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

General: Based on observation, the surveyor discovered the following: Hallway: 1. A brown substance on a ceiling tile in the hallway outside of the Nursery; therefore, the ceiling tile was not in good repair. Kindergarten Classroom: 1. There was a hole in the ceiling tile. Preschool 2 Classroom: 1. There was an area of the flooring that was not securely attached.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 11. Status of Employment.

General: Based on review of documentation and the child-care center's KARES report, the surveyor discovered that there were five (5) individuals who were listed as "current employees" on the roster who no longer work 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 8. General.

General: Based on observation, the surveyor discovered the following: Kindergarten Classroom: 1. There were multiple jackets hanging on hooks in the classroom. The jackets were touching creating a potential for cross-contamination. Nursery: 1. There were multiple diaper bags hanging on hooks in the classroom. This allowed the diaper bags to touch. This created a potential for cross-contamination. Three-Year-Old Classroom: 1. There were multiple backpacks and blankets in the cubbies located in the classroom. The backpacks and blankets were touching creating a potential for cross-contamination.

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 05/01/24) completed one (1) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 05/01/24 and 04/30/25. 2. A staff member (DOH: 10/04/23) did not complete the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/04/24 and 06/30/25. 3. A staff member (DOH: 10/04/23) did not complete the required one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training within the first year of employment. 4. A staff member (DOH: 07/09/24) did not complete the required one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training within the first year of employment. 5. A staff member (DOH: 07/09/24) completed twelve (12) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/09/24 and 07/08/25. 6. A staff member (DOH:08/05/24) completed eleven (11) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 08/05/24 and 08/04/25. 7. A staff member (DOH: 01/04/22) completed fourteen (14) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/24 and 06/30/25. 8. A staff member (DOH: 04/07/25) did not complete the required six (6) hours of cabinet-approved orientation completed within the first three (3) months of employment in a child care program.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered the following: Two-Year-Old Classroom: 1. There was approximately a one (1) inch gap between the wall and baseboard in two (2) different areas of the classroom. One-Year-Old Classroom: 1. There was food and dirt debris on the floor of the classroom. 2. There was dirt debris on the navy rug located in the classroom. 3. There was a dried substance on the mirror located on the wall inside the classroom. 4. There was drywall exposed approximately six (6) inches long and one (1) inch wide. 5. The window trim had a screw that created a split in the wood. Crawlers Classroom: 1. There was a hole approximately the size of a penny located by the air intake vent. Nursery Hallway: 1. There was a window seal that was cracked. Kindergarten Classroom: 1. There was approximately a one (1) inch gap between the wall and baseboard in the classroom. 2. There was a layer of dust on two (2) air vents. Preschool 2 Classroom: 1. There was a layer of dust on two (2) different air vents in the classroom.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of ECE-TRIS, the surveyor discovered that no date was entered indicating that one (1) staff (DOH: 05/01/24; First Year Start Date: 11/17/20) had received the training on first aid and cardiopulmonary resuscitation (CPR). During review of the staff personnel files, the surveyor did not find documentation indicating that the staff member had completed the training on first aid and cardiopulmonary resuscitation (CPR); therefore, the child-care center failed to ensure that every staff member had received training on first aid and cardiopulmonary resuscitation (CPR) as required. 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

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of ECE-TRIS, the surveyor discovered the following: 1. One (1) staff (DOH: 11/04/22) failed to complete one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training (PAHT); during review of the staff member’s personnel file, the surveyor was unable to find documentation indicating that the staff member had completed PAHT training. 2. One (1) staff (DOH: 11/04/22) completed two (2) hours of the fifteen (15) required hours of cabinet-approved early care and education training for the timeframe of 11/5/23- 06/30/24. 3. One (1) staff (DOH: 06/12/23) failed to complete any of the fifteen (15) required hours of cabinet-approved early care and education training for the timeframe of 06/10/23-06/30/24. 4. One (1) staff (DOH: 05/01/24; 1st Year Start Date: 11/17/20) failed to complete any of the fifteen (15) required hours of cabinet-approved early care and education training for the timeframe of 07/01/23-06/30/24. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on observation and interview, the surveyor found the following: 1. Through interview with staff, the surveyor learned that twenty-four (24) children and two (2) staff in the Afterschool Classroom were going on a walking field trip to Paradise Cove Aquatic Center on the day of the surveyor's visit, 07/12/23. The surveyor reviewed permission forms for the children that were signed by the child's parent. The permission form gave permission for the children to be walked to Morning Pointe, Gibson Bay Park and Paradise Cove. The permission form stated that the children would attend these places on a weekly basis with their classroom teachers. The surveyor observed the children and staff to leave the child-care center at approximately 11:00 a.m. to walk to Paradise Cove. Based on review of Google Maps, the surveyor learned that the driving distance was approximately 1.2 miles from the child-care center and the walking distance was approximately twenty-one (21) minutes one (1) way. Staff-in-charge stated that the staff and children walk on a sidewalk on their way to Paradise Cove. Staff-in-charge stated that the staff keep the children in the kiddie section and that the children are not allowed to go to the lap pool or slides while at Paradise Cove. The surveyor drove the distance from the child-care center and took approximately three (3) left turns before arriving at Paradise Cove Aquatic Center. During the drive to Paradise Cove Aquatic Center, the surveyor observed the side walk to end in areas and there to be several street/parking lot entrances that the children would have to cross. The surveyor observed the pool area to be fenced and there to be a very large and tall water slide within the fenced area. Staff-in-charge stated that the child-care center has been taking the children to Paradise Cove Aquatic Center since approximately 2009-2010 and it has never been an issue. 2. A loose screw that was observed to be easily pulled out from the wall air vent cover in the Four Year Old Classroom. The air vent was located near a white cabinet and observed to be accessible to the children. 3. The surveyor observed straps hanging down from backpacks that were hanging from hooks in the Two Year Old Classroom. The straps were observed to be within reach of the children. During interview, staff stated that they try to keep the straps tucked into the backpacks. 4. An unsecured black telephone cord was observed coming down the side of a cubby shelf in the Three Year Old Classroom. The cord was observed to be accessible to the children. 5. Several bags and backpacks were observed hanging from wall hooks in the Afterschool Classroom and were observed to be touching. During interview, staff stated that the items belonged to the children in the classroom and there were more items than usual. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 Inspection Report Employee Records Not In Compliance

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 of the Infant Room, the surveyor observed an infant asleep in a crib and what appeared to be a white/blue swaddle hanging on the side of a crib. Premises 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 that a staff’s (DOH: 05/01/23) file contained documentation of a TB skin test dated 01/12/20; therefore, the staff’s file did not contain documentation of a current TB skin test or a statement from a health professional stating that the staff was free from active tuberculosis. During interview, staff-in- charge stated that the staff person had a TB skin test yesterday and it had not been read yet.

