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

General: Based on review of documentation, the surveyor found liability insurance documentation that had an expiration date of 07/01/25; therefore, the surveyor was unable to verify if the childcare center maintained proof of current liability insurance coverage of at least $100,000 per occurrence. Staff-in-charge contacted the central office for a copy of the current policy declarations page, but did not receive the documentation while the surveyor was at the childcare center.

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. One (1) staff'S (DOH: 02/29/24) file contained a tuberculin (TB) skin test that was no longer current after 05/27/23. 2. One (1) staff's (DOH: 09/18/25) file contained documentation titled “TB test and results” with a date given of 06/10/25 in the left forearm; however, the documentation did not contain a date that the test results were read and did not indicate negative results. The form had written on the line for results “0mm.”

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 personnel file for one (1) staff (DOH: 02/29/24) contained a written annual professional development plan that was not signed or dated; therefore, the surveyor was unable to verify that this staff had completed an annual professional development plan as required. Staff-in-charge stated that she had planned to separate this staff member who had gone to work full-time at another school, but this staff requested to stay on as a substitute for the summer.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A volunteer's (DOH: 11/01/24) file did not contain documentation of background checks submitted through KARES. After review of KARES, the surveyor found that the volunteer had not been entered into KARES; therefore, the volunteer was allowed entrance into the child-care center prior to clearance from KARES. 2. A volunteer's (DOH: 11/01/24) file did not contain documentation of background checks submitted through KARES. After review of KARES, the surveyor found that the volunteer had not been entered into KARES; therefore, the volunteer was allowed entrance into the child-care center prior to clearance from KARES. During interview with staff-in-charge, she stated that the two (2) volunteers were hired by the school board and enter the classroom daily to help transition the preschool children from the licensed program to the public-school preschool program. Supervision In Compliance Staffing Requirements In Compliance General Administration In Compliance Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 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 7. First Aid and Medicine.

General: Based on review of documentation of ECE-TRIS, the surveyor found that two (2) staff (DOH: 08/30/23 and 05/17/24) had not completed the required cabinet approved training in first aid and cardiopulmonary resuscitation (CPR).

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 the following: 1. Based on review of ECE-TRIS, the following staff (DOH: 07/29/22, 07/18/23 and 10/5/23) files did not contain documentation of one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training; therefore, the training was not completed within one (1) year of employment. 2. Based on review of ECE-TRIS, one (1) staff person (DOH: 08/30/23) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 02/08/17; therefore, the training was not completed within the last five years. 3. Based on review of ECE-TRIS, the following staff person (DOH: 07/29/22 and 05/17/24) did not have documentation that Orientation was completed within the first three (3) months of hire. 4. Based on review of ECE-TRIS, one (1) staff person (DOH: 06/01/17) completed two and a half (2.5) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/23 - 06/30/24. 5. Based on review of ECE-TRIS, one (1) staff person (DOH: 05/26/23) completed three (3) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 05/27/24 - 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 In Compliance Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a child’s (DOE: 08/02/22) file contained an immunization certificate that was no longer current as of 09/26/24. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report

Open Not marked corrected in the state record

Category: 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 a child's (DOE: 08/08/24) file did not contain the contact telephone number for the preferred family physician, the name of the preferred hospital or the contact telephone number for the preferred hospital. 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 8. General.

General: Based on interview, the surveyor learned that a two-year-old child’s finger was severed after the child stuck their finger into a hole on a storage building’s lock and bracket. The storage building was located on the playground. The child was taken to the emergency room for medical treatment.

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 two (2) screwdrivers and a zip-lock bag of push pins inside an unlocked drawer beside the sink inside the Jump Start Classroom. The items were accessible to the children; therefore, the health, safety and comfort of the children was compromised. Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a staff’s (DOH: 09/28/22) file did not contain verification of a high school diploma, GED or Commonwealth Child Care Credential. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a staff’s (DOH: 03/21/22) 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.

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: 08/15/03, 06/11/10, 06/01/17, 04/15/19, 05/19/21, 12/02/21, 07/29/22 and 09/28/22 ) did not complete the required cabinet-approved training in first aid and cardiopulmonary resuscitation (CPR).

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 and ECE-TRIS. the surveyor found the following: 1. The following staff (DOH: 09/21/08, 12/01/09 and 06/11/10) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 05/03/18; therefore, the training was not completed within the last five years. 2. A staff (DOH: 06/01/17) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 05/10/18; therefore, the training was not completed within the last five years. 3. A staff (DOH: 04/15/19) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 05/26/16; therefore, the training was not completed within the last five years. 4. A staff's (DOH: 05/19/21) file did not contain documentation of one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training; therefore, the training was not completed within their first year of employment. 5. The following staff's (DOH: 07/29/22 and 09/28/22) files did not contain documentation of completing the six (6) hours of cabinet-approved Orientation I & II training; therefore, the training was not completed within three (3) months of employment. 6. A staff's (DOH: 06/29/22) file contained documentation of completing the six (6) hours of cabinet-approved Orientation I & II training on 04/11/23; therefore, the training was not completed within the three (3) months of employment. 7. A staff's (DOH: 11/01/22) file contained documentation of completing the six (6) hours of cabinet-approved Orientation I & II training on 05/28/23; therefore, the training was not completed within the three (3) months of employment. 8. A staff's (DOH: 07/29/22) file contained documentation of completing the six (6) hours of cabinet-approved Orientation I & II training on 01/30/23; therefore, the training was not completed within the 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 12. Toilet, Diapering, and Toiletry Requirements.

