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

General: Based on observation, the surveyor found the following: Four/Fives #1 Classroom: 1. There was an electrical outlet that was missing a protective cover beside a white bookshelf. Four/Fives #2 Classroom: 1. There was an electrical outlet that was missing a protective cover beside the door. Therefore, the health, safety and comfort of the children was compromised. Director Requirements In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 3 Inspection Report Employee Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and ECE-TRIS, the surveyor found the following one (1) staff member (DOH: 08/01/13) completed nine (9) hours of the required fifteen (15) hours of cabinet-approved early care and education training completed between 07/01/22 - 06/30/23. 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 the following: 1. The hot water temperature of two (2) sinks in the girls' restroom located off from the hallway had a temperature reading of approximately one hundred twenty-six (126) degrees Fahrenheit; therefore, the hot water was not a minimum temperature of ninety (90) degrees Fahrenheit and a maximum of one hundred twenty (120) degrees Fahrenheit. 2. The hot water temperature of two (2) sinks in the boys' restroom located off from the hallway had a temperature reading of approximately one hundred twenty-six (126) degrees Fahrenheit; therefore, the hot water was not a minimum temperature of ninety (90) degrees Fahrenheit and a maximum of one hundred twenty (120) degrees Fahrenheit. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following on the Toddler Playground: 1. A blue/green Little Tykes slide was observed to be placed on an area that contained grass. 2. A blue/orange Little Tykes slide was observed to be placed on an area that contained grass. 3. A climbing structure with a pink slide was observed to be placed on an area that contained grass. 4. A wooden swing set that contained two (2) baby swings and one (1) regular swing was observed to placed on an area that contained grass. Therefore, the equipment mentioned did not have an adequate protective surface. Equipment In Compliance Transportation In Compliance 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 In Compliance Children's Records Not In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found the following: 1. A child’s (DOE: 08/07/23) file did not contain a contact telephone number for the child’s preferred family physician. 2. A child’s (DOE: 08/07/23) file did not contain a contact telephone number for the child’s preferred hospital. 3. A child’s (DOE: 08/07/23) file did not contain the name of the child’s preferred hospital or the hospital's contact 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 2:090 · 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 (DOH: 08/22/2013) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma (PAHT) training on 04/09/2018; therefore, PAHT was not completed once every five (5) years. 2. A staff (DOH: 08/01/2013) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma (PAHT) training on 03/14/2018; therefore, PAHT was not completed once every five (5) years. Staff reported the staff have completed PAHT. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor observed the exhaust fan contained a thick layer of dust in the girl's restroom. Staff reported that she would have the exhaust fan cleaned.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on observation, the surveyor discovered a brown substance on a ceiling tile in the second stall located in the boy's restroom. Staff reported she would have the ceiling tile replaced. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Kitchen Requirements In Compliance Food Service In Compliance Meal Planning/Center Provides Meals In Compliance Meal Planning/Center Does Not Provide Meals Not Applicable Children's Records In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor discovered the following: 1. A staff's (DOH: 01/03/2017) file contained a professional development plan with no date; therefore, the surveyor was unable to verify if the professional development plan was completed annually. 2. A staff's (DOH: 06/11/2019) file contained a professional development plan with no date; therefore, the surveyor was unable to verify if the professional development plan was completed annually. 3. A staff's (DOH: 07/29/2021) file contained a professional development plan with no date or signature; therefore, the surveyor was unable to verify if the professional development plan was completed annually and if the plan was for that staff member. 4. A staff's (DOH: 07/05/2021) file contained a professional development plan with no signature; therefore, the surveyor was unable to verify if the professional development plan was for that staff member. Staff reported she would have the staff date and sign the professional development plans. Posted Documentation In Compliance Animals Not Applicable

