922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on interview and review of documentation, including review of the center’s KARES roster printed the morning of the surveyor’s visit, the surveyor found that one (1) staff (DOH: 08/04/25) observed currently working at the center was listed as separated on the KARES roster with an eligible-expired determination status. The staff’s eligibility determination date was listed as 08/22/18. The surveyor did not observe this staff member working with children on this date. During interview, staff-in-charge stated the staff member was rehired on 08/04/25 as an office administrator with no supervisory role over the children, and she would send the staff member for updated fingerprint background check immediately. Subsequent review of the staff’s individual applicant history in KARES on 08/29/25 revealed that the staff member submitted fingerprints on 08/21/25 and received auto-determination of eligibility on 08/21/25. Supervision 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 and review of documentation, the surveyor found that the childcare center failed to report to the cabinet or its designee an incident on 07/22/25 in which a staff member engaged in physically rough handling an approximately three-year-old child by jerking this child by the arm, which led to the childcare center terminating this staff member. During interview, staff-in-charge stated she knew she should have reported the incident but chose not to do so due to a past bad experience with the cabinet.

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 interview and review of documentation, the surveyor found that the childcare center failed to ensure the health, safety, and comfort of an approximately three- year-old child, when a staff member jerked the child’s arm and spoke disrespectfully to the child on 07/22/25. The staff member was terminated. Programming 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of documentation, 1) A staff member's (DOH: 09/20/08) file contained a copy of a negative tuberculin result that was no longer current as of 01/02/23.

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 on One Year Old Restroom located in Building #2, the surveyor found that the children's handwashing sink faucet was lose and not in good repair.

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, In the Four-Year-Old Room: 1) The door frame was missing, and dry wall was not painted. 2) Paint was chipping on the orange wall. 3) Paint was chipping on the green wall. In the Two-Year-Old Room: 1) The drywall was exposed on the marble wall. In the School Age Room: 1) Paint was chipping off from the ceiling. 2) The door frame was missing, and the dry wall was exposed. In the After School Room: 1) Paint was chipping off of the blue wall. 2) The ceiling was stained. In the hallway outside of the Two-Year-Old Room: 1) The floor tiles were broken. In the Four-Year-Old Restroom: 1) The floor tiles were cracked. In building #2 Two-year-Old Room: 1) Paint was chipping on the grey wall. In the kitchen: 1) The door frame was missing, and dry wall was exposed.

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, In the School Age Restroom: 1) The vent was covered in dust and debris.

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 of the outdoor playground, there were two (2) sand boxes covered by a tarp. The tarps were both holding water which created a safety hazard for the children.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, In the Infant Room: 1) A child was asleep in the crib with a bib on. 2) A child was asleep in the crib covered with a blanket.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and review of documentation, 1) The surveyor found that a child’s (DOE: 11/11/20) immunization certificate was no longer current as of 11/11/24. 2) The surveyor found that a child’s (DOE: 06/03/21) immunization certificate was no longer current as of 04/03/24. 3) The surveyor found that a child’s (DOE: 10/25/23) immunization certificate had no expiration date listed.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found that the door frames and parts of the dry wall were missing from several of the doors. During interview, staff stated that the center was being repaired.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found that there were several spots on the walls that needed repair to the drywall. There were several spots on the floor where the flooring was coming up. During interview, staff stated that the walls and floors would be repaired. Food Service In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, one (1) staff (DOH: 07/01/20) member was listed as separated on the child care center's KARES roster. The staff member had an eligibility date in KARES as 09/12/19. The staff member was present on the day of the surveyor's visit; however, she was not observed to be working alone with children. Staff-in- charge stated that she thought the staff person was listed as a current employee in KARES. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of ECE-TRIS, the surveyor found the following: 1. One (1) staff member (DOH: 08/30/23) did not completed the six (6) hours of cabinet-approved Orientation. 2. One (1) staff member (DOH 01/10/23) completed only twelve (12) of the required fifteen (15) hours of annual training for the review period of 01/11/24 - 06/30/24. The staff member complete Orientation on the day of the surveyor's visit 07/15/24. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following on the two-year-old's playground: 1. There was a screw protruding out of the left underside edge of the wooden ramp leading to the porch of Building #1, near the walkway. 2. There was a piece of metal siding that was pulled away from the building on the lower side of the building facing the two-year-old's playground, and a nail was protruding out of the siding. 3. There was a sizeable piece of a wooden slat missing from the wood fence surrounding the playground. Therefore, the items mentioned presented a foreseeable hazard or were not in good repair. 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 a soiled sheet that was located on a cot in the Busy Bees School Age Classroom. The soiled sheet was on the top cot of a stack of cots along the wall in the classroom. Based on interview with staff, the surveyor learned that the cots were not used during the summer with the school age children and that the cots had not been used since the end of the school year. Transportation In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 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 one (1) child’s (DOE: 9/25/23) file that did not contain the phone number to the child's family physician or the preferred hospital. 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 5. Evacuation Plan.