General: Based on observation, the surveyor found that the toilet seat moved easily and was not tightly secured to the toilet located in the second stall in the girls restroom; therefore, the toilet was not kept in good repair. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report 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 6. License Issuance.

General: Based on review of documentation presented, the surveyor found that the center’s liability insurance was no longer current as of 07/01/2021. During interview with a staff, the surveyor was informed that the center's insurance is current; however, verification was not presented during the renewal survey.

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 during a tour of the center, the surveyor found the following: 1. A plunger was stored beside the commode in the classroom for the two-year-old children. The toilet brush and holder were within reach and accessible to the children. 2. A basket with what appeared to be dirty towels was on the floor in the two-year-old restroom. The dirty towels were within reach and accessible to the children. 3. A toilet brush and holder were stored beside the commode in the classroom for the three-year-old children. The toilet brush and holder were within reach and accessible to the children. 4. A box of open baby wipes was stored in the two-year-old restroom. The wipes label indicated the wipes should be kept out of the reach of children. The wipes were within reach and accessible to the children. During interview, staff stated both restrooms will have the items removed or put on a high shelf to keep the items out of the reach of the children. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation presented, the surveyor found the following: 1. A staff’s (DOH: 06/08/2021) file contained a copy of a negative tuberculin result that was no longer current as of 10/21/2021. 2. A staff’s (DOH: 09/21/2008) file contained a copy of a negative tuberculin result that was no longer current as of 12/15/2021. 3. A staff’s (DOH: 03/09/2020) file contained a copy of a negative tuberculin result that was no longer current as of 03/11/2019. During interview, staff stated they were not aware of staff not having updated tb results.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Based on review of documentation presented, the surveyor found the following: 1. A staff member (DOH: 04/15/2019) last completed the one and one half (1 ½) hours of pediatric abusive head trauma training (PAHT) on 05/26/2016. 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. No verification was found that a staff (DOH: 12/02/2021) completed six (6) hours of cabinet-approved orientation training. 3. No verification was found that a staff (DOH: 07/01/2021) completed six (6) hours of cabinet-approved orientation training. 4. No verification was found that a staff (DOH: 07/29/2021) completed six (6) hours of cabinet-approved orientation training. During interview, staff was not aware that staff needed to complete PAHT training. 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 during a tour of the center, the surveyor found the following: 1. The lesson plan posted in the Toddler room was dated for 04/18/2022 through 04/22/2022; therefore, the lesson plan was not current. 2. The lesson plan posted in the three-year-old room was dated for 04/18/2022 through 04/22/2022; therefore, the lesson plan was not current. During interview, staff stated the updated lesson plans will be updated weekly. Premises In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation 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 presented, the surveyor found a child's (DOE: 09/11/2020) file contained an immunization certificate that was no longer current as of 11/09/2021. Staff reported this was the most recent immunization certificate that was provided to the childcare center. Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, the surveyor found one (1) staff member providing care for seven (7) children in the Infant Classroom for approximately two (2) minutes. During interview with staff, the surveyor learned that the youngest child was three (3) months old; therefore, the staff-to-child ratio was not maintained and was exceeded by two (2) children. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 4 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 observation, the surveyor found bottles of hand soap in both the boys and girls restroom that were marked "Keep Out of Reach of Children." The hand soap was accessible to the children; therefore, the children's health and safety was compromised. Director Requirements In Compliance Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor was unable to find verification that staff (DOH: 1/5/2019) completed six (6) hours of cabinet-approved orientation training or one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training. During interview, staff-in-charge stated that the employee was not very computer oriented and that she was scheduled to come in on Friday (6/25/2021) for computer assistance so that she could complete the training. 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 6. Sleeping and Napping Requirements.

General: Based on observation, a loose blanket was placed over a sleeping infant in the Infant Classroom. Premises Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A toilet in the girls restroom was not flushed and contained feces. 2. A toilet in the boys restroom was not flushed and contained a large amount of toilet paper. Therefore, the toilets were not kept clean. 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, a staff member in the Infant Classroom wiped a child's hands with a diaper wipe after changing the child's diaper and did not wash the child's hands with liquid soap and warm water; therefore, the staff failed to clean the child's hands with liquid soap and warm water as required.