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 and review of documentation, the surveyor found the following: 1. A staff’s (DOH: 07/01/20) file did not contain documentation of background checks submitted through the Kentucky National Background Check Service. Based on review of the Kentucky National Background Check Service, the staff person did not have a completed background check as of the date of the survey, 02/17/22. During interview, staff-in-charge stated that the staff person has not worked alone with children. The surveyor did not observe the staff person working alone with children. The staff’s file contained a completed Child Abuse/Neglect Background Check dated 08/27/20 and a completed Criminal Records Background Check dated 06/22/20. 2. A brown cabinet that was pulled out from the wall in the Two Year Old Classroom. The cabinet appeared to have a separate top piece that was placed slightly sideways and did not appear to be secured to the bottom of the cabinet. 3. Three (3) black knives located on a black shelf beside the exit door in the Four-Five Year Old Classroom that appeared to be within reach of the children. 4. A white knife located on a white wooden shelf beside the exit door in the Four-Five Year Old Classroom that appeared to be within reach of the children. The knife was observed placed on top of a small white wire shelf that was placed on the wooden shelf. The classroom was located across from the Sleep/Nap Classroom. 5. Two (2) green/white bottles of Alcohol-Free Foaming Hand Sanitizer placed on a yellow child sized table, two (2) green/white bottles of Alcohol-Free Foaming Hand Sanitizer placed on a red child sized table, and one (1) green/white bottle of Alcohol-Free Hand Sanitizer placed on a brown child sized table in the Four-Five Year Old Classroom that read “Keep Out of the Reach of Children” on the back labels. The classroom was located across from the Sleep/Nap Classroom. 6. A bottle of Soft Soap Antibacterial placed on a brown table in the girls’ restroom located beside the Gym that read “Keep Out of the Reach of Children” on the back label. The soap was observed to be accessible to the children. 7. A bottle of Soft Soap Antibacterial placed on the sink in the girls’ restroom located beside the Gym that read “Keep Out of the Reach of Children” on the back label. The soap was observed to be accessible to the children. 8. One (1) bottle of Soft Soap Antibacterial that read “Keep Out of the Reach of Children” on the back label placed on the sink in the boys’ restroom located next to the Gym. 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: 01/03/17) file contained an annual written performance evaluation dated 07/30/20; therefore, the evaluation was not completed annually. 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 and ECE-TRIS, the surveyor found the following: 1. A staff’s (DOH: 07/01/20) 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 one (1) year of employment. 2. A staff (DOH: 07/01/16) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 07/14/16; therefore, the training was not completed within the last five (5) years. 3. A staff (DOH: 08/16/16) completed one and one-half (1 ½) hours of cabinet-approved pediatric abusive head trauma training on 11/16/16; therefore, the training was not completed within the last five (5) years. Programming In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 5 Inspection Report Premises Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. A container of Disinfecting Wipes that read “Keep Out of the Reach of Children” on the back label and a clear spray bottle that read “Disinfectant Diapering Areas” and stated bleach on the label placed on top of the diaper changing table that was attached to the wall in the girls’ restroom located beside the Gym. 2. Two (2) containers of Disinfecting Wipes placed on a table near the exit door in the Gym that read “Keep Out of the Reach of Children” on the back label. 3. A brown purse placed on the floor beside a brown cabinet in the Two Year Old Classroom. Through interview with staff, the surveyor learned that the purse belonged to a staff person.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the following: 1. Five (5) blue chairs in the boys' restroom located beside the Gym that contained a brown residue that appeared to be dirt/debris; therefore, the chairs were not kept clean. 2. Three (3) blue chairs in the girls' restroom located beside the Gym that contained a brown residue that appeared to be dirt/debris; therefore, the chairs were not kept clean. 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 found a rip/tear in the diaper changing pad and debris on the diaper changing table underneath the diaper changing pad in the Changing Room; therefore, the diaper changing surface was not kept clean or free of holes, rips, tears, or other damage. The diaper changing table was located next to the sink. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 5 Inspection Report First Aid/Medication 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 7. First Aid and Medicine.

General: Based on observation, the surveyor found a First Aid Kit placed on top of a diaper changing table that was attached to the wall in the girls' restroom. The First Aid Kit appeared to be within reach of the children; therefore, the First Aid Kit was not stored out of reach of a child. Outdoor Play Area 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 4. Premises Requirements.