General: Based on review of documentation and interview, the surveyor was not presented with an updated Emergency Preparedness Plan. Staff-in-charge stated that she was unable to find an updated plan posted on the wall or in the files. 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 11. Staff Requirements.

General: Based on review of documentation and ECE- TRIS, the surveyor discovered the following: 1. A staff member (DOH: 10/21/20) completed six and one-half (6 1/2) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 10/21/2021 through 06/30/2022. 2. A staff member (DOH: 07/30/18) completed twelve (12) of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/2021 through 6/30/2022. Staff reported that she would make sure the staff completes their yearly trainings. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 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, the surveyor discovered a layer of dust on the exhaust vent located in the Two Year Old's restroom. Staff reported that she would have the exhaust vent cleaned. Hygienic Practices Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered a rip in the diaper changing pad located in the Younger One Year Old Classroom. Staff reported that she will place a new diaper changing pad in the classroom. First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered the following: 1. There were multiple roof shingles placed on the ground around the storage building located on the playground. 2. The hand rail leading from the porch to the playground was disconnected. 3. There was a board with an exposed nail on the front part of the porch. 4. There were multiple small pieces of glass placed on the ground of the little playground.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

Based on observation, the surveyor found an aluminum hose hanging downward from what appeared to be a window air conditioner on the little playground. The aluminum hose contained exposed wires that appeared to be sharp and were accessible to the children; therefore, the playground was not safe from foreseeable hazard. Staff reported she would place the hose where it would not be accessible to the children. Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A bulletin board with an exposed nail placed beside a set of cubbies by the front entrance door. 2. A cabinet with drawers in the Wild Things Classroom that contained the following: the top drawer contained three (3) small pieces of wood that had splintered edges/ends and the middle drawer contained two (2) packs of anti-bacterial wipes that stated "Keep Out of the Reach of Children" on the back label. The drawers were observed to have child-safety locks that appeared broken. 3. An electrical outlet that was turned slightly sideways on the wall and exposed the hole in the wall behind the electrical outlet located near the window in the Lion King Classroom. 4. A set of steps that are used for the sink area placed on top of the diaper changing table and appeared to not be secured in the Lion King Classroom. 5. An electrical outlet missing one (1) outlet cover located beside a small book case in the Jungle Classroom. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 10/21/20) file contained an annual written performance evaluation dated for 10/15/20; therefore, the evaluation was not completed annually. During interview, staff-in-charge stated that the staff person's evaluation may have been included in the paperwork the staff person completed before her start date. 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

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 08/24/20) file contained a document that had "TB test" written on the front of the document. The document verified a date of transaction at First Care on 12/08/21. The document did not state that it was for a TB Skin Test. During interview, staff-in-charge stated that the document was of the staff persons TB skin test; however, she was unsure why the document did not state that.

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 that a staff (DOH: 07/30/18) obtained eleven and one-half (11 1/2) hours of the required fifteen (15) hours of cabinet-approved early care and education training for the review period 07/01/20 – 06/30/21. 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 4. Premises Requirements.

General: Based on observation, the surveyor found a blue square leaf rug that contained brown spots; therefore, the rug was not kept clean.

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. The toilet seat moved easily and was not tightly secured to the toilet in the restroom located beside the Jungle Classroom; therefore, the toilet was not kept in good repair. 2. The toilet seat moved easily and was not tightly secured to the toilet in the restroom located beside the School Age Classroom; therefore, the toilet was not kept in good repair. 3. The toilet seat moved easily and was not tightly secured to the toilet in the restroom located inside the Infant Classroom; therefore, the toilet was not kept in good repair. 4. What appeared to be rust/brown substance on the rim of the toilet by the toilet seat hinges in the restroom located beside the Jungle Classroom; therefore, the toilet was not kept clean. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found a tear in the diaper changing pad in the Infant Classroom; therefore, the diaper changing surface was not free of holes, rips, tears, or other damage. First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation of the playground, the surveyor found the following: 1. An exposed white pipe coming out of the ground on the one-year-old playground. Staff-in-charge stated that the white pipe used to have a cover. 2. One (1) gutter downspout located beside the exit door that leads into the Infant Classroom that contained a sharp edge at the bottom of the gutter. 3. A loose gray garden hose placed on the ground beside a wooden walkway. 4. A small red tricycle that was missing one (1) petal located by a wooden fence on the playground. 5. The flat end of four (4) exposed nails sticking out of the wood located on the back of a wooden play house on the playground. 6. What appeared to be a wooden stake located behind a garbage can on the playground with approximately two (2) exposed nails sticking out of the board. 7. A loose board on the front of the porch that leads inside the child-care center building that contained approximately eight (8) exposed nails that were sticking out on the board. 8. One (1) gutter downspout located beside a set of steps that leads inside the child-care center building that contained a sharp edge at the bottom of the gutter. 9. Pieces of cream underpinning located under a building on the playground that contained jagged edges. 10. An exposed nail that was sticking out on a wooden gate entrance located at the back of the playground. 11. What appeared to be a small piece of the end of a gutter placed on the ground beside a set of porch steps that lead up to the exit door from the playground.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor found that the protective surface was depleted and exposing the liner underneath on the following items on the two-year-old playground: a gray/red structure with a slide, a blue round tunnel, and pink/green/yellow structure with a slide. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report 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 13. Toys and Furnishings.

