Child Abuse/Neglect Background Checks (CAN) or Criminal Records Background Checks (CRC) in the staff’s files. During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service, CAN or a CRC was submitted. The surveyor observed staff supervising two (2), two (2) year old in the Two-Year-Old Classroom. 5. A staff’s (DOH: 08/16/2021) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. The staff’s file contained a Criminal Records Background Checks (CRC) completed on 08/31/2021. The staff’s file did not contain a Child Abuse/Neglect Background Check (CAN). During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service or a CAN was submitted. Staff stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. 6. A staff’s (DOH: 08/17/2020) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. The staff’s file contained a Criminal Records Background Checks (CRC) completed 12/01/2020 and a Child Abuse/Neglect Check (CAN) completed on 10/05/2020. During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service. Staff stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. 7. There were two (2) staff’s (DOH: 08/17/2021) files that did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff members did not have a completed background check; therefore, the staff persons were hired prior to clearance for employment. Each staff member’s file contained a Criminal Records Check (CRC) completed on 08/31/2021. The staff’s file did not contain a completed Child Abuse/Neglect Background Checks (CAN). During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service or a CAN was submitted for either of the staff members. Staff stated that the staff persons have not worked alone with children. The surveyor did not observe the staff persons working alone with children. 8. A staff’s (DOH: 08/02/2021) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff member did not have a completed background check; therefore, the staff person was hired prior to clearance for employment. The staff’s file contained a Criminal Records Background Checks (CRC) completed on 08/13/2021. During interview, staff was unable to confirm that a background check was submitted through the Kentucky National Background Check Service. Staff stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. Staff reported that she was told staff did not have to have a background check due to COVID-19. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report Director Requirements Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.
General: Based on review of documentation, the surveyor found the following: 1. The staff’s (DOH:08/17/2020) file did not contain an evaluation. Through interview, the surveyor learned that the staff’s evaluation was not available for review during the renewal survey. 2. The staff’s (DOH:08/26/2019) file did not contain an evaluation. Through interview, the surveyor learned that the staff’s evaluation was not available for review during the renewal survey. 3. The staff’s (DOH:08/16/2017) file did not contain an evaluation. Through interview, the surveyor learned that the staff’s evaluation was not available for review during the renewal survey. 4. The staff’s (DOH:09/10/2019) file did not contain an evaluation. Through interview, the surveyor learned that the staff’s evaluation was not available for review during the renewal survey. 5. There were two (2) staff’s (DOH:08/21/2018) files that did not contain an evaluation for either person. Through interview, the surveyor learned that the staff’s evaluations were not available for review during the renewal survey. 6. There were two (2) staff’s (DOH:08/18/2020) files that did not contain an evaluation for either person. Through interview, the surveyor learned that the staff’s evaluations were not available for review during the renewal survey. 7. There were two (2) staff’s (DOH:08/20/2019) personnel files that did not contain an evaluation for either person. Through interview, the surveyor learned that the staff’s evaluations were not available for review during the renewal survey. Staff reported that she would work on staff evaluations. Employee Records Not In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation, the staff found the following: 1. There were five (5) staff (DOH: 08/17/2021) files that did not contain educational documentation; therefore, the surveyor was unable to verify the five (5) staff member's education. 2. There were three (3) staff (DOH: 08/16/2021) files that did not contain educational documentation; therefore, the surveyor was unable to verify the three (3) staff member's education. 3. A staff 's (DOH: 01/17/2021) file did not contain educational documentation; therefore, the surveyor was unable to verify the staff member's education. Staff reported that she would get staff's educational documentation. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation, the surveyor discovered the following: 1. There were two (2) staff (DOH: 08/17/2021) files that did not contain a copy of a statement from a health professional stating that the individuals were free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff were free from active tuberculosis. 2.There were two (2) staff (DOH: 08/16/2021) files that did not contain a copy of a statement from a health professional stating that the individuals were free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff were free from active tuberculosis. 3. A staff’s (DOH: 01/17/2021) file did not contain a copy of a statement from a health professional that the individual was free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff person was free from active tuberculosis. 