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 and ECE-TRIS, the surveyor found that the following staff (DOH: 01/19/23, 03/02/23, and 09/27/22) had not received training on first aid and cardiopulmonary resuscitation (CPR); therefore, the child-care center failed to ensure that every staff member has obtained training on first aid and CPR as required.

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 ECE-TRIS, the surveyor found the following: 1. A staff (DOH: 01/04/22) obtained twelve (12) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 01/05/23-06/30/23. 2. A staff (DOH: 09/27/22) obtained six (6) hours of the cabinet-approved orientation training on 12/29/22; therefore, the training was not completed within the first three (3) months of employment. Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. In the Three-Year-Old Classroom, two (2) white cabinet doors were observed to be loose from the cabinet; therefore, the cabinet doors were not kept in good repair. 2. The bottom side stall wall in the boys’ restroom contained rust and was flaking; therefore, the stall wall was not kept in good repair. The rust was observed to have a rough texture. 3. The bottom side stall walls inside the first and second stalls in the girls’ restroom contained rust; therefore, the stalls walls were not kept in good repair. The rust was observed to have a rough texture. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 Inspection Report 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. A thick black cable coming up out of the ground located next to the child-care center building and behind a play house on the playground; therefore, the playground was not safe from foreseeable hazard. During interview, staff-in-charge stated that she did not know what the cable was and that she keeps covering the cable with dirt and mulch. 2. The surveyor observed a dip/uneven area in the grassy part of yard located beside the back fence roll on the playground; therefore, creating a tripping hazard for the children. 3. The surveyor observed approximately three (3) gaps between the deck railings on the playground; therefore, the deck was not well maintained. During interview, staff-in-charge stated that she had called someone about redoing the deck. 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 6. Sleeping and Napping Requirements.

General: Based on observation, the surveyor found the following: 1. Three (3) cribs in the Infant Classroom were observed to contain loose fitting sheets with excess fabric; therefore, the crib mattress did not contain a tight fitted sheet. The surveyor observed an infant asleep in one (1) of the cribs. Staff stated that the children ranged in age from three-months-old to eight-months-old. 2. Three (3) cribs in the Crawler Classroom were observed to contain loose fitting sheets with excess fabric; therefore, the crib mattress did not contain a tight fitted sheet. Staff stated that the children ranged in age from six-months-old to one-year-old. 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: 02/06/23) file contained an immunization certificate that was no longer current as of 06/10/23 Through interview with staff-in-charge, the surveyor learned that a current immunization certificate was not available for review for the child mentioned.

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 interview with staff, the surveyor learned that twenty-four (24) children and two (2) staff in the Afterschool Classroom were going on a walking field trip to Paradise Cove Aquatic Center on the day of the surveyor's visit, 07/12/23. The surveyor reviewed permission forms for the children that were signed by the child's parent. The permission form gave permission for the children to be walked to Morning Pointe, Gibson Bay Park and Paradise Cove. The permission form stated that the children would attend these places on a weekly basis with their classroom teachers; however, the permission form did not contain specific dates or times for each location. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 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 2:120 · 922 KAR 2:120. Section 2. Child Care Services.

General: Based on interview, the surveyor was able to determine that at least one (1) classroom (Crawler) is out of ratio at times. Staff reported that the out of ratio problem has been fixed by placing a different worker in the classroom. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report General Administration Not In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 8. General.

General: Based on interview, the surveyor was able to determine the children's health, safety, and comfort was compromised when a staff member took a prescribed medication in front of the children. Staff reported that she spoke with the staff member about taking personal prescriptions in front of the children. 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 Drink Requirements for All Child-Care Centers.

General: Based on interview, the surveyor discovered that children were not getting developmentally appropriate portions for children. During interview, staff reported that all children would get the same portion of food; for example, two (2) crackers and cheese. Staff stated that a new cook was hired and children are getting more than enough.

Open Not marked corrected in the state record

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. There was an electrical outlet on the building with no safety plug cover, located on the playground. Staff reported that she would have the electrical outlets covered. 2. There was an electrical outlet that appeared to have a substance sticking out of the plug in the Two-Year-Old Classroom. Staff reported that she would have the electrical outlet repaired. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 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 learned a staff's (DOH: 03/21/2022) file did not contain education documentation; therefore, the surveyor was unable to verify the staff's education. Staff reported that she would have staff bring proof of education documentation.

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. A staff's (DOH: 01/03/2022) file contained a negative tuberculin (TB) skin test result with no patient name listed; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. 2. A staff's (DOH: 03/01/2022) file contained a TB skin test with no results of having been read; therefore, the surveyor was unable to verify if the staff person was free of active tuberculosis. Staff reported that she would have the staff's TB skin test completed.

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 observation and review of documentation, and review of ECE TRIS, the surveyor discovered the following: 1. A Staff (DOH: 10/19/2020) did not complete the training on first aid and cardiopulmonary resuscitation (CPR). 2. A Staff (DOH: 08/12/11) did not complete the training on first aid and CPR. 3. A Staff (DOH: 07/12/2021) did not complete the training on first aid and CPR. Staff reported that she would have staff complete first and CPR training.