General: Based on observation, the surveyor found the following: 1. Two (2) boards in a set of cubbies in the Jungle Classroom that were leaning and appeared to not be properly attached; therefore, the cubby was not kept in good repair. 2. Three (3) boards inside a set of cubbies in the Lion King Classroom that were leaning and appeared to not be properly attached; therefore, the cubby was not kept in good repair. 3. One (1) board inside a set of cubbies located in front of the window in the Lion King Classroom that was leaning and appeared to not be properly attached; therefore, the cubby was not kept in good repair. 4. A brown shelf that appeared unsteady when pushed or pulled on in the Lion King Classroom; therefore, the shelf was not kept in good repair. 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. The follow children’s (DOE: 06/01/21, 12/22/21, 07/22/20) files did not contain the contact telephone number for the child’s preferred hospital or the name and contact telephone number of each person to be contacted in an emergency involving or impacting the child. 2. The following children’s (DOE: 09/03/19 and 08/06/18) files did not contain the contact telephone numbers for the child’s preferred hospital or family physician or the name and contact telephone number of each person to be contacted in an emergency involving or impacting the child. 3. The following children’s (DOH: 07/05/21, 06/05/19, 10/08/19, 09/10/20, and 06/26/20) files did not contain the name or contact telephone number of each person to be contacted in an emergency involving or impacting the child. Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a staff’s (DOH: 10/21/20) file contained a professional development plan dated 10/15/20; therefore, the plan was not completed annually. During interview, staff-in-charge stated that the staff person's professional development plan may have been included in the paperwork the staff person completed before her start date. Posted Documentation In Compliance Animals In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5

Open Not marked corrected in the state record

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 Two Year Old Classroom, the surveyor found an older child cleaning in the classroom. During interview, the surveyor learned that the older child was a school-age child. Staff stated that the school-age child gets bored and asks if she can help clean. Based on an email from director and during interview, DRCC learned that two (2) school-age children assist in the younger children’s classrooms for a "couple of hours on whatever day they chose". The director stated during interview that, in the future, she would assure that the school-age children are not mixed with the younger children for more than one (1) hour per day.

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 review of documentation presented, the surveyor found that two (2) staff members (DOH: 10/25/2020 and 03/09/2021) did not have the criminal record background checks. The center did not request the required background checks, staff stated they were not aware they were needed. During interview, staff stated the staff members have not worked alone with the children. Director Requirements In Compliance Employee Records In Compliance 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 during a tour of the center, the surveyor found that an infant was asleep in a crib and a pacifier was attached with a clip to the child’s clothing. During interview, staff stated that staff members knew not to attach pacifiers during sleep. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the center, the surveyor found there were brown circular stains on the ceiling tiles in the restroom located by four and five year old's classroom. During interview, staff stated there was a leak during a recent storm. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on interviews, the surveyor found that on 4/23/2021, the health, safety and comfort of a child was compromised due to a PVC pipe being exposed on the playground. A child tripped and fell over the PVC pipe, causing injury to a child. 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 interviews, the surveyor found that on 4/23/2021, a child was injured due to a PVC pipe being exposed on the playground; therefore, the outdoor play area was not safe from foreseeable hazard.

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 determined that the supervision of an eight year-old child was compromised on 10/8/2020, when a staff member had asked for the child to get milk. A staff memeber reported there was no one in the kitchen or in the classroom beside the kitchen at the time of the incident. Staff reported that the staff member who helped the child was in another room and was not aware the child was in the kitchen. 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: supervision. Open / not marked corrected.

922 KAR 2:090 · 922 KAR 2:090. Section 13. Reports.

General: Based on interview and review of documentation, the surveyor discovered an incident that occurred on 10/8/2020 which required medical attention was not reported to the Cabinet within twenty-four (24) hours from the time it was discovered. A staff member reported that she was asked by the parent not to report the incident.