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 debris under the diaper changing pad, located on the diaper changing table, in both the boys and girls restroom; therefore, the diaper changing surface was not clean. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation In Compliance Food Service/Food Program In Compliance Food Service Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the refrigerator freezer located in the Infant Classroom did not contain a thermometer; therefore, the surveyor was unable to determine if the temperature was maintained at zero (0) degrees Fahrenheit or below as required. During interview, staff stated that she thought there was a thermometer in the freezer, but was unable to locate one. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 4 Inspection Report 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 the files presented for review for two children (DOE: 5/3/2021) and (DOE: 5/1/2021) did not contain the name or telephone number for the preferred hospital; therefore, the child-care center failed to maintain children's records. 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 and review of documentation, the surveyor determined that the center did not have a procedure to ensure compliance with and inform child care staff of the laws of the Commonwealth pertaining to child abuse or neglect set forth in KRS 620.030. Upon reviewing center policies, the surveyor found that the only Child Abuse & Neglect policy that the center had only addressed the Director's responsibilities as related to staff being suspected of abuse or neglect. Staff stated that she was not aware of the center having any other policy relating to abuse & neglect. Director Requirements Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation and interview, the surveyor found that the lid to the toilet tank in the restroom off of the Three's Classroom did not fit properly. The lid was loosely sitting on top of the tank; therefore, the lid could be easily knocked off and injury a child. Staff was not aware that the lid to the tank did not fit. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of documentation, the surveyor found the following: 1. A staff file (DOH: 4/8/19) did not contain documentation of a negative tuberculin skin test within the past two (2) years. 2. A staff file (DOH: 5/21/19) did not contain documentation of a negative tuberculin skin test within the past two (2) years. Staff stated that both staff members had obtained a tuberculin skin test; however, she did not locate documentation at time of inspection.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on interview and review of ECE-TRIS, the following were found: 1. A staff file (DOH: 6/11/10) presented for review only contained documentation of six (6) hours of annual training for 6/11/18 - 6/10/19. Review of ECE-TRIS confirmed that the staff member had only completed six (6) hours of annual training. 2. A staff file (DOH: 2/15/18) presented for review only contained documentation of six and a half (6.5) hours of annual training for 2/15/18 - 2/14/19. Review of ECE-TRIS confirmed that the staff member had only completed six and a half (6.5) hours of annual training. 3. A staff file (DOH: 10/1/08) presented for review contained documentation of zero (0) hours of annual training for 10/1/17 - 9/30/18. Review of ECE-TRIS confirmed that the staff member had not completed any annual training. 4. A staff file (DOH: 3/21/16) did not contain documentation of having completed Pediatric Abusive Head Trauma (PAHT) training. Review of ECE-TRIS, revealed that the staff person had not completed PAHT training. 5. A staff file (DOH: 1/5/19) did not contain documentation of the completion of six (6) hours of orientation. Review of ECE-TRIS revealed that orientation had not been completed. Upon interview, staff stated that she was new to her position and was not aware of the training descrepancies. 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 and interview, the surveyor found the following: 1. A swiffer wet mop, broom, & dustpan were leaning against the wall in the restroom off of the Two's Classroom. The items were accessible to the children. 2. A broom, dustpan, and toilet plunger were leaning against the wall of the restroom off of the Three's Classroom. The items were accessible to the children. Staff were not aware that the items 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 3. General Requirements.

General: Based on observation and interview, the surveyor found that a pair of non safety scissors had been placed on the table in Room Nine where they were accessible to the children. Staff had recently used the scissors and failed to put them away prior to taking the children outside. Hygienic Practices In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report 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

Open / not marked corrected.

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

General: Based on interview and review of documentation, the surveyor found that a child's file had not been maintained for five (5) years. The Director reported that all children's enrollment packets and files had recently been updated for the new 2019 - 2020 school year. The Director was not able to locate a child's file or enrollment packet from the previous school year when the child was enrolled.

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: 6/8/18) file contained a negative tuberculin result dated 11/7/01; therefore, the test is no longer current. The director confirmed that the staff works for the school system and the tuberculin result dated 11/7/01 is the most recent one on 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 and ECE - TRIS, the surveyor found the following: (1.) Staff (DOH: 6/1/17) obtained seven and one - half (7 1/2) of the required fifteen (15) hours of cabinet - approved early care and education training. (2.) Staff (DOH: 6/1/17) obtained orientation training on 4/19/18. The training was not obtained during the staff's first three (3) months of employment. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: (1.) A child's (DOE: 7/17/17) file did not contain a preferred hospital's telephone number. (2.) A child's (DOE: 8/5/15) file did not contain a preferred hospital's telephone number. (3.) A child's (DOE: 11/13/17) file did not contain a preferred hospital's telephone number. (4.) A child's (DOE: 9/2/17) file did not contain a preferred hospital's telephone number. (5.) A child's (DOE: 3/27/16) file did not contain a preferred hospital's telephone number. (6.) A child's (DOE: 9/13/17) file did not contain a preferred hospital's telephone number. (7.) A child's (DOE: 5/11/17) file did not contain a preferred hospital's telephone number. (8.) A child's (DOE: 4/13/15) file did not contain a preferred hospital's telephone number. (9.) A child's (DOE: 7/7/17) file did not contain a preferred hospital's telephone number. 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 2:110 · 922 KAR 2:110. Section 5. Staff Requirements.