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 observation and review of documentation and ECE TRIS, the surveyor discovered the following: 1. A staff (DOH: 01/17/2019) completed two and one-half of the required fifteen (15) hours of cabinet-approved early care and education training between July 1 and the following June 30. 2. A staff (DOH: 01/09/2018) completed nine and one-half of the required fifteen (15) hours of cabinet-approved early care and education training between July 1 and the following June 30. 3. A staff (DOH: 01/09/2018) did not complete the required six (6) hours of cabinet-approved orientation within the first three (3) months of employment. Staff reported that she would have staff complete training. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor observed the following: 1. The daily schedule was not being followed in the After-School Classroom. Review of documentation showed that group reading should be from 10:30-11:00. The surveyor observed at 10:36 the children in the After-School Classroom having free time. 2. The daily schedule was not being followed in the One-Year-Old Classroom. Review of documentation showed art time was 10:30-11:00; however, the surveyor observed the children at 10:47 am playing in the classroom. Staff reported that she would talk to staff about following program activities.

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, the surveyor observed a child asleep in a crib with a sleep sack not properly secured. During interview, staff reported the child is two (2) months old and the parents asked for the sleep sack to be used but not properly secured. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor observed the following: 1. There was a staff member's McDonald's Cup on a shelf in view of the children in the Crawler Classroom. 2. There was a Marathon Styrofoam cup placed on the half wall in view of the children in the One-Year-Old Classroom. 3. There was a Marathon Styrofoam cup placed on a cabinet by the door in view of the children in the Two-Year-Old Classroom. Staff reported that she would talk with staff about having drinks in cups that children will not be able to identify. 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 2:120 · 922 KAR 2:120. Section 4. Premises Requirements.

General: Based on observation, the surveyor discovered the following: 1. There was an exhaust fan with heavy dust located in the restroom located off the After-School Classroom. Staff reported that she would have the exhaust fan cleaned. 2. There was a light cover that appeared to have multiple dead bugs located in the After-School Classroom. 3. There was heavy dust on the air vent located in the Kindergarten Classroom. 4. There was heavy dust on the three (3) air vents located in the Two-Year-Old Classroom. 5. There was heavy dust on two (2) of the air vents located in the After-School Classroom. 6. There was heavy dust located on two (2) air vents located in the Three-Year-Old Classroom. 7. There was heavy dust located on two (2) air vents located in the Four-Year-Old Classroom. 8. There was heavy dust located on the intake vent located in the After-School Classroom. 9. There was heavy dust located on the intake vent located in the Four-Year-Old Classroom. 10. There was heavy dust located on the intake vent located in the Three-Year-Old Classroom. Staff reported that she would have all vents dusted.

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. There was about a half inch gap caused by the ceiling tile being off the drop ceiling grid located in the After-School Classroom. 2. There was about a half inch gap caused by the ceiling tile being off the drop ceiling grid located in the Kindergarten room. 3. There was about a half of an inch gap caused by the ceiling tile being off the drop ceiling grid located outside of the Two-Year-Old Classroom. 4. There was about a half of an inch gap cause by the ceiling tile being off the drop ceiling grid located in the Three-Year-Old Classroom. 4. There were two (2) ceiling tiles that appeared to have brown stains located in the Crawler Classroom. Staff reported that she would have the ceiling tiles repaired and properly installed.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. There was a yellow substance in the toilet bowl located in the restroom off the After-School Classroom. 2. There was what appeared to be bowel movement and paper in the toilet bowl located in the restroom off the Three-Year-Old Classroom. Staff reported that she would remind staff to check the toilets after each use. 3. The first toilet seat was not tightly secured to the toilet located in the boy's restroom. 4. The first and third toilet seats were not tightly secured to the toilet located in the girl's restroom. 5. The toilet seat was not tightly secured to the toilet located in the restroom off the Four-Year-Old Classroom. Staff reported that she would have maintenance to check all the toilet seats to make sure they are secured properly. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report 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 discovered the following: 1. The downspout located by the playground fence had sharp edges. Staff reported that she would have the downspout repaired. 2. The landscape timber around the playground closest to the stairs was loose. Staff reported that she would have the landscape timber repaired. 3. The handrail by the stairs leading to the playground was not tightly secured to the building. Staff reported that she would have the handrail repaired. 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 13. Toys and Furnishings.

General: Based on observation, the surveyor discovered the following: 1. There were three (3) steering wheels on the helicopter that had multiple cracks; therefore, the steering wheels on the helicopter were not in good repair. Staff reported that she would have the steering wheels replaced. 2. There was an oversized pillow that appeared to have brown stains located in the Two-Year-Old Classroom. Staff reported that she would have the oversized pillow cleaned. 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 interview, the surveyor found the following: 1. The Two Year Old Classroom exceeds ratio by one (1) to two (2) children approximately every morning for approximately thirty (30) minutes. 2. Based on interviews, the surveyor learned that the Three Year Old Classroom exceeded ratio by approximately five (5) to eight (8) children for approximately twenty (20) minutes to one (1) hour on the day of the surveyor's visit, 03/11/22. Through interview, the surveyor learned that the children inside the Three Year Old Classroom were approximately three- years-old and one (1) staff person was supervising the children. Employee Records Not In Compliance

Open Not marked corrected in the state record

Category: ratio. 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 that a staff’s (DOH: 01/17/19) file did not contain documentation of a current TB skin test or a statement from a health professional stating that the adult was free from active tuberculosis. During interview, staff-in-charge confirmed that the staff person has not had a TB skin test.

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 staff's (DOH: 01/17/2019) personnel file contained a negative TB skin test dated for 01/17/2019; therefore, the TB verification was no longer current. The surveyor was unable to verify if the staff person was free of active tuberculosis. Staff reported that staff member's medical provider would not conduct a TB skin test due to the staff's medical condition.