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 interview and review of documentation, the surveyor determined that the health, safety, and comfort of an eight year-old child were compromised on 10/8/2020, when a staff member had asked for the child to get milk. Upon interview, the staff member stated that the child went in to the kitchen on her own to get the milk when the door of the refrigerated milk cooler fell on her hand. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview, the surveyor discovered the Director did not comply with 922 KAR 2:120, 922 KAR 2:280 and this administrative regulation by not reporting an incident from 10/8/2020 to the Cabinet. A staff member reported that the child's parent stated she did not want the incident to be reported to the Cabinet.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on review of documentation and the National Background Check Program, the surveyor found the following: 1. A staff’s (DOH: 9/12/19) fingerprints were collected on 9/19/19; therefore, the childcare center hired the staff prior to being cleared for employment. 2. A staff’s (DOH: 1/20/2020) fingerprints were collected on 1/28/2020; therefore, the childcare center hired the staff prior to being cleared for employment. 3. A staff’s (DOH: 11/19/19) fingerprints were collected on 11/22/19; therefore, the childcare center hired the staff prior to being cleared for employment. Supervision In Compliance 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

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 the following: 1. During a tour of the Infant Room, the surveyor observed that a child stood up while holding onto a gate. The latch did not correctly secure the gate allowing the child to fall on the floor. 2. A cup containing soda from Culver’s was observed on a shelf in the classroom for the two and three-year-old children. The cup was within reach of the children. 3. A can of Mellow Yellow was observed on a shelf located in the School-age Room. The soda 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 that a staff (DOH: 9/12/19) completed six (6) hours of cabinet-approved orientation training on 12/26/19; thus, not within the first three (3) months of employment. 2. The surveyor found that a staff (DOH: 12/12/18) completed only seven and one-half (1 ½) hours of cabinet-approved early care and education annual 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 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. The surveyor found that a vinyl type baseboard was protruding outward from the wall located near the sink in the classroom for the two-year-old children. 2. The surveyor found that a vinyl type baseboard was protruding outward from the wall located in front of the kitchen sink. 3. The surveyor observed that a latch was not working correctly on a gate located in the Infant Room.

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 a round golfball-size hole in the wall near the toilet in the classroom for the two and three-year-old children. Hygienic Practices In Compliance First Aid/Medication In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Outdoor Play Area Not In Compliance

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 no protective surface under or around a slide located on the Infant/Toddler playground. Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 8. Kitchen Requirements.

General: Based on observation, the surveyor found no thermometer in the refrigerator located in the kitchen. Therefore, the surveyor could not determine the interior temperature of the refrigerator. 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 that a child’s (DOE: 8/30/19) immunization was no longer current as of 11/14/19. Interview with staff found that a current immunization certificate was not available for review. Written Documentation In Compliance Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:280 · 922 KAR 2:280. Section 3. Implementation and Enforcement.

General: Based on observation and review of documentation, the surveyor found a staff (DOH: 9/12/19) working alone with children inside a classroom without a completed background check in KARES. Staff confirmed the child care center was short staffed on the day of the surveyor’s visit. The day of the surveyor’s visit was the staff’s first day working in the child care center. The surveyor reviewed the KARES report to find the staff’s name was not on the child care center’s list. Staff confirmed through interview that the background check had not been completed. Supervision In Compliance Staffing Requirements In Compliance Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and review of documentation, the surveyor found a staff (DOH: 9/12/19) working alone with children inside a classroom without a completed background check in KARES. Staff confirmed the child care center was short staffed on the day of the surveyor’s visit. The day of the surveyor’s visit was the staff’s first day working in the child care center. The surveyor reviewed the KARES report to find the staff’s name was not on the child care center’s list. Staff confirmed through interview that the background check had not been completed. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a staff’s (DOH: 9/12/19) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. Staff confirmed through interview that the documentation was not obtained for the staff’s file.

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 a staff’s (DOH: 9/12/19) file did not contain a statement from a health professional stating that the individual was free of active tuberculosis or a copy of a negative tuberculin result. During interview, staff confirmed the documentation had not been obtained for the staff’s file. Programming In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found a staff was aggressive with children on the playground on 5/15/19. Video surveillance provided by the child care center shows the following: (1.) Staff can be seen pinching a child on the arm two (2) times. (2.) Staff jerks a child by their arms on more than one (1) occassion. (3.) Staff can be seen spanking children on the bottom with her open hand. (4.) Staff smacks a child on the arm using an open hand. The staff's employment was terminated from the child care center after staff reviewed the video footage.