General: Based on review of documentation, review of ECE-TRIS, and interview, the following were found: 1. A staff file (DOH: 4/14/16) presented for review did not contain documentation that Pediatric Abusive Head Trauma had been completed within the first year of employment. Review of ECE-TRIS revealed that Pediatric Abusive Head Trauma had not been completed. 2. A staff file (DOH: 4/14/16) presented for review contained documentation that state required orientation had been completed 4/4/17; therefore, it was not completed within the three (3) months of employment. Review of ECE-TRIS confirmed that orientation had been completed on 4/4/17. 3. A staff file (DOH: 6/11/10) presented for review only contained documentation of seven and a half (7.5) hours of training being completed for 6/11/15 - 6/10/16. Review of ECE- TRIS revealed that the staff member had completed thirteen and a half (13.5) hours of annual training for 6/11/15 - 6/10/16. The Director reported that the staff member was enrolled in college classes that counted toward her training hours; however, she did not have a college transcript on file. 4. A staff file (DOH: 12/1/09) presented for review only contained documentation of six (6) hours of training being completed for 12/1/15 - 11/30/16. Review of ECE-TRIS revealed that the staff member had completed six (6) hours of annual training for 12/1/15 - 11/30/16. The Director reported that the staff member was enrolled in college classes that counted toward her training hours; however, she did not have a college transcript on file. 5. A staff file (DOH: 3/16/16) presented for review only contained documentation of eight (8) hours of training being completed for 3/16/16 - 3/15/17. Review of ECE-TRIS revealed that the staff member had completed eight (8) hours of annual training for 3/16/16 - 3/15/17. The Director reported that the staff member was enrolled in college classes that counted toward her training hours; however, she did not have a college transcript on file. 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 2. Child Care Services.

General: Based on observation and interview, the following were found: 1. A current lesson plan was not posted in Room Nine. Staff stated they had not printed the updated lesson plan off yet. 2. A current lesson plan was not posted in the Three's Classroom. The Director was not able to locate the lesson plan at time of inspection. 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 following were found: 1. There were two (2) bags/purses on the floor next to the counter in Room Six. Staff confirmed that the bags/purses were staff belongings. 2. The were two (2) tubes of diaper ointment, a spray bottle containing disinfectant cleaner, and a spray can of disinfectant spray in the unlocked cabinet under the diaper changing station in the girls' restroom. The Director reported that the cabinet is supposed to be locked. 3. There was a candle in a glass jar and loose plastic bags in the unlocked cabinet under the sink in the Three's Classroom. The Director reported that the cabinet is supposed to be locked.

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 a significant amount of toilet paper was in the floor of the girls' restroom. The Director and Janitor reported that the restrooms are cleaned three (3) times per day. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 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 surveyor found that children's belongings were hanging on hooks underneath the cubbies in the Toddler Classroom. The children's individual items were touching presenting a risk of cross contamination. The Director was not aware that the children's individual items should not be touching.

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 review of documentation and interview, the surveyor found that the staff were not following the proper methods posted in the classroom for sanitizing the infant's mouth contact toys. Staff reported that the mouth contact toys are washed in a bleach solution with a washcloth or sponge. Upon further questioning the staff member reported that soapy water is also utilized to was the toys prior to allowing them to air dry. First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation 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 and interview, the surveyor found that there was not a thermometor in the milk cooler located in the cafeteria. Cafeteria staff reported that the thermometor may have been taken out by mistake when the milk was delivered. Children's Records In Compliance Written Documentation In Compliance Posted 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 2. General.

General: Based on observation and interview, the surveyor found that the Consumer Product Safety information was not posted in the center. The Director reported that the the information is usually posted with the center's license; however, it may have been taken down so an updated one could be posted. Animals 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, the surveyor found the following: 1. A staff member (DOH: 10/17/14) did not complete the required one and one-half (1 ½) hours of Pediatric Abusive Head Trauma training within the first year of employment. A review of ECE-TRIS shows the training was completed on 5/26/16. 2. A staff member (DOH: 3/3/15) did not complete the required one and one-half (1 ½) hours of Pediatric Abusive Head Trauma training within the first year of employment. A review of ECE-TRIS found no additional Pediatric Abusive Head Trauma training documentation for the staff member. 3. A staff member (DOH: 5/1/15) did not complete the required one and one-half (1 ½) hours of Pediatric Abusive Head Trauma training within the first year of employment. A review of ECE-TRIS shows the training was completed on 5/26/16. 4. A staff member (DOH: 5/1/15) did not complete the required six hours of Orientation within three (3) months of employment. A review of ECE-TRIS documentation shows the training was completed on 3/24/16.

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 child care center, the surveyor found the following items accessible to children: 1. A laundry basket containing soiled clothing was placed in the floor of the two-year-old classroom’s bathroom. 2. A broom and dustpan was placed beside the sink in the three-year-old classroom. 3. A broom was placed beside the sink in the three & four-year-old classroom I. 4. A mop and bucket was placed near the sink in the three & four-year-old classroom II. The bucket was empty.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the following issues were found: 1) An employee (DOH 03/23/13) file presented for review did not contain an annual performance evaluation as required by regulations. 2) An employee (DOH 11/30/07) file presented for review contained an annual performance evaluation dated 03/03/10; therefore, the evaluation had not been updated annually as required.