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: The surveyor reviewed video footage from 07/30/21 while at the child care center on 08/31/21. Based on review of the video footage, the surveyor found the following: 1. A staff person to leave the Infant Classroom approximately four (4) times while children were present inside the classroom without proper supervision from the approximate time of 3:30 p.m. - 5:45 p.m. 2. A school age child to come into the Infant Classroom on two (2) occasions between the approximate time period of 3:30 p.m. - 4:05 p.m. The surveyor observed the child to appear to be alone and without proper supervision when he entered the Infant Classroom. Based on multiple interviews, the surveyor learned that the child was eleven-years-old (11) and it was unclear if the child had proper supervision when going to and from the Infant Classroom. 3. A school age child to come into the Infant Classroom on two (2) occasions between the approximate time period of 5:05 p.m. - 5:45 p.m. The surveyor observed the child to appear to be alone and without proper supervision when he entered the Infant Classroom. Based on multiple interviews, the surveyor learned that the child was eight-years-old (8) and it was unclear if the child had proper supervision when going to and from the Infant Classroom. Based on interview, the surveyor learned that it was also unclear if the eight-year-old child had been signed out for the day by his parent when going into the Infant Classroom. 4. A child playing in the doorway of the Infant Classroom and was observed to leave the doorway. The surveyor observed a staff person to walk over to the doorway and look down the hallway. The surveyor observed the staff person to then leave the doorway and come back to the Infant Classroom with the child. The surveyor observed other children to be left inside the Infant Classroom unsupervised. Based on interview with staff, the surveyor learned that the child was two-years-old (2). 5. A school age child to leave the Infant Classroom with another child without proper supervision. Based on interview with staff, the surveyor learned that the children were eleven- years-old (11) and two-years-old (2). The surveyor did not observe a staff person to be with the eleven-year-old child and two-year-old when they left the Infant Classroom. Staffing Requirements In Compliance General Administration In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Director Requirements Not In Compliance

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

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

General: The surveyor reviewed video footage from 07/30/21 while at the child care center on 08/31/21. Based on review of the video footage, the surveyor found that a staff person was on their cell phone several times while working inside the Infant Classroom with children present. During interview, staff-in-charge stated that the child-care center does have a cell phone policy. Staff-in-charge stated that staff persons are not permitted to use their cell phones during work hours. Programming 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 5. Infant and Toddler Play Requirements.

General: The surveyor reviewed video footage from 07/30/21 while at the child care center on 08/31/21. Based on review of the video footage, the surveyor found that a school age child was inside the Infant Classroom from approximately 4:05 p.m. - 5:45 p.m. Based on multiple interviews, the surveyor learned that the school age child was eleven-years-old (11) and the other children in the classroom ranged in age from approximately five-months-old (5) to two-years-old (2). Based on interview, the surveyor learned that the eleven-year-old (11) child was inside the Infant Classroom for longer than one (1) hour. The surveyor observed the eleven-year-old (11) child to pick children up and carry them around the room, hold children, feed a child a bottle, and feed a child what appeared to be baby food.

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 multiple interviews, the surveyor learned that a letter of negative action was completed for a staff person regarding the staff person placing an approximately eight- month-old (8) child in a bouncer with a blanket while asleep. The letter of negative action was signed by the staff person. The surveyor reviewed video footage from 07/30/21 while at the child care center on 08/31/21. Based on review of the video footage, the surveyor found that a school age child placed a bouncer beside a staff person who was holding a child that was asleep. The surveyor observed the staff person to lean over and appear to place the child inside the bouncer. Based on multiple interviews, the surveyor learned that the school age child was eleven-years-old (11) and the child that the staff person was holding was approximately eight-months-old (8). Based on multiple interviews, the surveyor learned that the eight-month-old (8) child was placed in a bouncer while asleep.

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 during a walk through of the Infant/Crawler Classroom, the surveyor found three (3) infants asleep in cribs with loose blankets.. Through interview with staff, the surveyor learned that the infants were five (5) months old, eight-months-old (8), and one-year-old (1) children. 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 3. General Requirements.

General: The surveyor reviewed video footage from 07/30/21 while at the child care center on 08/31/21. Based on review of the video footage, the surveyor learned that a school age child was inside the Infant Classroom and feeding a child in a rocker/bouncer a bottle; therefore, the child was not placed in an appropriate feeding position. Based on multiple interviews, the surveyor learned that the child in the rocker/bouncer was approximately five-month-old (5) and the school-age child was eleven-years-old (11). An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A child’s (DOE: 05/17/21) file contained an immunization certificate that was no longer current as of 06/28/21. 2. A child’s (DOE: 04/12/21) file contained an immunization certificate that was no longer current as of 06/06/21.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation presented, the surveyor found that one (1) staff member (DOH: 08/23/2019) did not have Pediatric Abusive Head Trauma (PAHT) that had been updated within the past five (5) years. According to TRIS Records, the staff member last completed PAHT training on 11/06/2014. During interview, staff stated all staff will be caught up on PAHT. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the center, the surveyor found a thick coat of dust on the ceiling air vent in the restroom located in the School Age Classroom. During interview, staff stated they will have the vent cleaned.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation during a tour of the center, the surveyor found: 1. In the girls’ restroom, the last toilet had not been flushed and had soiled toilet paper in the bowl. 2. In the boys’ restroom, the last toilet had not been flushed and had a urine like substance in the bowl. During interview, staff stated they usually follow up behind the children to be sure toilets are flushed. 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 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 2:090 · 922 KAR 2:090. Section 13. Reports.

General: Based on interview with staff-in-charge, the surveyor found that the accident/injury that occurred on 03/29/2021 was not reported within twenty-four (24) hours from the time of discovery. Based on review of documentation, the accident/injury was reported on 03/31/2021; therefore, the accident/injury was not reported within the specified timeframe.

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 the following: (1.) A toilet seat was not securely fastened on a toilet in the Girls' Restroom; therefore, the toilet was not in good repair. (2.) A toilet seat was not securely fastened on a toilet in the Boys' Restroom; therefore, the toilet was not in good repair. 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

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 the lid was left off a garbage can containing soiled diapers in the Infant Room; therefore, the soiled diapers were not in a covered container. 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 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 10. Director Requirements and Responsibilities.

General: Based on observation and interview, the surveyor observed that one (1) infant child had a pacifier with a stuffed animal attachment. The stuffed animal can fall over the mouth and nose of the infant; thus, a safety risk to the child. 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 6. Sleeping and Napping Requirements.

General: Based on observation and interview, the surveyor found that two (2) infant children were sleeping in a swing in the Infant Room. Upon interview, staff confirmed that there was no documentation from a medical professional on file recommending an alternative sleep position for the infant. Based on observation and interview, the surveyor found that one (1) infant child was sleeping in a swing in the Infant Room II. Upon interview, Staff confirmed that there was no documentation from a medical professional on file recommending an alternative sleep position for the infant. 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 2:120 · 922 KAR 2:120. Section 6. Sleeping and Napping Requirements.