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 a staff’s (DOH: 12/12/18) file did not contain a high school diploma, GED, or Commonwealth Child Care Credential. The director reported the staff recently graduated from high school and she confirmed the documentation was not obtained for the staff’s file. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 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 and ECE–TRIS, the surveyor found the following: (1.) Staff (DOH: 4/15/13) obtained none of the required fifteen (15) hours of cabinet–approved early care and education training. (2.) Staff (DOH: 10/8/14) obtained ten (10) of the required fifteen (15) hours of cabinet–approved early care and education training. (3.) Staff (DOH: 10/17/16) obtained twelve (12) of the required fifteen (15) hours of cabinet–approved early care and education training. (4.) Staff (DOH: 6/1/17) obtained six (6) of the required fifteen (15) hours of cabinet–approved early care and education training. (5.) Staff (DOH: 7/21/18) obtained the six (6) hours of cabinet–approved orientation training on 11/13/18; therefore, the training was not obtained during the staff’s first three (3) months of employment. 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 10. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found the faucet was loose in the restroom’s handwashing sink located in the second floor restroom. The director reported the issue would be repaired.

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 toilet seat was loose; therefore, the toilet was not kept in good repair. The toilet was located in the second floor restroom that the preschool and school age children use. The director reported she would immediately repair the toilet seat. 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 following: (1.) The diaper changing pad in the Twos Classroom contained small tears. (2.) The diaper changing pad in the Ones Classroom contained two small tears. (3.) Debris was located underneath the diaper changing pad in the Ones Classroom. 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 plastic underneath the mulch was exposed in areas on the small playground located beside the main building; therefore, the playground is not well maintained. The director reported during interview that the issue would be corrected.

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 small playground located beside the main building contained two (2) Little Tykes slides without an adequate protective surface. The director reported she contacted someone to bring in additional mulch for the playground. 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 following: (1.) Child’s (DOE: 2/5/18) file did not contain a physician or hospital’s contact telephone number. (2.) Child’s (DOE: 10/15/18) file did not contain a preferred physician or hospital’s information. (3.) Child’s (DOE: 2/18/17) file did not contain a preferred physician or hospital’s information. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: (1.) A fire drill was not documented for the month of December 2018. During interview, the director confirmed the fire drill was completed; however, documentation was not provided during the surveyor’s visit. (2.) A list of the children who participated in all the fire, earthquake, and tornado drills for 2018 and 2019 was not documented. The director confirmed through interview that a list of participants was not documented during the drills. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation during a tour of the School-age Room, the surveyor found that three (3) of the children’s coats were in a pile on the classroom floor. Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS, the surveyor found the following: 1. A staff (DOH: 09/13/08) completed pediatric abusive head trauma training on 02/11/13; therefore, the training was no longer current as of 02/10/18. 2. A staff (DOH: 05/01/98) completed pediatric abusive head trauma training on 02/12/13; therefore, the training was no longer current as of 02/11/18. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 5 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation during a tour of the childcare center, the surveyor found the following: 1. A large bag of salt and a pressure washer were stored beside the exit door in the dining area of Toddler Room #1. Through interview with staff, the surveyor learned that the children had eaten lunch in the dining area; therefore, the items were accessible to the children. 2. Four (4) large blue empty plastic bags were stored in the children’s cubbies located in Toddler Room #1. The bags were accessible to the children. 3. A can of paint was stored in an unlocked cabinet located under the sink in the classroom for the two-year-old children. The paint was accessible to the children. 4. A pair of sharp-pointed scissors were observed in an unlocked cabinet located in the classroom for the four-year-old children. The scissors were within reach and 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 classroom for the four-year-old children, the surveyor found an abundance of dead bugs in the ceiling light fixture located in the restroom.

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 the hot water was not working at the sink located in the restroom used by the three-year-old children. 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 that the diaper changing table used for the two-year-old children was not padded. Through interview, staff confirmed that a diaper pad is not used when changing the children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 11. Toys and Furnishings.

General: Based on interview, the surveyor found the following: 1. Staff in Toddler Room #1 stated that the mouth contact toys are sprayed with soapy water, scrubbed with a brush, rinsed, submerged in bleach water for five (5) minutes and air dried. 2. Staff in the classroom for the three-year-old children confirmed that not all of the children are potty trained. The staff identified that the mouth contact toys are washed in a bucket using antibacterial soap. The toys are then wiped dry. The proper method to sanitize mouth contact toys is as follows: Scrub in warm, soapy water using a brush to reach into crevices, rinse in clean water, submerge in a sanitizing solution for at least two (2) minutes and air dry. First Aid/Medication Not In Compliance

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 during a tour of the classroom for the two-year-old children, the surveyor found that an unlocked first aid kit was located on a table within reach of the children.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation during a tour of the classroom for the two-year-old children, the surveyor found that an unlocked first aid kit was located on a table within reach of the children. The first aid kit contained A&D Ointment, two (2) tubes of Nystatin Ointment, sunblock, Bag Balm, and prescription Hydrocortisone Cream. The medications were not stored in a separate and locked place. Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: health medication. 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 kitchen, the surveyor found that the interior temperature of the freezer was twenty (20) degrees Fahrenheit.