General: Based on observation, the surveyor found the following: 1. Water standing inside four (4) containers located under a wooden play structure on the Preschool Playground that had what appeared to be black plastic bags placed over the containers. 2. The fence around what appeared to be a air/heat unit was broken and no longer attached to the other railing located on the Toddler Playground. The fence was observed to be leaning against the other railing and several cables were located behind the air/heat unit. 3. What appeared to be a vine/brush hanging over a wooden fence railing in the back corner of the Toddler Playground. 4. The top part of a baluster that was detached from a wooden railing and exposing one (1) nail located around what appeared to be an air unit near a gate entrance on the Toddler Playground. 5. A wooden baby gate that was placed in front of a set of steps on the Toddler Playground that lead up to a second level that contained a gap and did not appear to be secured. 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 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

Category: physical safety. 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 staff’s (DOH: 07/01/20) file contained a professional development plan dated for 08/09/20; therefore, the plan was not completed annually. 2. A staff’s (DOH: 08/29/16) file contained a professional development plan that was not dated; therefore, the surveyor was unable to determine that the plan was completed annually. 3. A staff’s (DOH: 08/22/13) file contained a professional development plan that was not dated; therefore, the surveyor was unable to determine that the plan was completed annually. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found a staff's (DOH: 8/29/16) file did not contain an annual written performance evaluation. Employee Records In Compliance Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable 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 An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Emergency Regulation 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 and ECE-TRIS, the surveyor found the following: 1. The surveyor found verification of only fourteen (14) hours of cabinet-approved early care and education annual training for a staff (DOH: 8/22/13). 2. The surveyor found verification of only three (3) hours of cabinet-approved early care and education annual training for a staff (DOH: 7/15/15). 3. The surveyor found verification of only twelve (12) hours of cabinet-approved early care and education annual training for a staff (DOH: 8/16/16). 4. The surveyor found no verification that a staff (DOH: 7/15/15) completed any cabinet-approved early care and education annual training hours. 5. The surveyor found verification of only thirteen (13) hours of cabinet-approved early care and education annual training for a staff (DOH: 7/1/16). 6. The surveyor found no verification that a staff (DOH: 8/29/16) completed any cabinet-approved early care and education annual training hours. 7. The surveyor found verification of only nine (9) hours of cabinet-approved early care and education annual training for a staff (DOH: 1/3/17). Programming In Compliance Premises In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Hygienic Practices 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 In Compliance Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation and review of documentation, the surveyor found the following: 1. The surveyor found no verification that the staff and children at the childcare center practiced an earthquake drill during the second and third quarters of 2019. 2. The surveyor found no verification that the staff and children at the childcare center practiced a tornado drill during the second and fourth quarters of 2019. Posted Documentation In Compliance Animals Not Applicable

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on interview and review of documentation, the files presented for surveyor review, the surveyor found the following: 1. A staff member (DOH: 08/01/13) last completed the one and one half (1 ½) hours of pediatric abusive head trauma training on 12/15/13. A review of the staff member’s file and a review of ECE-TRIS found no additional PAHT training; therefore, the PAHT training is not being completed every five (5) years. 2. A staff member (DOH: 08/01/13) last completed the one and one half (1 ½) hours of pediatric abusive head trauma training on 01/25/14. 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. During interview, the director could not be provide proof of training documentation at the time of the survey. Programming In Compliance Premises In Compliance Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 2 Inspection Report Transportation Not Applicable Food Service/Food Program In Compliance Food Service In Compliance Children's Records In Compliance Written Documentation In Compliance Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Category: 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 surveyor observed a child walking into the lunchroom with out supervision. The Director asked the child where he was going and the child stated he was going to the restroom. Upon interview, the Director stated that the five-year-old children are permitted to walk to the restroom from their classrooms without staff supervising them. 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

Category: supervision. Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that an employee (DOH: 8/1/17) had been permitted to work over the ninety (90) day probationary period without a completed criminal records check for a previous state of residence. Per documentation the out of state criminal record check had been submitted but the results had not yet been returned. Upon interview, the Director reported that the staff member has not been permitted to work alone with the children due to the results of the criminal record check not being returned. 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 2:110 · 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: 3/15/16) contained documentation of completing on seven and a half (7.5) hours of annual training for 3/15/16 - 3/14/17. Review of ECE-TRIS, confirmed that only seven and a half (7.5) hours of training had been completed. 2. A staff file (DOH: 7/1/16) contained documentation of completing on thirteen and a half (13.5) hours of annual training for 7/1/16 - 6/30/17. Review of ECE-TRIS, confirmed that only thirteen and a half (13.5) hours of training had been completed. 3. A staff file (DOH: 8/29/16) contained documentation that six (6) hours of state required orientation training was completed on 1/29/17; therefore, orientation was not completed within the required time frame. Upon interview, the Director reported that some of the training hours may have been completed late and that one (1) of the staff members was on maternity leave for part of her first years 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 3. General Requirements.