General: Based on observation and interview, two (2) infant children were observed in their cribs with cuddly blankets that were loose in the cribs. 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 presented and confirmed through interview with staff, the surveyor found that on 10/31/19, daily attendance records did not document the arrival and departure time of one (1) child each time the child left and came into the center. During interview, staff confirmed that the daily attendance sheet for 10/31/19 were not appropriately maintained.

Open Not marked corrected in the state record

Category: recordkeeping. 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 plunger was stored on the floor beside the commode located in the boys’ restroom. The plunger was within reach of the children. 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. The surveyor found verification that a staff (DOH: 8/12/11) completed only thirteen (13) hours of cabinet-approved early care and education annual training. 2. The surveyor found that a staff (DOH: 6/4/18) completed six (6) hours of cabinet-approved orientation training on 11/9/18; thus, not within the first three (3) months of employment. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the childcare center, the surveyor found that one (1) staff person was providing care for eight (8) three-year-old children and two (2) two-year-old children. Through review of the two-year-old children’s transition plans, the surveyor found that staff had not documented the specific day and time that the children are in either age group. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. During a tour of the classroom for the two-year-old children, the surveyor observed that a soft drink was on a shelf near the classroom door. Through interview, the surveyor learned that the drink belonged to a staff person. 2. During a tour of the classroom for the four-year-old children, the surveyor found that a bottle of hand sanitizer was stored on an approximate four (4) foot shelf. The bottle indicated that the hand sanitizer should be kept out of the reach of children. The hand sanitizer was 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found that a commode, located in the boys’ restroom, contained a brown watery substance. Therefore, the commode was not kept in a clean condition. 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 rug was on the landing of the exterior side of the door located on the playground. The edges of the rug had rolled up presenting a risk for falls. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report 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 during a tour of the Older Infants Classroom, the surveyor found that two (2) of the infants bottles were not labeled. 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 for the kindergarten-age children, the surveyor found that staff had not documented the departure times for two (2) children. Through interview, the surveyor learned that the children leave the childcare center and ride the bus to school. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor observed an uncovered electrical outlet located in the four-year-old room on the back wall between windows two (2) and three (3). 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 file presented for surveyor review for one (1) staff (DOH: 05/01/18) did not contain the results from a TB skin test or health professional’s statement. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A staff member (DOH: 05/15/17) last completed the one and one half (1 ½) hours of pediatric abusive head trauma training on 02/23/12. A review of the staff member’s file and a review of ECE-TRIS found no additional PAHT training; therefore, the PAHT training is not being completed every five (5) years. 2. A staff member (DOH: 05/22/17) had not completed the one and one half (1 ½) hours of pediatric abusive head trauma training. A review of the staff member’s file and a review of ECE-TRIS found no evidence of PAHT training. 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 that the staff person’s personal items were accessible to the children. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records 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 file for a child (DOE: 02/12/18) did not contain an immunization certificate. 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 2:110 · 922 KAR 2:110. Section 4. Director Requirements and Responsibilities.

Based on interview, the surveyor learned that on 7/11/17, two (2) staff in the school-age classroom engaged in a verbal argument by screaming and yelling at one another. This altercation occurred in front of the children.

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 one of the standing freezers contained spilled ice cream and a significant amount of crumbs. Staff reported that the freezer is cleaned once a week. 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 6. License Issuance.

General: Based on review of documentation, observation, and interview, the surveyor found the following: 1. A staff member (DOH: 6/5/17) was observed working in the Pre-K Classroom under supervision of a qualified staff person. The Director reported that the staff member came from the public school system to work in the Pre-K Classroom that is a partnership between the center and school system. The Director explained that she had requested the staff member's personnel file from the school but had not yet recieved it. She stated that a criminal records background check had not yet been submitted for the staff member. 2. A staff member (DOH: 6/5/17) was observed working in the Pre-K Classroom under supervision of a qualified staff person. The staff member documented in her resume that she had lived outside the state of Kentucky within the past five years. The Director reported she had not yet submitted an out of state criminal records check. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, observation, and interview, the surveyor found that there was not a personnel file for one (1) staff member (DOH: 6/5/17) who was observed working in the Pre-K Classroom. The Director reported that the staff member came from the public school system as the Pre-K program was a partnership with the school system. She explained that she had requested a copy of the staff member's personnel file from the school but had not yet recieved it.

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, the surveyor found that a staff member (DOH: 6/5/17) that was working in the Pre-K Classroom did not have proof of education in the form of a high school diploma, GED, or Commonwealth Child Care Credential on file. The Director reported that the staff member was an employee of the county school system and she had requested documentation from them but had not yet recieved it.

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, the surveyor found that a staff member (DOH: 6/5/17) had not submitted a negative tuberculin skin test upon hire. The Director stated she had requested the staff member's personnel file from the local school system as the staff member is employed by the school system. The Director explained she had not recieved the file from the school yet but had thought the staff member would have a tuberculin skin test in the file. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 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 3. General Requirements.

General: Based on observation and interview, the surveyor found the following: 1. There was a radio located on a table in the Four’s Classroom. A vacuum cleaner was being stored behind the table. The vaccuum cleaner was accessible to the children. Staff reported that they did not realize the vaccuum cleaner could not be accessible to the children. 2. There was one (1) can of air freshener stored in the unlocked cabinet under the sink in the Infant Classroom. Staff stated they were not usually in that classroom and did not know that the air freshner was under the sink. 3. There was a carpet sweeper sitting next to the door in the Infant Classroom. The carpet sweeper was accessible to the children. Staff stated they were not usually in that classroom and was not aware the carpet sweeper could not be 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 and interview, the surveyor found that there were multiple ceiling tiles that contained brown water stains in the Kindergarten Classroom. The Director reported that the roof had been replaced recently and she was not aware of there being any leaks since the roof was replaced.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found the following: 1. There was soiled wet paper towels in the floor of the boys' restroom. 2. There was soiled toilet paper in the floor of the restroom located off of the Kindergarten Classroom. Staff reported that the the restrooms are cleaned once at the end of each day.