4. A staff’s (DOH: 08/02/2021) file did not contain a copy of a statement from a health professional that the individual was free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff person was free from active tuberculosis. 5. A staff’s (DOH: 08/16/2017) file did not contain a copy of a statement from a health professional that the individual was free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff person was free from active tuberculosis. 6. A staff’s (DOH: 08/21/2018) file did not contain a copy of a statement from a health professional that the individual was free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff person was free from active tuberculosis. 7. A staff’s (DOH: 09/10/2019 file did not contain a copy of a statement from a health professional that the individual was free of active tuberculosis or a copy of a negative tuberculin (TB skin test) results; therefore, the surveyor was unable to verify if the staff person was free from active tuberculosis. Staff reported that she would have staff to bring documentation of a negative tuberculin (TB skin test) results or a statement from a health professional stating the individual was free of active tuberculosis.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation and ECE-TRIS, the surveyor found the following: 1. Staff (DOH: 01/29/2020) obtained zero (0) of the fifteen (15) hours of required cabinet-approved early care and education training completed between 07/01/2020-06/30/2021. 2. Staff (DOH: 08/18/2020) obtained zero (0) of the fifteen (15) hours of required cabinet-approved early care and education training completed between 07/01/2020-06/30/2021. 3. Staff (DOH: 08/20/2019) obtained thirteen (13) of the fifteen (15) hours of required cabinet-approved early care and education training completed between 07/01/2020-06/30/2021. 4. Staff (DOH: 08/18/2020) obtained six (6) of the fifteen (15) hours of required cabinet-approved early care and education training completed between 08/18/2020-08/17/2021. 5. Staff (DOH: 08/20/2019) obtained ten (10) of the fifteen (15) hours of required cabinet-approved early care and education training completed between 07/01/2020-06/30/2021. 6. Staff (DOH: 08/18/2020) did not obtained the one and a half (1 ½) hours of cabinet- approved pediatric abusive head trauma training within the first-year old employment. 7. Staff (DOH: 01/17/2021) did not obtained the six (6) hours of cabinet- approved orientation completed within the first three (3) months of employment in a child care program. Staff reported that she would make sure trainings are completed in the future. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Premises Not In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.
General: Based on observation, the surveyor found a cigarette butt on the parking lot surface walking towards the entrance of the center; therefore, the children had access to the cigarette butt. Staff reported that she would have the cigarette butt cleaned up. 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 Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records In Compliance Written Documentation Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor found the following: 1. Staff (DOH: 08/17/2020) file did not contain a professional development plan. 2. Staff (DOH: 08/18/2020) file did not contain a professional development plan. 3. Staff (DOH: 01/29/2020) file contain a professional development plan with no date on it; therefore, the surveyor was unable to determine if the plan was current. 4. Staff (DOH: 08/21/2018) file contain a professional development plan dated for 08/21/2019; therefore, the professional development plan was not current. 5. Staff (DOH: 01/29/2020) file contain a professional development plan with no date on it; therefore, the surveyor was unable to determine if the plan was current. Staff reported that she would complete professional development plans for staff. Posted Documentation In Compliance Animals In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.
General: Based on review of documentation, the surveyor found the following: (1.) Staff’s (DOH: 8/26/19) file did not contain an annual written performance evaluation. (2.) Staff’s (DOH: 8/1/19) file did not contain an annual written performance evaluation. (3.) Staff’s (DOH: 8/21/18) file did not contain an annual written performance evaluation. (4.) Staff’s (DOH: 8/20/19) file did not contain an annual written performance evaluation. (5.) Staff’s (DOH: 8/20/19) file did not contain an annual written performance evaluation. (6.) Staff’s (DOH: 8/16/17) file did not contain an annual written performance evaluation. (7.) Staff’s (DOH: 8/21/18) file did not contain an annual written performance evaluation. (8.) Staff’s (DOH: 8/21/18) file did not contain an annual written performance evaluation. (9.) Staff’s (DOH: 9/10/19) file did not contain an annual written performance evaluation. (10.) Staff’s (DOH: 2/3/2020) file did not contain an annual written performance evaluation. Staff confirmed through interview that annual written performance evaluations were not completed with staff. Staff was not aware that this needed to be completed annually. Employee Records In Compliance Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report 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 a disposable facemask on the ground of the playground area; therefore, the outdoor play area was not free from litter. Staff was not aware of the issue. Equipment Not In Compliance
Open Not marked corrected in the state record
Category: physical safety. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 11. Toys and Furnishings.