General: Based on observation and interview, the surveyor found the following: 1. There were three (3) containers of Clorox Wipes stored in an unlocked cabinet in the Two's Classroom. The Clorox wipes were accessible to the children. Staff reported they must have failed to lock the cabinet back after being in it that morning. 2. There were two (2) unlocked drawers in the Two's Classroom that contained a screw, thumb tacks, paper clips, and a packing tape dispenser that possessed a sharp edge for cutting the tape. The items were accessible to the children. Staff reported that the drawers are supposed to be locked. 3. There was a box of loose white trash bags and one (1) loose black trash bag in the floor of the Five's Classroom beside the doorway. The bags were accessible to the children. 4. There was an unlocked drawer in the desk located in the Math Room that contained thumb tacks which were accessible to the children. Upon interview, the Director stated that staff are aware these items are not supposed to be accessible to the children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found the windows in the Five's Classroom were full of cobwebs and dead insects. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable Food Service In Compliance Children's Records In Compliance An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 3 Inspection Report Written Documentation Not In Compliance

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that a staff file (DOH: 8/22/13) contained an annual professional development plan that was last updated in July of 2016; therefore, it had not been updated annually as required. The Director stated that she must have forgotten to update the professional development plan. Posted Documentation In Compliance Animals In Compliance

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that an employee record presented for review (DOH: 08/01/13) did not contain an annual evaluation. Upon interview, the staff in charge was not aware the evaluation was missing from the employee's file.

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 review of documentation and interview, the file presented for review for an employee (DOH: 08/25/16) did not contain a criminal records check for a previous state of residence. The employee's file did contain record of an FBI check being submitted on 09/02/16; however, the results had not yet been returned. The FBI check was not submitted within five (5) days of the employee's date of hire. The surveyor observed the employee working alone with seven (7) two (2) to three (3) year-old children in the music room. Upon interview, the staff in charge was not aware that the employee did not have all required background checks. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 1 of 6 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 6. License Issuance.