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 the toilet in the middle stall of the girls' restroom was not flushed. Staff stated that the cook cleans the restroom once at the end of every day. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Hygienic Practices 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 and interview, the following were found: 1. The children's coats, bags, and blankets were stored on wall hooks in the Pre-K Classroom. Their individual belongings were touching one another thus increasing the risk of cross contamination. 2. The children's coats, bags, and blankets were stored on wall hooks in the Two's Classroom. Their individual belongings were touching one another thus increasing the risk of cross contamination. 3. The children's coats, bags, and blankets were stored on wall hooks in the Four's Classroom. Their individual belongings were touching one another thus increasing the risk of cross contamination. 4. The children's coats, bags, and blankets were stored on wall hooks in the Kindergarten Classroom. Their individual belongings were touching one another thus increasing the risk of cross contamination. 5. The children's coats, bags, and blankets were stored on wall hooks in the One's Classroom. Their individual belongings were touching one another thus increasing the risk of cross contamination. Staff reported that the children's belongings are always stored in this manner. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

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 that multiple nap mats located in the Kindergarten Classroom contained holes and tears that exposed the foam padding, thus preventing them from being properly sanitized. Staff was not aware of the holes in the nap 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 that a white wooden chair located in the dramatic play center in the School-Age Classroom was broken and not in good repair. Upon interview, the Director was not aware of the broken chair. 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 8. Kitchen Requirements.

General: Based on observation and interview, the surveyor found that the thermometor located in the chest freezer was reading four (4) degrees fahrenheit; therefore, the frozen food was not maintained at zero (0) degrees fahrenheit or less as required. Staff reported that they had not been in and out of the freezer any on the day of inspection. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report

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 and interview, the surveyor found that one (1) child's file (DOE: 7/21/14) presented for review did not contain the preferred hospital name or telephone number. Upon interview, the Director was not aware that the information was missing from the file. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that only one (1) classroom had documented the completion of tornado and earthquake drills for July - Sept. of 2016 and Jan. - March of 2017. Upon interview, the Director was not aware of the missing documentation.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that only one (1) classroom had documented the completion of tornado and earthquake drills for July - Sept. of 2016 and Jan. - March of 2017. Upon interview, the Director was not aware of the missing documentation and could not confirm if the drills had been completed. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a staff member (DOH: 6/27/16) aggressively took a toy away from a toddler child. The child was seated in the floor of the classroom playing with a toy when the staff member grabbed the toy and jerked it out of the child's hands.

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 four-year-old classroom, there was one (1) outlet located in the listening center that was not being used and did not have a protective covering. This outlet was accessible and within reach of the children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 5 of 25 Web site: http://chfs.ky.gov/ Inspection Report

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 of the staff files, a staff member's (DOH: 1-7-16) criminal records check was not submitted timely, i.e., it was submitted on 1-8-16 which was not on or before their hire date. Based on interview, this staff member was not left alone with children prior to the results being received.

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 Training Record and staff files, a staff member (DOH: 8-21-13) had completed fourteen (14) of the required fifteen (15) training hours for the year 8-21-14 to 8-20-15.

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 one-year-old classroom, the cabinet under the sink had a child proof latch that was broken; therefore, the children had access to a container of diaper ointment that was located inside of the cabinet.

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 observation, there were seven (7) children present in the two-year-old classroom. However, there were only five (5) children signed in on the attendance sheets located in the classroom.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

Based on interviews, the surveyor determined that staff to child ratio's were not maintained on the morning of 3/3/16. There were eleven (11) children age birth - 12 months being supervised by one (1) staff person. Director Requirements

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.

Based on interviews, the following was found: 1. The surveyor determined that a child's medication was sent home with another child. Based on interview, the two children were taking the same medication and the staff person gave the wrong medication to the parent. 2. The surveyor determined that in February, a child had a messy bowel movement which resulted in the child being changed. The staff person placed the child in a Onsie and shorts and did not re-dress the child appropriately. Food Service

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 of a child's (DOE: 12/28/15) file, the surveyor found that the child's immunization certificate was not contained in the file. Based on an interview with the director, the surveyor was informed that she had repeatedly asked the parent to provide the immunization certificate. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report Written Documentation

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.

Based on interview, a child's medical information i.e. a medication that he was taking was not protected. The child's medication was sent home with another child that attends the center.

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 during a tour of the five-year-old children's classroom, the surveyor found that there were sixteen (16) children and one (1) staff person present; therefore, the staff-to-child ratio was exceeded by one (1) child.

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, the surveyor found the following: 1. During a tour of the Crawler's Room, the surveyor found that the children’s bowls and spoons had been placed in the wash basin located in the classroom near the diaper changing table. Through interview, the surveyor learned that staff washes their hands in the same sink after diaper changes. Staff reported that the sink is not sanitized after hand washing; thus, creating a potential for cross contamination. 2. During a tour of the two-year-old children’s classroom, the surveyor found that a child was napping on a cot. A white two (2) tier wooden shelf was observed to be leaning precariously toward the child creating a risk of harm. 3. During a tour of the two-year-old children’s classroom, the surveyor found that the cords of a television and DVD player were dangling down from an approximate four (4) foot shelf on which they had been placed. The cords were within reach of the 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 and ECE-TRIS, the surveyor found verification that a staff (DOH: 08/12/11) had obtained only fourteen (14) hours of cabinet-approved early care and education annual training. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of Infant Room #1, the surveyor found that an infant child was sleeping in a bouncy seat. Upon reviewing documentation contained in the child’s enrollment file, the surveyor found no documentation indicating that a health professional had recommended an alternate sleeping position.

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 two-year-old children's classroom, the surveyor found that empty plastic bags had been stored in an unlocked drawer located under the diaper changing table. The bags were 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 three-year-old children’s classroom, the surveyor found a thick coating of dust on the wall vent.

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 that the paint had eroded on the toilet seat located in the boys' restroom. The erosion exposed the underlying surface resulting in easy absorbancy and could not be properly sanitized. Hygienic Practices

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 during a tour of the two-year-old children's classroom, the surveyor found that the garbage can containing soiled diapers was not covered.