Open Not marked corrected in the state record

Category: nutrition. 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 kitchen, the surveyor found that the interior top, sides and bottom of the oven contained baked-on food particles and dark stains. Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a child’s (DOE: 08/01/17) file contained an immunization certificate that was no longer current as of 02/28/18.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that a child’s (DOE: 02/22/17) enrollment file did not contain the following information: 1. The name and phone number of each person to be contacted in an emergency involving or impacting the child. 2. The name of each person that is designated in writing to pick up the child. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 5 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found verification that tornado and earthquake drills were practiced quarterly during 2017. However, only one (1) time of day was recorded for both drills. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation of staff files, one (1) staff (DOH: 4-15-13) did not have an updated annual performance evaluation, i.e., the evaluation present in the file was dated 1-4-16.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation of the pre-school classroom, there were two (2) unprotected outlets located in the reading area. 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 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation of ECE-TRIS and staff files, the following was found: 1) Staff with DOH: 5-1-98 completed eleven (11) of the required fifteen (15) hours of annual training for the training year 5-1-15 to 4-30-16. 2) Staff with DOH: 9-13-08 completed seven (7) of the required fifteen (15) hours of annual training for the training year of 9-13-15 to 9-12-16. 3) Staff with DOH: 4-15-13 completed fourteen (14) of the required fifteen (15) hours of annual training for the training year of 4-15-15 to 4-14-16. 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 of the two-year-old classroom, there was not a current lesson plan posted, i.e., the posted lesson plan was for the week of 1-9-17. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation of the infant/toddler classroom, there were two (2) areas where the plastic baseboard had come unglued from the wall. Therefore, the glue and sharp edges of the baseboard were within reach and accessible to the children in the classroom. Based on interview, the director stated she was aware of this issue and that the baseboards would be glued back down over the weekend.

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 pre-school bathroom did not have any toilet paper. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 4 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 3. General Requirements.

General: Based on observation of the infant/toddler classroom, staff did not wash their hands after changing a child's diaper.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation of the two-year-old classroom, the changing table did not include a padded surface. Based on interview, staff stated they do not use a padded surface on the changing table when they are diapering the children. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120. Section 11. Toys and Furnishings.

General: Based on observation of the infant/toddler classroom, there was one (1) Bumbo seat that was not in good repair, i.e., there were several areas around the middle piece of the Bumbo seat that was missing the protective shell; therefore, the underlying foam was visible. 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, the refrigerator in the infant/toddler classroom did not have a thermometer inside; therefore, it cannot be confirmed that the temperature was maintained at the required forty (40) degrees Fahrenheit. Children's Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report 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 observation, there were a total of nineteen (19) children present during this surveyor’s visit; however, based on review of documentation, there were only thirteen (13) children signed in on the attendance sheets.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation of staff files, the following was found: 1) Staff with DOH: 4-15-13 did not have a current professional development plan, i.e., the file contained a plan that was current until 1-6-16. 2) Staff with DOH: 10-8-14 did not have a current professional development plan, i.e., the file contained a plan that was current until 1-4-16. 3) Staff with DOH: 1-10-16 did not have a professional development plan in their file. 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 6. Reports.

General: Based on review of documentation and interview, the center failed to report an incident of suspected abuse or neglect to the Cabinet for Health and Family Services in a timely manner. The incident occurred on 6/20/16 at 1:40 p.m. Per interview and documentation, the director did not notify the Cabinet of the incident until 6/22/16 at 3:00 p.m. 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 and interview, the following was found: 1. There were no provisions to keep the toilet tissue in the preschool bathroom clean and sanitary. The surveyor observed the roll of toilet tissue sitting on the sink beside the toilet. The staff person in charge stated that the broken toilet paper dispensor was removed from the wall when the walls were recently painted. 2. A radio was observed sitting on the block shelf in the two (2) year old classroom during the visit. The radio was plugged into a low socket under the window. The cord was not securely attached to the wall and was accessible to the children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Review of Documentation and interview, this regulatory requirement was not met. An employee hired on 10/2/15 has lived in Tennessee within the last five (5) years. The staff person in charge stated that she has not submitted a Tennessee background check for this employee.