General: Based on observation, the surveyor found a blue cozy coop on the playground that the top and doors were broken off the toy; therefore, the piece of outdoor equipment was not in good repair. Staff was not aware of the issue stating they would throw away the toy. Transportation Not Applicable Food Service/Food Program In Compliance 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 8. Kitchen Requirements.
General: Based on observation, the surveyor found the refrigerator’s temperature was forty-nine (49) degrees Fahrenheit instead of the recommended temperature reading of forty (40) degrees Fahrenheit or below.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.
General: Based on observation, the surveyor found the freezer’s temperature reading was four (4) degrees Fahrenheit instead of the recommended temperature reading of zero (0) degrees Fahrenheit or below. Children's Records Not In Compliance
Open Not marked corrected in the state record
Category: nutrition. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor found a child’s (DOE: 1/2/19) record contained an immunization certificate that was no longer current as of 10/29/2020. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Written Documentation Not In Compliance
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on observation, the surveyor found the following: (1.) The Nursery was observed to have four (4) children in attendance with only one (1) child’s arrival time documented on the daily attendance record for 2/8/2021. (2.) The Twos Classroom was observed to have one (1) child in attendance with no children signed in on the daily attendance record for 2/8/2021. (3.) The Preschool Classroom was observed to have nine (9) children in attendance with only four (4) children’s arrival times documented on the daily attendance record for 2/8/2021. Staff reported parents do not always sign their children in on the daily attendance record.
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor found the following: (1.) Staff’s (DOH: 8/26/19) file did not contain a written annual plan for professional development. (2.) Staff’s (DOH: 8/1/19) file contained a written annual plan for professional development that was dated 8/1/19; therefore, the plan needs updated. (3.) Staff’s (DOH: 8/21/18) file did not contain a written annual plan for professional development. (4.) Staff’s (DOH: 8/20/19) file contained a written annual plan for professional development that was dated 8/7/19; therefore, the plan needs updated. (5.) Staff’s (DOH: 8/20/19) file did not contain a written annual plan for professional development. (6.) Staff’s (DOH: 8/16/17) file did not contain a written annual plan for professional development. (7.) Staff’s (DOH: 8/21/18) file did not contain a written annual plan for professional development. (8.) Staff’s (DOH: 8/21/18) file contained an annual written plan for professional development that was dated 8/1/19; therefore, the plan needs to be updated. (9.) Staff’s (DOH: 9/10/19) file did not contain an annual written plan for professional development. (10.) Staff’s (DOH: 1/29/2020) file did not contain an annual written plan for professional development. (11.) Staff’s (DOH: 2/3/2020) file did not contain an annual written plan for professional development. Staff was not aware that annual written plans for professional development were a requirement for staff.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation, the surveyor found the following: (1.) The last completed and documented fire drill for the child care center was conducted on 10/8/2020. Staff confirmed through interview that fire drills were not completed for November 2020, December 2020, or January 2021. (2.) The surveyor was not presented with tornado drills for the year of 2020. Staff confirmed the drills were not completed or documented. (3.) The surveyor was not presented with earthquake drills for the year of 2020. Staff confirmed the drills were not completed or documented. Posted Documentation In Compliance Animals In Compliance Emergency Regulation In Compliance
Open Not marked corrected in the state record
Category: physical safety. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 11. Staff Requirements.
General: Based on review of documentation and ECE-TRIS, the surveyor found that staff (DOH: 08/16/2017) obtained fourteen and one-half (14 1/2) of the required fifteen (15) hours of cabinet - approved early care and education training. Upon interview, staff stated that they completed the additional one-half hour of training and provided a certificate from their file. Staff contacted ECE-TRIS regarding the missing time and advised the surveyor that they were instructed to complete and submit a document requesting the time be corrected. Programming In Compliance Premises In Compliance 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: recordkeeping. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.