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 the following: 1. During a tour of the Toddler’s Room, the surveyor learned that the mouth contact toys are submerged in a sanitizing solution for fifteen (15) seconds rather than two (2) minutes. 2. During a tour of the two-year-old children’s classroom, the surveyor learned that staff does not use a brush to scrub the mouth contact toys. First Aid/Medication

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 during a tour of the Infant's Room, the surveyor found that a cabinet door knob was loose and easily pulled off of the diaper changing table.

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 had a medication chart with six (6) different children listed on the chart with the following information included: date, child's name, medication name, amount to be given, time to be given, time given, parent's signature, and teacher's signature. Therefore, this medication chart is not keeping children's information in strict confidence as required by regulations. Director Requirements

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, DRCC overheard a staff person (DOH: 05/13/15) use the word "bitch" while caring for children in the Two Year Old Classroom. The staff person used inappropriate language while in the classroom. First Aid/Medication

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 interview, a staff (DOH: 06/30/08) person applied A&D Ointment to a child (DOE: 08/01/13) on 06/10/15; however, the staff did not have permission to administer A&D Ointment to the child. Based on review of documentation, the child care center had a blanket permission slip dated for 01/03/14 to administer "diaper rash cream/ointment". The blanket permission slip did not list the specific medication that was to be administered; therefore, the child care center did not have permission to administer A&D Ointment to the child.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor was not presented with documentation of diaper rash cream or ointment being administered. The staff at the child care center stated during interview that the child care center staff do not document when they administer diaper rash cream or ointment to children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 2 of 3 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation, the following was observed: 1. There were three (3) medications located in a child's (DOE: 08/01/13) diaper bag. 2. There were two (2) medications located in a child's (DOE: 08/01/13) diaper wipe box. Therefore, these medications were not stored in a separate and locked place, out of the reach of children.

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, one (1) child's file (DOE: 2/5/14) presented for surveyor review failed to contain the perferred hospital and perferred hospital telephone number.

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 fence was not in good condition as the wooden gate has warped causing a large gap in this barrier intended to promote the children's safety. During the inspection on 07/11/14, the wooden gate was open at the bottom approximately ten (10) inches without applying any force. With the surveyor applying some pressure, the gate opened open up wider, which could allow a child space to vacate the playground or a person from outside of the perimeter to enter the outdoor play area.

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 file presented for review and a check of ECE-TRIS for an employee (date of hire: 1/9/2012) did not contain documentation that fifteen (15) hours of cabinet-approved early care and education training had been obtained during the most recent subsequent year of employment. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the following was found: 1) A plastic spray bottle labeled "soap water" was hanging from a shelf accessible to children in the kindergarten class room. 2) A plastic spray bottle labeled "bleach water" was hanging from a shelf accessible to children in the kindergarten classrooom.

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, a small area of the wall in the toddler room was damaged exposing the drywall powder which was accessible 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 11. Toys and Furnishings.

General: Based on observation, a yellow piece of playground equipment located beside the fence has a large area of rust where the paint has chipped off.

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, zero (0) of the ten (10) children's files presented for review contained information to allow the person in charge to contact the child's preferred hospital.

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 observation, the child care center failed to maintain the confidentiality of children's records as a list of children's full names (first and last) and their birthdays were posted without a cover sheet on the wall in the kindergarten classroom.

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, each classroom conducts their own earthquake and tornado drills separately. The earthquake and tornado drills were being documented together on one (1) sheet of paper and for some of the classrooms, the time of each drill is not documented separately for the months of March 2013, December 2012, September 2012 and June 2012.

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 criminal records checks presented for review for eight(8) staff members (DOH: 4/1/13, 4/15/13, 9/20/12, 4/15/13, 4/16/13, 6/10/13, 2/4/13, 4/26/13) were not submitted timely in accordance with KRS 199.896(19). The child abuse and neglect check presented for review for one (1) staff member (DOH: 6/10/13) was not submitted timely in accordance with 922 KAR 1:470.

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, the lesson plan posted in the kindergarten room on 6/18/13 was dated 6/10 - 6/14. The staff person stated that she was filling in for the regular teacher who had just left for the day and she was not sure where the current lesson plan was kept.

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, a child wiped his nose and did not wash his hands with soap and water.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Reports.

General: Based on interview, the director transported a child to the emergency room in her personal vehicle on 5/22/13. The center implemented a change of service by transporting a child without being approved for transportation.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110 - Section 6

General: Based on interview, the director was made aware of an allegation of abuse on 4/1/13 at approximately 5:30 p.m. and did not report to the Cabinet until approximately 2:30 p.m. on 4/2/13. The director failed to report suspected abuse/neglect immediately to the Cabinet as required in KRS 620.030. Director Requirements

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 and interview, a five-year-old child sustained a round circular bruise to the back of her neck and two scratch marks, one on each side of her neck while being cared for at the center. Equipment - Classroom

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 Equipment.

school age: Based on observation, a school age child was sleeping on the floor on her jacket. Therefore, a mat/cot was not available for the child. 237 - Crib Mattress/Standards 922 KAR 2:120 - Section 6 (2) A crib shall: (a) Be equipped with a firm, comfortable waterproof mattress; and (b) Meet the standards set forth in 16 C.F.R. 1508 and 1509. 2) Meets Standards In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 11

Crawlers: Based on interview, staff stated that mouth contact toys are sanitized in the following manner: 1. Spray the toys with soapy water. 2. Wipe off the toys with a cloth. 3. Spray the toys with bleach water. 4. Wipe off the toys with a cloth. This procedure does not meet the regulatory requirement. Infants: Based on interview, staff stated that mouth contact toys are sanitized in the following manner: 1. Spray a cloth with bleach water. 2. Wipe off the toys with the cloth. 3. Allow the toys to air dry. This procedure does not meet the regulatory requirement. Toddlers: Based on interview, mouth contact toys are sanitized in the following manner: 1. Spray a cloth with bleach water. 2. Wipe off the toys with the cloth. 3. Allow the toys to air dry. This procedure does not meet the regulatory requirement. 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 2:120 · 922 KAR 2:120 - Section 6

Kindergarten: Based on interview, the staff person stated that the mats are sanitized once a week instead of daily as required. The mats are not labeled for individual use.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infants: Based on observation, two (2) children were sleeping in bouncy seats.