General: Based on review of documentation and interview, the file presented for review for an employee (DOH: 08/25/16) did not contain a criminal records check for a previous state of residence. The employee's file did contain record of an FBI check being submitted on 09/02/16; however, the results had not yet been returned. The FBI check was not submitted within five (5) days of the employee's date of hire. The surveyor observed the employee working alone with seven (7) two (2) to three (3) year-old children in the music room. Upon interview, the staff in charge was not aware that the employee did not have all required background checks.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the child care center failed to maintain personnel files as required: 1. An employee’s (DOH: 03/15/16) TB test was not completed until 07/08/16; therefore, negative tuberculin verification was not obtained prior to employment. Staff in charge stated that the employee had record of a negative turberculin test upon employment at the center; however, the date was not legible. Staff in charge reported that after multiple failed attempts to obtain a legible copy the employee was asked to obtain a new tuberculin skin test. 2. An employee’s (DOH: 07/01/16) TB test was not completed until 07/29/16; therefore, negative tuberculin verification was not obtained prior to employment. Staff in charge stated that the child care center only operates during the school year; therefore, the employee did not work with children until after the negative tuberculin test results were obtained. 3. The surveyor found that the file for one (1) staff (DOH: 08/25/16) did not contain a copy of a negative tuberculin result or a statement from a health professional that the individual is free of active tuberculosis. Staff in charge was not aware that the employee had not obtained a tuberculin skin test. 4. The surveyor found that the files for two (2) staff (DOH: 07/15/15 and 09/27/16) did not contain verification of a High School Diploma, GED, or Commonwealth Child Care Credential. Staff in charge reported that the proof of education for one (1) employee (DOH: 07/15/15) had been submitted; however, she was not aware of where it would be located since it was not in the employee file. 5. The surveyor found that an employee record presented for review (DOH: 08/01/13) did not contain an annual evaluation. Upon interview, the staff in charge was not aware the evaluation was missing from the employee's file. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 2 of 6 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 and interview, the surveyor found that the files for two (2) staff (DOH: 07/15/15 and 09/27/16) did not contain verification of a High School Diploma, GED, or Commonwealth Child Care Credential. Staff in charge reported that the proof of education for one (1) employee (DOH: 07/15/15) had been submitted; however, she was not aware of where it would be located since it was not in the employee 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, the following was found: 1. An employee’s (DOH: 03/15/16) TB test was not completed until 07/08/16; therefore, negative tuberculin verification was not obtained prior to employment. Staff in charge stated that the employee had record of a negative turberculin test upon employment at the center; however, the date was not legible. Staff in charge reported that after multiple failed attempts to obtain a legible copy the employee was asked to obtain a new tuberculin skin test. 2. An employee’s (DOH: 07/01/16) TB test was not completed until 07/29/16; therefore, negative tuberculin verification was not obtained prior to employment. Staff in charge stated that the child care center only operates during the school year; therefore, the employee did not work with children until after the negative tuberculin test results were obtained. 3. The surveyor found that the file for one (1) staff (DOH: 08/25/16) did not contain a copy of a negative tuberculin result or a statement from a health professional that the individual is free of active tuberculosis. Staff in charge was not aware that the employee had not obtained a tuberculin skin test.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that one (1) of the two (2) persons identified as substitutes (DOH: 08/01/13) do not meet the staff requirements of this administrative regulation for a Type One (1) center as the substitute had only obtained six (6) hours of cabinet-approved early care and education annual training hours from 08/01/15 throught 07/31/16. Staff in charge reported that it is difficult getting staff to complete required annual training.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that one (1) of the two (2) persons identified as substitutes (DOH: 08/01/13) do not meet the staff requirements of this administrative regulation for a Type One (1) center as the substitute had only obtained six (6) hours of cabinet-approved early care and education annual training hours from 08/01/15 throught 07/31/16. Staff in charge reported that it is difficult getting staff to complete required annual training. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 3 of 6 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, ECE-TRIS, and interview, the following was found: 1. The surveyor found verification that three (3) staff (DOH: 08/01/13) had obtained only eleven (11) hours of cabinet-approved early care and education annual training. 2. The surveyor found verification that one (1) substitute (DOH: 08/01/13) had obtained only six (6) hours of cabinet-approved early care and education annual training. 3. The surveyor found no verification that a staff (DOH: 07/01/16) had obtained six (6) hours of cabinet-approved orientation training within the first three (3) months of employment. 4. The surveyor found that a staff (DOH: 03/01/16) obtained six (6) hours of cabinet-approved orientation training on 07/05/16; therefore, it had not been completed within three months of the staff's date of hire. 5. The surveyor found that a staff (DOH: 03/15/16) obtained six (6) hours of cabinet-approved orientation training on 10/06/16; therefore, it had not been completed within three months of the staff's date of hire. Staff in charge stated that it is difficult to get staff to complete their required training within required time frames. 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 following was found: 1. There were two (2) pairs of scissors, that were not safety scissors, in a blue craft caddy next to the trash can in the Four's Classroom. The scissors were accessible to children. Staff stated the scissors are supposed to be locked up. 2. There were some large push pins and a staple remover on a shelf over the puzzle area in the Four's Classroom. The shelf was approximatley four (4) feet high; therefore, the items were accessible to the four (4) year-old and five (5) year-old children in the classroom. Staff stated they thought the items were high enough for the children not to reach them. 3. There was one (1) pair of scissors, that were not safety scissors, located in an unlocked drawer next to the nap mats in the Three's Classroom. The scissors were accessible to the children. Staff stated that the drawer is typically locked.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on Observation, and interview, the following was found: 1. There were twelve (12) children observed leaving the Four's Classroom. Upon interview, staff stated that all twelve (12) children were in the Four's Classroom. Per the child care center's diagram, the licensed capacity for the Four's Classroom is ten (10) children; therefore, the capacity of the Four's Classroom was exceeded by two (2) children on the date of the survey. 2. There were twelve (12) children observed in the Three's Classroom. Upon interview, staff stated that twelve (12) children were present in the Three's Classroom. Per the child care center's diagram, the licensed capacity for the Three's Classroom is eleven (11) children; therefore, the capacity of the Three's Classroom was exceeded by one (1) child on the date of the survey. Hygienic Practices In Compliance First Aid/Medication In Compliance Outdoor Play Area In Compliance Equipment In Compliance Transportation Not Applicable An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 4 of 6 Inspection Report 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 temperature for the freezers located in the kitchen, which are used to store frozen food for the children, were reading at ten (10) degrees Fahrenheit and five (5) degrees Fahrenheit. Staff reported that the temperature is checked regularly. Children's Records Not In Compliance