General: Based on observation, the staff person (DOH: 08/16/2017) caring for children in the one (1) year old classroom was observed to change a child’s diaper; however, the child’s hands were not washed after the diaper change. During interview, staff stated that all staff would be reminded to not only wash their hands after diaper changes, but to also wash the children’s hands after diapering. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance 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
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on observation, the surveyor found four (4) children present in the one (1) year old classroom. Upon review of the daily attendance log for 11/15/2019, the arrival time for one (1) child was not documented. Based on observation, the surveyor found fourteen (14) children present in the three (3) to five (5) year old classroom. Upon review of the daily attendance log for 11/15/2019, the arrival time for three (3) children was not documented. During interview, staff stated that they did not realize that not all children were signed in on the attendance log; therefore, the daily attendance records were not being maintained. Posted Documentation In Compliance Animals In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 9. Food and Meal Requirements.
General: Based on observation, the surveyor found that popcorn and graham crackers were stored on the bottom of a shelf. The items were less than six (6) inches from the floor. Children's Records Not In Compliance
Open Not marked corrected in the state record
Category: nutrition. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 10. Director Requirements and Responsibilities.
General: Based on review of documentation, the surveyor found the following: 1. The surveyor observed a staff using her cell phone while supervising the children. Through review of documentation, the surveyor found the childcare center’s policy states that “All cell phones are to be used at a minimum”. “I don’t want to see anyone just talking or texting.” The Director did not supervise staff to ensure implementation of the childcare center’s policies and procedures. 2. The childcare center’s nutrition policy states that children’s snacks must include two (2) food components per regulatory compliance. During snack time, the surveyor found that three (3) of the children’s snacks contained water and one (1) of the following: Cheese Puffs, cookies or potato chips. Three (3) other children brought potato chips with juice, Kool- Aid or milk; thus, the children did not receive the required food components. The director did not supervise staff to ensure implementation of the childcare center’s policies and procedures. 3. The childcare center’s policy states that all staff must complete pediatric abusive head trauma training and orientation training within the first three (3) months of hire. Review of staff files and ECE-TRIS, found the following: A. A staff (DOH: 08/02/17) completed one and one-half (1 ½) hours of pediatric abusive head trauma training on 03/25/18; thus, not within three months of hire per the childcare center’s policy. B. A staff (DOH: 08/16/17) completed one and one-half (1 ½) hours of pediatric abusive head trauma training on 08/08/18; thus, not within three months of hire per the childcare center’s policy. C. A staff (DOH: 08/16/17) completed one and one-half (1 ½) hours of pediatric abusive head trauma training on 07/06/18; thus, not within three months of hire per the childcare center’s policy. D. A staff (DOH: 08/16/17) completed one and one-half (1 ½) hours of pediatric abusive head trauma training on 03/26/18; thus, not within three months of hire per the childcare center’s policy. E. A staff (DOH: 09/18/17) completed one and one-half (1 ½) hours of pediatric abusive head trauma training on 04/01/18; thus, not within three months of hire per the childcare center’s policy. Employee Records In Compliance Programming In Compliance Premises Not In Compliance
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 3. General Requirements.
General: Based on observation during a tour of the childcare center, the surveyor found a bottle of Germ-X on a desk located in the Preschool Room. The Germ-X was within reach and accessible to the children. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report Food Service/Food Program 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 observation during snack time, the surveyor found that the preschool-age children bring their snacks from home. The surveyor found that three (3) of the children’s snacks contained water and either Cheese Puffs, cookies or potato chips. Three (3) other children brought potato chips with juice, Kool-Aid or milk. The children did not receive the required food components. Food Service Not In Compliance
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation contained in ten (10) children’s files, the surveyor found the following: 1. A child’s (DOE: 08/13/18) file contained an immunization certificate that was no longer current as of 09/11/18. 2. A child’s (DOE: 02/01/18) file contained an immunization certificate that was no longer current as of 06/13/18.
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
922 KAR 2:090 · 922 KAR 2:090. Section 9. Records.
General: Based on review of documentation in ten (10) children’s enrollment files, the surveyor found that nine (9) files did not contain information to enable a person in charge to contact the preferred hospital. Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4
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 of ECE-TRIS and staff files, a staff member (DOH: 8/1/05) completed the pediatric abusive head trauma training on 4/8/12; therefore, it was not completed within the last five (5) years as required. 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 An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Food Service Not In Compliance
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.
General: Based on observation, the refrigerator temperature read fifty (50) degrees Fahrenheit; therefore, it was not kept at the required forty (40) degrees Fahrenheit or below.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.
General: Based on observation, the freezer temperature read four (4) degrees Fahrenheit; therefore, it was not kept at the required zero (0) degrees Fahrenheit or below. Children's Records Not In Compliance
Open Not marked corrected in the state record
Category: nutrition. Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 3. Records.