Open Not marked corrected in the state record

Open / not marked corrected.

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

School Age: Based on observation, one (1) staff person left the classroom to go to the office to get a key which left one (1) staff person alone with eighteen (18) children. The staff person stated during interview that the youngest child in the classroom was six (6) years of age. Therefore, the staff-to-child ratio was exceeded by three (3) children during this time. 163 - Defined Groups 922 KAR 2:120 - Section 2 (2) (a) In a Type I center, a group size shall: 1. Be separately maintained in a defined area unique to the group; and 2. Have specific staff assigned to, and responsible for, the group. 1) Separate/Defined Area In Compliance 2) Specific Staff In Compliance

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation, the following was found: (1) The children's names and dates of birth were posted on the wall in the following classrooms: School Age, Kindergarten, Pre K Four's, Two Year Olds, and Infant classrooms. (2) The children's names and dates of birth were posted on a cabinet in the Pre K Three's classroom.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the record for a staff member (DOH: 10/15/09) did not contain a current professional development plan. The last completed professional development plan was dated 12/21/10. 107 - Maintenance of Background check/Out of State 922 KAR 2:110 - Section 3 (12) For the director, employee, volunteer, or any person with supervisory or disciplinary control over, or having direct contact with a child, results of the: (a) Criminal records check in accordance with KRS 17.165; (b) Child abuse and neglect check in accordance with 922 KAR 1:470; and (c) Background check from: 1. Previous state of residence, if the individual has been a resident outside of Kentucky in the previous five (5) years; or 2. Current state of residence, if other than Kentucky; 1) Criminal Records Check In Compliance 2) Child Abuse/Neglect Check In Compliance 3) Previous State of Residence In Compliance 4) Current State other than KY In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

Toddlers: Based on observation, the children were running around the classroom and hitting one another which indicates that the children do not have a regular routine of activity to keep them occupied.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Kindergarten: Based on observation, the children's mats were placed on the floor. The children walked over the mats while wearing their shoes. One (1) child's mats was walked on by three (3) different children. Pre K Three's: Based on observation, upon entrance into the classroom at approximately 11:50 a.m., the children's lunch plates and drinks were already placed on the tables. However, the children were in the hallway washing their hands. Staff brought the children into the classroom and had them sit on the carpet. At approximately 12:10 p.m., the children were allowed to go to the tables and eat lunch. Therefore, the children's lunch meals were on the tables for at least twenty (20) minutes before the children were allowed to eat. Two's: Based on observation, the following was found: (1) A female child was in the restroom waiting go to the bathroom. A male child entered the restroom, stepped up onto the step stool, and urinated while the female child watched him. The staff person instructed the male child to wash his hands when he was finished. The female child then stepped onto the step stool and began to pull her pants down to try to urinate like the male child had done. The staff person informed the female child that "girls pee sitting down" and the staff person instructed the female child to sit down on the commode. (2) The children ran on the mats while wearing their shoes. The children also held their blankets over their faces and hit one another. Infants: Based on observation, an electrical cord was hanging from a radio that was located on a shelf. The cord was hanging beside the changing table which was accessible to children as they are being diapered. Toddlers: Based on observation, the following was found: (1) Two (2) children kept opening and closing the refrigerator door. Cups of milk for the children were stored inside the refrigerator. (2) Before nap time, the children ran around the classroom and stepped on the mats while wearing their shoes. 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 43 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. 7) Personal belongings of staff Not In Compliance Findings: Kindergarten: Based on observation, a staff person's purse was placed on the floor where it was accessible to the children. School Age: Based on observation, a staff person's purse was placed on a shelf where it was accessible to the children. Infants: Based on observation, a staff person's purse was placed on the floor where it was accessible to the children. 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 3) Good repair In Compliance 4) Land-line phone accessible 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. 2) Clean Not In Compliance Findings: Pre K Three's: Based on observation, an air vent was covered with dust. A child's cot had been placed beside the dusty air vent. During nap time, a child was observed to be sleeping on the cot. 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 An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 43 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. 1) Windows In Compliance 2) Doors In Compliance 3) Stoves In Compliance 4) Heaters In Compliance 5) Furnaces In Compliance 6) Pipes In Compliance 7) Stairs In Compliance

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

General: Based on observation, the surveyor found the following: (1) On 2/3/12 at 12:36 p.m., there were fourteen (14) children present in the Two Year Old classroom with one (1) staff member. The youngest child present was two years old. Therefore, the minimum staff-to-child ratio was exceeded by four (4) children at this time. (2) On 2/3/12 at 12:37 p.m., there were twenty (20) children present in the Three Year Old classroom with one (1) staff member. The youngest child present was three years old. Therefore, the minimum staff-to-child ratio was exceeded by eight (8) children at this time. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 1 of 2 Web site: http://chfs.ky.gov/ Inspection Report Director Requirements

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that one hundred and thirty-one (131) biting incidents have occurred in the Toddler Room since June 2011. In addition, the greatest number of incidents, a total of thirty-eight (38), occurred most recently in January 2012. Children's Records 96 - Enrollment Information 922 KAR 2:110 - Section 3 The following records shall be maintained at the child-care center for 5 years: (1) Sufficient records to: (a) Identify each child enrolled in the child-care center; and (b) Enable the person in charge to contact each child's: 1. Parent at: a. Home; or b. Place of employment; and 2. Family physician; and (c) Identify the name of each person designated in writing by the parent to pick up the child; 1) Identification Information In Compliance 2) Parent Contact Information In Compliance 3) Physician Contact In Compliance 4) Designated Pick-up In Compliance 97 - Emergency/Medical Information 922 KAR 2:110 - Section 3 The following records shall be maintained at the child-care center for five (5) years: (2) Each child's medical history, along with authorization for emergency medical care, signed by the parent and left with the child-care center director at the time of enrollment; 1) Medical History In Compliance 2) Emergency Authorization In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the files for three (3) children (DOE: 3/30/11, 9/26/11, and 11/29/10) contained immunization certificates that were no longer valid.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.