Open Not marked corrected in the state record

Category: recordkeeping. 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 03/23/13) record presented for review did not contain evidence of educational verification as required by regulations.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the following issues were found: 1) An employee (DOH 03/23/13 ) record presented for review contained negative tuberculin verification dated 03/25/13 which was no longer valid. 2) An employee (DOH 11/30/07) record presented for review contained negative tuberculin verification dated 03/27/13 which was no longer valid. 3) An employee (DOH 07/15/11) record presented for review contained negative tuberculin verification dated 01/09/13 which was no longer valid.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the following issues were found: 1) An employee (DOH 03/23/13) record did not contain evidence of the employee completing six (6) hours of cabinet-approved orientation based on the file presented for review. During an interview with the director, she confirmed that the employee had not completed orientation. 2) An employee (03/23/13) record did not contain evidence of the employee receiving any training hours based on the file presented for review. During an interview with the director, she confirmed that the employee was a substitute and had not completed required training hours. 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 8. Kitchen Requirements.

General: Based on observation of the Infant room, five (5) bottles were not individually labeled as required by regulations.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the following issues were found: 1) A child's (DOE 08/07/13) record presented for review did not contain completed preferred hospital contact information required in the event of an emergency. 2) A child's (DOE 01/03/11) record presented for review did not contain completed preferred hospital contact information required in the event of an emergency. 3) A child's (DOE 02/04/14) record presented for review did not contain completed preferred hospital contact information 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 3. Records.

General: Based on review of documentation, the following issues were found: 1) An employee (DOH 03/23/13) file presented for review did not contain a written professional development as required by regulations. 2) An employee (DOH 11/30/07) file presented for review contained a professional development plan dated 04/13/10; therefore, the plan had not been updated annually as required.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation of the Three's room, the lesson plan of activities was dated 04/20/15-04/24/15; therefore, the posted lesson plans were not maintained up-to-date as required by regulations.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, a used toilet bowl plunger was located next to the toilet in the restroom used by the children in the Three's Room.

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 ceiling tile in the restroom located in the Toddler Room was unsecured in one (1) corner and along two (2) sides.

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 review of documentation, the center's toy sanitization procedure consisted of spraying the toys with warm soapy water, wiping them with a clean cloth, spraying them with bleach and water solution and allowing the solution to remain on the toys for thirty (30) seconds to two (2) minutes prior to allowing them to air dry. This procedure does not meet the regulatory requirements. First Aid/Medication

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 front of a storage building was located inside the fenced playground area. The building was approximately one foot (1') above the ground and because the space underneath the building was not underpinned, it was accessible to 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 on the playground, the following were found: 1) One (1) pedal was missing on each of two (2) tricycles. 2) The bar assemblies from the handle bars to the front wheels were loose on two (2) tricycles. 3) The paint was chipped on three (3) tricycles.

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 statement of deficiency issued by the cabinet and the plan of correction submitted by the child-care center to the cabinet during the current licensure year were not posted as required.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, evaluations were not presented for review for two (2) staff members (dates of hire - 2/7/11 and 2/9/12).

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, used toilet bowl plungers were on the floor beside toilets in both children's restrooms located in the hallway and in the restroom located in the Two's Room.

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 following were found during the visit: 1) The file for a staff member (date of hire - 5/25/12) who is not yet eighteen (18) years old, was presented for review. The file included a Child Abuse and Neglect (CAN) check that was dated 2/8/13 and the signature date was 1/11/13. Two (2) Central Office receipt dates (1/16/13 and 2/5/13) were stamped on the front of the CAN check. The director stated during interview that the CAN check was submitted but that it was returned for parent signature as explanation of the 1/16/13 stamp date. The parent signed the CAN check and it was resubmitted as explanation of the 2/5/13 stamp date. Therefore, the CAN check for this staff member was not submitted in accordance with 922 KAR 1:470. 2) The file for a staff member (date of hire - 12/5/12) was presented for review. The file did not include a criminal records check (CRC). The director stated that the center did not conduct a CRC because this staff member is currently enrolled in high school and she thought the school was required to do the CRCs. 3) Three (3) staff members were present in different classrooms and providing child care during the visit. Other staff members were in each of the classrooms so that these three (3) staff members were not working alone with children. However, files including CAN checks and CRCs were not presented for review for these staff members. NOTE: This regulatory violation was not identified until after the survey visit was concluded and a comparison was made between staff records that were presented for review at the time of the visit and staff who were in classrooms during the visit. A call was made back to the center and the director stated that files were maintained for these staff members. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 6 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, three (3) staff members were present in different classrooms and providing child care during the visit. However, files including CAN checks and CRCs were not presented for review for these staff members. Other staff members were in each of the classrooms so that these three (3) staff members were not working alone with children. NOTE: This regulatory violation was not identified until after the survey visit and a comparison was made between staff records that were reviewed at the time of the visit and staff who were in classrooms during the visit. A call was made back to the center and the director stated that files were maintained for these staff members.