General: Based on review of documentation of children's files, one (1) child's file (DOE: 8/26/14) did not have a current immunization certificate for review, i.e., the immunization certificate present in the file was only current until 4/30/17.
Open Not marked corrected in the state record
Category: health medication. Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 3. Records.
General: Based on review of documentation of children's files, the following things were found: 1) The telephone number of the preferred hospital was not listed for the following ten (10) children's files: DOE: 8/20/15, DOE: 1/7/13, DOE: 1/2/13, DOE: 10/24/16, DOE: 8/17/17, DOE: 8/17/17, DOE: 8/5/13, DOE: 11/18/16, DOE: 8/5/15, DOE: 8/26/14. 2) The name of the preferred hospital was not listed for the following two (2) children's files: DOE: 8/17/17 and DOE: 8/17/17. 3) The telephone number for the preferred physician was not listed for one (1) child (DOE: 10/24/16). Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.
General: Based on review of documentation, a staff members (DOH:8/20/14) file did not contain verification that fifteen (15) hours of cabinet approved training has been completed. A review of ECE-TRIS found no additional training documentation. 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 2:110 · 922 KAR 2:110. Section 2. General.
General: Based on observation and interview, a list containing children's first name, last name, and date of birth was posted on the wall in the classroom; therefore, information concerning the children was not maintained confidentially as required by regulations. The director stated during interview that she had just recently posted the information on the wall.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 6. Reports.
General: Based on observation and interview, the surveyor attempted to complete the renewal inspection on 09/28/15; however, the child care center was not operating when the surveyor arrived. The child care center failed to notify the agency that the center was closed. The director stated during interview that the area in which the child care center is located had a power outage on 09/28/15 which forced the center to close due to no electricity.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 3. Records.
General: Based on review of documentation and interview, there was one (1) staff (DOH: 08/13/14) file that did not contain documentation of an annual evaluation. The director stated that she had not completed an evaluation on the staff person.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.
General: Based on review of documentation and interview, an employee (DOH: 08/21/15) record presented for review did not contain evidence of education qualification. The director stated during interview that she had requested the documentation from the staff person; however, she had not received the education documentation.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.
General: Based on review of documentation, a review of the ECE-TRIS website, and interview, the file presented for review for a staff member (DOH: 08/28/14) did not contain evidence of fifteen (15) hours of cabinet approved training. The file contained zero (0) hours of training. The director stated during interview that the staff person had completed college classes for her training hours; however, the staff failed to get the final grades for her classes to the director.
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 of the outdoor playground, the surveyor found that the landscape fabric installed under the mulch was exposed in many areas and created a safety hazard to the children. The director stated during interview that the child care center had been using their indoor gross motor area due to observing a snake on the outdoor playground by a student at the college.
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 and interview, there was one (1) bottle containing milk located in a cubby in the Nursery Classroom. The bottle was not covered and was not labeled for an individual child. The staff in the classroom stated that the bottle of milk belonged to a child present in the classroom.
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 infant and toddler classroom, the surveyor found seven (7) rolls of garbage bags stored in an unlocked cabinet under the sink accessible to the children.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.
General: Based on observation during a tour of the outdoor play area, the surveyor found that the landscape fabric installed under the mulch was exposed in many areas and created a safety hazard to the 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 6. Sleeping and Napping Requirements.
General: Based on observation during a tour of the nursery classroom, the surveyor found two (2) infants covered with loose bedding.
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 nursery classroom, the surveyor found one (1) bottle of Lemon Quat Plus specifically labeled "Keep Out of Reach of Children", stored in an unlocked cabinet accessible to the children.
Open Not marked corrected in the state record
Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110. Section 3. Records.
General: Based on review of documentation, the surveyor found the arrival times for two (2) children were not documented on 9/18/13.
Open Not marked corrected in the state record
Category: recordkeeping. Open / not marked corrected.
922 KAR 2:110 · 922 KAR 2:110 - Section 4 (1)
General: Based on observation, the following was found: (1) Three (3) electrical outlets in the auxillary gym area were not covered. (2) An electrical outlet in the girls' locker room was not covered.
Open Not marked corrected in the state record
Open / not marked corrected.