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, one (1) staff person (hire date: 10/2/15) did not have educational documentation on file.

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, this regulatory requirement was not met. Two (2) staff files (hire dates: 12/2/15 and 10/28/15) did not contain evidence of the six (6) hours of cabinet-approved training being completed within the first three (3) months of employment. The surveyor reviewed the Early Care and Education Training Records Information System (ECE-TRIS) website and the staff person's personnel file at the facility and found no evidence that this training had been completed. The staff person in charge stated that this training had been completed and indicated that she was in process of obtaining their certificates. 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 11. Toys and Furnishings.

General: Based on Observation and interview, this regulatory requirement was not met. A tour of the playground found five (5) missing foot pedals on a trike merry-go-round. Also, the metal rims on the trikes contained significant amounts of rust. The staff person in charge acknowledged the finding during the exit interview.

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, two (2) children (enrollment dates: 5/11/15 and 11/24/15) had immunization certificates on file that were no longer current as of 8/19/15 and 1/29/16. The staff person in charge stated that she would contact the parents and request the updated records.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 2. General.

General: Based on Review of Documentation and interview, this regulatory requirement was not met. A review of the organizational chart posted on the parent bulletin board found that it was not current. The organizational chart had two (2) staff names listed that are no longer employed at the facility. The staff person in charge acknowledged this during the exit interview.

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 observation, the surveyor found the first and last names of children enrolled in the center posted on the wall of the preschool classroom, two's classroom, school- age classroom, infant classroom, and toddler classroom.

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 during a tour of the school-age classroom, the surveyor found one (1) television that was not secured and was moved easily. The television was accessible to the children and creates a safety risk for the children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 5 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the preschool classroom, the surveyor found an unlocked cabinet door under the diaper changing table that contained multiple empty plastic bags and one (1) can of Hospicide Disenfictent labeled "Keep Out of Reach of Children" which 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 during a tour of the two's classroom, the surveyor found that the sink located in the classroom did not have any hot water.

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 infant and toddler outdoor play area, the surveyor found one (1) climbing play structure that did not contain a protective surface; the structure was placed on grass.

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 dining area, the surveyor found one (1) wooden chair that had an unstable back. The chair back was missing the necessary screws to connect the back portion of the chair to the seat portion of the chair.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the posted daily schedule for the preschool and school-age children indicated that the center opens at 5:00 AM. At 5:00 AM to 6:00 AM children are greeted, they wash their hands, and then the children play. The children are not served breakfast until 8:30 AM. Therefore, there is a three (3) hour and thirty (30) minute lapse between the children's arrival to the center and breakfast for the preschool and school-age children.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

922 KAR 2:110 · 922 KAR 2:110. Section 2. General.

General: Based on observation, the surveyor found that the infant classroom, toddler classroom, and two's classroom did not have a posted daily schedule.

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 padded toilet seat in the upstairs restroom was not in good repair as a tear in the vinyl type covering was visible. Hygienic Practices

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 observation and interview, the center did not have an updated copy (revised 11/2013) of the Administrative Regulations available, nor had staff been provided with an updated copy as required by regulations.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on review of documentation, an employee (DOH 09/24/12) record presented for review contained evidence of only twelve (12) hours of cabinet approved training as verified by ECE-TRIS and the file presented for review. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the following issues were found: (1) In the restroom located in the infant room, chemical supplies (Comet, Murphy Soap Oil Spray, air freshener) were accessible to children in an unlocked cabinet; and (2) In the dining room, bleach water solution was accessible to children in an unlocked cabinet.

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 sink located in the upstairs restroom had restricted flow of hot water as barely more than a stream flowed from the faucet; therefore, the sink was not equipped with an adequate hot water supply to properly wash hands at a temperature ranging from ninety (90) to one hundred twenty (120) degrees Fahrenheit as required by regulations.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a child in the Pre-School classrooom used the restroom and returned to activities without washing his hands with soap and water after toileting as required by regulations.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a training chair in the restroom located near the toddler room was approximately half full of urine; therefore, the chair had not been promptly emptied or sanitized as required.

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, medication was being stored in an unlocked box in a storage closet located in the dining room. Medications (acetaminophen and cetirizine) for a child were contained in the medication box. Outdoor Play Area

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, a file presented for review for a child (DOE 07/09/12) contained an immunization certificate which was no longer current after 07/25/13. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 26 Web site: http://chfs.ky.gov/ Inspection Report

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, none of the ten (10) children's records presented for review contained completed preferred hospital contact information as required in the event of an emergency.