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, three (3) staff members were present in different classrooms and providing child care during the visit. Other staff members were in each of the classrooms so that these three (3) staff members were not working alone with children. However, files were not presented for review for these staff members. NOTE: This regulatory violation was not identified until after the survey visit and a comparison was made between staff records that were reviewed at the time of the visit and staff who were in classrooms during the visit. A call was made back to the center and the director stated that files were maintained for these staff members.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the following were found: 1) Three (3) staff members were present in different classrooms and providing child care during the visit. However, files were not presented for review for these staff members. Other staff members were in each of the classrooms so that these three (3) staff members were not working alone with children. NOTE: This regulatory violation was not identified until after the survey visit and a comparison was made between staff records that were reviewed at the time of the visit and staff who were in classrooms during the visit. A call was made back to the center and the director stated that files were maintained for these staff members. However, since files were not presented for review for these staff members during the visit, the surveyor could not determine that the center met this regulatory requirement. 2) Documentation that a staff member is currently enrolled in high school was not presented for a a staff member (date of hire - 12/5/12). An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 7 of 26 Web site: http://chfs.ky.gov/ Inspection Report

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, three (3) staff members were present in different classrooms and providing child care during the visit. However, files were not presented for review for these staff members. Other staff members were in each of the classrooms so that these three (3) staff members were not working alone with children. NOTE: This regulatory violation was not identified until after the survey visit and a comparison was made between staff records that were reviewed at the time of the visit and staff who were in classrooms during the visit. A call was made back to the center and the director stated that files were maintained for these staff members. However, since files were not presented for review for these staff members during the visit, the surveyor could not determine that the center met this regulatory requirement.

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, staff did not complete cabinet-approved orientation or early care and education training as follows: 1) Only eight (8) hours of training was presented for two (2) staff members (dates of hire - 10/1/02 and 6/11/10). 2) Only seven and one/half (7 1/2) hours of training was presented for review for a staff member (date of hire - 6/11/10). 3) No documentation of orientation training and child development training was presented for review for a staff member (date of hire - 2/9/12). 4) No orientation training was presented for review for three (3) staff members (dates of hire - 2/9/12, 5/25/12 and 12/5/12). 5) Files were not presented for review for three (3) staff members who were present and providing child care during the visit. NOTE: This regulatory violation was not identified until after the survey visit and a comparison was made between staff records that were reviewed at the time of the visit and staff who were in classrooms during the visit. A call was made back to the center and the director stated that files were maintained for these staff members. However, since files were not presented for review for these staff members during the visit, the surveyor could not determine that the center met this regulatory requirement. 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 the background checks as described in 922 KAR 2:110; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; 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 4. Premises Requirements.

General: Based on observation, a ceiling tile was unsecured on two (2) sides in the restroom located in the Two's 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 following foreseeable hazards were observed: 1) Five (5) swings were approximately two feet (2') above the ground and were too high for small children to safely use. 2) Landscape fabric was exposed through the mulch in two (2) areas creating safety hazards. 3) A tree was in the middle of the small playground and several of the branches were hanging approximately three feet (3')above the ground and within the children's direct line of play.

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, an uncovered sandbox was on the playground. No one was using the playground at the time of the visit.

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 thermometer in the freezer in the Two's Room was embedded in ice with only one (1) end exposed. Therefore, the surveyor could not determine that the temperature was maintained at zero (0) degrees Fahrenheit as required.

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, professional development plans for two (2) staff members (dates of hire - 2/7/11 and 2/9/12) were not presented for review.

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, a daily schedule was not posted in Classroom #9.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, a lesson plan was not posted in Room #9.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Nursery: Based on observation, three (3) infants were sleeping in cribs with thin blankets covering their faces. Staff stated during interview that the youngest child was six (6) months old and the oldest child was nine (9) months old. General Premises 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 279 - Toilet Room 922 KAR 2:120 - Section 10 (2) A toilet room shall: (a) 1. Be provided for each gender; or 2. A plan shall be implemented to use the same toilet room at separate times; (b) Have a supply of toilet paper; and (c) Be cleaned and sanitized daily. 3) Clean/Sanitized In Compliance 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 281 - Toilet 922 KAR 2:120 - Section 10 (4) Each toilet shall: (a) Be kept in clean condition; (b) Be kept in good repair; (c) Be in a lighted room; and (d) Have ventilation to outside air. 1) Clean 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)

Three-Year-Old Room: Based on observation, the surveyor found the following: 1). A toilet plunger was found in the bathroom accessible to the children. 2) The garbage can was located directly below the automatic paper towel dispenser. The paper towel that the children use to dry their hands was touching the top and inside of the garbage can. Two-Year-Old Room: Based on observation, there was a broom, dust pan, and toilet plunger located in the bathroom accessible to the children. Toddler Room: Based on observation, there was a broom and dust pan found in the bathroom accessible to the children. Room 6: Based on observation, the surveyor found that a toddler-size toilet seat in the Boys' Restroom had been placed on the diapering pad located on the diapering surface. The toddler-size toilet seat had a dried brown substance around the backside of the seat along the rim. The toddler-size toilet seat was accessible to the children. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 12 of 44 Web site: http://chfs.ky.gov/ Inspection Report 191 - Inaccessible Items 922 KAR 2:120 - Section 3 (7) The following shall be inaccessible to a child in care: (a) Toxic cleaning supplies, poisons, and insecticides; (b) Knives and sharp objects; (c) Matches, cigarettes, lighters, and flammable liquids; (d) Plastic bags; (e) Litter and rubbish; (f) Bar soap; and (g) Personal belongings of staff. 1) Toxic cleaning supplies, poisons, and insecticides Not In Compliance Findings: Room 6: Based on observation during a tour of Room #6, the surveyor found four (4) bottles of Liquid Paper and two (2) bottles of bonding cement in an unlocked drawer located on the counter. The manufacturer’s instructions on the four (4) bottles of Liquid Paper and two (2) bottles of bonding cement stated to "Keep out of reach of children". 2) Knives and sharp objects Not In Compliance Findings: Room 6: Based on observation during a tour of Room #6, the surveyor found nine (9) pairs of sharp-pointed scissors and four (4) hole punches in an unlocked drawer that was located on the counter. The nine (9) pairs of scissors and (4) hole punches were accessible to the children. 4) Plastic bags Not In Compliance Findings: Room 6: Based on observation during a tour of Room #6, the surveyor found four (4) empty plastic bags located in an unlocked drawer in the file cabinet. The four (4) empty plastic bags found in the unlocked drawer were within reach and accessible to the children. 7) Personal belongings of staff Not In Compliance Findings: Three-Year-Old Room: Based on observation, there was an employee's purse hanging on a hook in the bathroom used by the children and 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. 3) Matches, cigarettes, lighters, and flammable liquids In Compliance 5) Litter and rubbish In Compliance 6) Bar soap 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 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: Three-Year-Old Room: Based on observation, the sink faucet in the bathroom was corroded and contained a green and brown residue on and around the faucet. Two-Year-Old Room: Based on observation, the sink in the bathroom used by the children contained a green residue around the sink faucet and around the drain. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 13 of 44 Web site: http://chfs.ky.gov/ Inspection Report 3) Good repair Not In Compliance Findings: Room 6: Based on observation during a tour of Room #6, the surveyor found a metal wall that contained rust along the side and bottom in a stall located in the boys' restroom. 200 - Building Requirements 922 KAR 2:120 - Section 4 (4) The building shall be constructed to ensure the: (a) Building is: 1. Dry; 2. Adequately heated; 3. Ventilated; and 4. Well lit, including clean light fixtures: a. That are in good repair in all areas; and b. Shielded or have shattered proof bulbs installed; and 1) Dry In Compliance 2) Adequately heated In Compliance 3) Adequately ventilated In Compliance 4) Well Lit In Compliance 5) Clean Light Fixtures In Compliance 6) Lights good repair In Compliance 7) Shielded/shatter proof bulbs In Compliance 201 - Protected Items 922 KAR 2:120 - Section 4 (4) (b) Following are protected: 1. Windows; 2. Doors; 3. Stoves; 4. Heaters; 5. Furnaces; 6. Pipes; and 7. Stairs. 1) Windows In Compliance 2) Doors In Compliance 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 11

Toddler Room: Based on interview, the mouth contact toys are not being scrubbed with soap, water, and a brush nor are they being soaked in a sanitizing solution for at least two (2) minutes. 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 247 - Daily written request for prescription Not Applicable 922 KAR 2:120 - Section 7 (4) Prescription medication shall not be administered to a child in care, without a daily written request of the parent. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 23 of 44 Web site: http://chfs.ky.gov/ Inspection Report 248 - Nonprescription medication protocol Not Applicable 922 KAR 2:120 - Section 7 (5) Nonprescription medication: (a) May be given to a child only with the written daily request of the: 1. Parent; or 2. Person exercising custodial control of the child; and (b) Shall be administered according to the instructions on the label. 248 - Nonprescription medication protocol 922 KAR 2:120 - Section 7 (5) Nonprescription medication: (a) May be given to a child only with the written daily request of the: 1. Parent; or 2. Person exercising custodial control of the child; and (b) Shall be administered according to the instructions on the label. 1) Written daily request In Compliance 2) Administered according to label In Compliance 249 - Administration Record Not Applicable 922 KAR 2:120 - Section 7 (6) The child-care center shall keep a written record of the administration of medication, including: (a) Time; (b) Date; (c) Amount; and (d) Name of staff person giving the medication. 249 - Administration Record 922 KAR 2:120 - Section 7 (6) The child-care center shall keep a written record of the administration of medication, including: (a) Time; (b) Date; (c) Amount; and (d) Name of staff person giving the medication. 1) Time Not In Compliance Findings: Two-Year-Old Room: Based on interview and review of documentation, the time of day that diaper rash cream is applied to a child is not documented. Toddler Room: Based on interview and review of documentation, the time of day that diaper rash cream is applied to a child is not documented. 2) Date Not In Compliance Findings: Two-Year-Old Room: Based on interview and review of documentation, the date that diaper rash cream is applied to a child is not documented. Toddler Room: Based on interview and review of documentation, the date that diaper rash cream is applied to a child is not documented. 3) Amount Not In Compliance Findings: Two-Year-Old Room: Based on interview and review of documentation, the amount of diaper rash cream applied to a child is not documented. Toddler Room: Based on interview and review of documentation, the amount of diaper rash cream applied to a child is not documented. 4) Staff name Not In Compliance Findings: Two-Year-Old Room: Based on interview and review of documentation, the name of the staff applying diaper rash cream to a child is not documented. Toddler Room: Based on interview and review of documentation, the name of the staff applying diaper rash cream to a child is not documented. 250 - Medication Storage Not Applicable 922 KAR 2:120 - Section 7 (7) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child; (b) Kept in the original bottle; and (c) Properly labeled. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 24 of 44 Web site: http://chfs.ky.gov/ Inspection Report 250 - Medication Storage 922 KAR 2:120 - Section 7 (7) Medication, including refrigerated medication, shall be: (a) Stored in a separate and locked place, out of the reach of a child; (b) Kept in the original bottle; and (c) Properly labeled. 1) Separate and locked In Compliance 2) Original Bottle In Compliance 3) Labeled In Compliance

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

General: Based on review of documentation, the records for two (2) employees (DOH: 2/27/12 and 2/9/12) did not contain documentation for education verification.