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 interview, the surveyor found that on 06/12/13, a nine-month-old child was bitten four (4) times on the face by a one-year-old child. Through interview, the surveyor learned that the child care center staff had prior knowledge that the one-year-old child had bitten on four (4) previous occasions within the past four (4) months, necessitating the need for an increased level of supervision. Employee Records

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 surveyor found that a staff (DOH: 05/20/13) person's file did not contain documentation of a High School Diploma, GED or Commonwealth Child Care Credential.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, there were notices posted on the wall at the entrance of the Preschool building and in the Infant classroom. The notices listed children's names that needed new immunization certificates on file at the child care center. These notices contained protected health information of children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Infant: Based on observation, there was one (1) crib (Crib #1) that had a toy attached to the inside of the crib. Preschool: Based on observation, the following electrical outlets were uncovered: 1. There was one (1) electrical outlet located in the restroom that was uncovered. 2. There was one (1) electrical outlet located in the classroom that was uncovered. Two Year Olds: Based on observation, there was a plunger located beside the commode in the restroom. The plunger was accessible to the children. 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 1) Toxic cleaning supplies, poisons, and insecticides In Compliance 2) Knives and sharp objects In Compliance 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 4) Plastic bags In Compliance 5) Litter and rubbish In Compliance 6) Bar soap In Compliance 7) Personal belongings of staff In Compliance 197 - Premises Requirements 922 KAR 2:120 - Section 4 Premises Requirements. (1) The premises shall be: (a) Suitable for the purpose intended; (b) Kept clean and in good repair; and (c) Equipped with a land-line telephone accessible to a room used by a child. 1) Suitable In Compliance 2) Clean In Compliance 3) Good repair In Compliance 4) Land-line phone accessible In Compliance 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 40 Web site: http://chfs.ky.gov/ Inspection Report 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 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

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 4 (18)

General: Based on observation, there were two (2) areas of underpinning of the yellow building located on the playground that were cracked and broken. The cracked and broken areas had sharp edges causing a safety hazard.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation of a staff's file (DOH: 07/02/10) on 08/17/12, the surveyor found that the most current TB Skin Test Certificate was dated 06/28/10; therefore, it was not maintained within regulatory requirements. 139 - Training 922 KAR 2:110 - Section 5 (14) A staff person with supervisory authority over a child shall complete the following: (a) Six (6) hours of cabinet-approved orientation within the first three (3) months of employment; (b) Nine (9) hours cabinet-approved child development training within the first year of employment; and (c) Fifteen (15) hours of cabinet-approved training during each subsequent year of employment. 1) Orientation Not In Compliance Findings: General: Based on review of documentation of two staff person's files (DOH: 06/06/11 and 06/22/11), the surveyor found that orientation training had not been obtained within the first three months of employment. 3) 15 hours annually Not In Compliance Findings: General: Based on review of documentation of a staff person's file (DOE: 06/22/11), the surveyor found that fifteen hours of annual cabinet-approved training had not been obtained. 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 139 - Training 922 KAR 2:110 - Section 5 (14) A staff person with supervisory authority over a child shall complete the following: (a) Six (6) hours of cabinet-approved orientation within the first three (3) months of employment; (b) Nine (9) hours cabinet-approved child development training within the first year of employment; and (c) Fifteen (15) hours of cabinet-approved training during each subsequent year of employment. 2) 9 hours-first year Not Applicable Food Service 269 - Food Requirements 922 KAR 2:120 - Section 9 (8) Food shall be: (a) Clean; (b) Free from: 1. Spoilage; 2. Adulteration; and 3. Misbranding; (c) Safe for human consumption; (d) Withheld from service or discarded if the food is hermetically sealed, nonacidic, or low-acidic food that has been processed in a place other than a commercial food-processing establishment; (e) Obtained from a source that is in compliance with the Department of Public Health's food safety standards and permits, established in KRS Chapter 217; (f) Acceptable if from an established commercial food store; (g) Served in a quantity reflecting the developmental stage of the child with additional portions provided upon request of the child; and (h) Protected against contamination from: 1. Dust; 2. Flies; 3. Rodents and other vermin; 4. Unclean utensils and work surfaces; 5. Unnecessary handling; 6. Coughs and sneezes; 7. Flooding; 8. Drainage; and 9. Overhead leakage. 9) Appropriate quantity/Additional portions In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation during a tour of the child care center, the surveyor found that an infant (DOE: 05/24/12) was lying in a bouncy seat while drinking a bottle. Employee Records

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 of a staff person's file (DOH: 05/01/98) on 08/17/12, the surveyor found that the Professional Development Plan was dated 02/15/11; thus, it had not been completed annually to maintain regulatory 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 file presented for review for a toddler child (date of enrollment - 09/28/11) contained an immunization certificate was not longer current as of 2/24/2011.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.