Open Not marked corrected in the state record

Open / not marked corrected.

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

Nursery: Based on observation, an employee (DOH: 9/21/08) did not use a wipe to clean the affected area when diapering a child.

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.

Room 6: Based on observation, the mats in use by the children at nap time were approximately one (1) inch thick; therefore, they did not meet the regulatory requirement that states that mats used at naptime must be at least two (2) inches thick. 237 - Crib Mattress/Standards Not Applicable 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. 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. 1) Mattress In Compliance 2) Meets Standards In Compliance 238 - Sheets/Covers 922 KAR 2:120 - Section 6 (3) Individual sheets and covers shall be: (a) Provided for a child; (b) Laundered a minimum of once per week or more often, if necessary; and (c) Stored in a sanitary manner. 1) Provided In Compliance 2) Laundered In Compliance 3) Sanitary Storage In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 6

Room 6: Based on observation, the surveyor found that the mats being used by the children were not labeled. Through interview with a staff, the surveyor learned that the mats are sanitized weekly; therefore, they are not properly sanitized within regulatory requirements.

Open Not marked corrected in the state record

Open / not marked corrected.

922 KAR 2:120 · 922 KAR 2:120 - Section 6

Room 6: Based on observation, the vinyl covering was torn on two (2) mats being used by children; therefore, the mats were not in good repair. 294 - Toys/Equipment/Furniture 922 KAR 2:120 - Section 11 (1) All toys, equipment, and furniture contacted by a child shall be: (a) Kept clean and in good repair and (b) Free of peeling, flaking, or chalking paint. 1) Clean In Compliance 2) Good repair In Compliance 3) Free from peeling, flaking, chalking paint In Compliance 295 - Indoor/outdoor Equipment 922 KAR 2:120 - Section 11 (2) Indoor and outdoor equipment shall: (a) Be clean, safe, and in good repair; (b) Meet the physical, developmental needs, and interests of children of different age groups; (c) Be free from sharp points or corners, splinters, protruding nails or bolts, loose or rusty parts, hazardous small parts, lead-based paint, poisonous material, and flaking or chalking paint; and (d) Be designed to guard against entrapment or situations that may cause strangulation. 1) Clean In Compliance 2) Safe In Compliance 3) Good repair In Compliance 4) Meets needs In Compliance 5) Free from harmful conditions In Compliance 6) Guard against entrapment/strangulation In Compliance 296 - Toys 922 KAR 2:120 - Section 11 (3) Toys shall be: (a) Used according to the manufacturer's safety specifications; (b) Durable; and (c) Without sharp points or edges. 1) Used according to manufacturers specifications In Compliance 2) Durable In Compliance 3) No sharp points/edges 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 following was found: 1). The records for three (3) children (DOE: 5/29/09, 7/25/11, and 11/30/11) contained immunization ceritificates that were no longer current. 2). The record for a child (DOE: 10/4/11) did not contain an immunization ceritificate. 99 - Documentation for Off Premise Trip Not Applicable 922 KAR 2:110 - Section 3 The following records shall be maintained at the child-care center for five (5) years: (4) Permission forms for each trip off the premises signed by the parent; Written Documentation 93 - Policies and Procedures 922 KAR 2:110 - Section 2 (5) Program policies and procedures shall: (a) Be in writing; and (b) Include: 1. Staff policies; 2. Job descriptions; 3. An organization chart; 4. Chain of command; and 5. Other procedures necessary to ensure implementation of: a. KRS 199.898, Rights for children in child-care programs and their parents, custodians, or guardians - posting and distribution requirements; b. 922 KAR 2:090, Child-care center licensure; c. 922 KAR 2:120, Child-care center health and safety standards; and d. This administrative regulation. 1) Writing In Compliance 2) Staff Policies In Compliance 3) Job Description In Compliance 4) Organization Chart In Compliance 5) Chain of Command In Compliance 6) Other Procedures-a) Rights for Children b)922 KAR 2:090 c) 922 KAR 2:110 d)922 KAR 2:120 In Compliance 100 - Daily Attendance Records 922 KAR 2:110 - Section 3 (5) Daily attendance records documenting the arrival and departure time of each child; 1) Arrival Not In Compliance Findings: General: Based on review of documentation, arrival times for three (3) children were not documented on 5/29/12. 2) Departure Not In Compliance Findings: General: Based on review of documentation, departure times for two (2) children were not documented on 5/24/12 and 5/25/12.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.