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on review of documentation and interview, the surveyor found that three (3) of the ten (10) children’s records reviewed (DOE: 08/01/16, 08/29/16, and 02/11/16) did not contain the name or contact information of the family’s preferred hospital. Staff in charge stated that they were not aware that the information was missing from the children's files. 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 2. General.

General: Based on observation and interview, the surveyor found that the Children's and Parent's Rights were not posted. Upon interview, the staff in charge stated that the Children's and Parent's Rights had been posted with the child care center's other required postings; however, she was not able to locate them at the time of the inspection. An Equal Opportunity Employer M/F/D @chfsky | CHFS.KY.GOV Page 5 of 6 Inspection Report

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 review of documentation, and interview, the surveyor was not presented with an Orientation Training Policy for the child care center which states that staff will obtain the state required orientation within three (3) months of hire and implement what is learned in the classroom. Staff in charge was not aware of the child care center having such a policy or where it would be located. 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 4. Director Requirements and Responsibilities.

General: Based on observation and interview, the surveyor found that there was not a lesson plan posted in the Infant Classroom. Upon interview, staff stated they had not updated the lesson plan and therefore did not have one 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 4. Director Requirements and Responsibilities.

General: Based on observation of the Two's room, an electrical outlet was found uncovered presenting a safety risk to the children who were present.

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 was found: 1) An employee (DOH 08/01/13) record presented for review contained a performance evaluation dated 01/10/14; therefore, the evaluation was not completed annually as required. 2) Performance evaluations on the following staff were not dated (DOH 08/01/13, DOH 08/01/13, DOH 08/01/13, DOH 10/01/13, and DOH 09/02/14); therefore, it could not be verified that the employees' evaluations were conducted annually. During an interview, the director stated that she could not recall the dates of each employee evaluation and further could not confirm if the evaulations were completed timely. 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

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 07/15/15) record presented for review did not contain verification of education qualification as required by regulations. During an interview, the director stated that the employee had not submitted a high school diploma as of the inspection date.

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 observation, the following was found: 1) An employee (DOH 08/01/13) file contained only twelve (12) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. 2) An employee (DOH 08/01/13) file contained only twelve (12) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. 3) An employee (DOH 08/01/13) file contained only five (5) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. 4) An employee (DOH 08/01/13) file contained only twelve (12) hours of cabinet-approved training as verified by ECE-TRIS and the record presented for review. During an interview with the director, the proper method of calculating training hours based upon the employee's hire date was discussed. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on observation of both the girls' and boys' restrooms, soiled toilet brushes were placed in the two (2) showers and were accessible to children. During an interview, the director stated that she had previously informed cleaning staff to remove the toilet brushes from the restroom; however, brushes were present during the inspection.

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 temperature of the GE refrigerator was measured at forty-six (46) degrees Fahrenheit; therefore, exceeding the requirement that perishable, nonfrozen food be stored at a temperature of forty (40) degrees Fahrenheit or below. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 20 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 8. Kitchen Requirements.

General: Based on observation, the following was found: 1) The temperature of the GE freezer was measured at twenty-four (24) degrees Fahrenheit exceeding the requirement that frozen food be stored at a temperature of zero (0) degrees Fahrenheit or below. 2) The temperature of the Frigidaire freezer was measured at four (4) degrees Fahrenheit exceeding the requirement that frozen food be stored at a temperature of zero (0) degrees Fahrenheit or below.

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 review of documentation, neither the statement of deficiency, nor the plan of correction from the current licensure year were posted and made available for public inspection as required by regulations. During an interview, the director stated that she was unaware that the SOD/POC documents were required to be posted.

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’s (DOH: 08/01/13) file contained documentation of a tuberculin result that was no longer current as of 08/27/2014.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, during a tour of the child care center the surveyor found the following: 1. A twenty-three-month-old child (DOE: 09/17/14) was being provided care along with seven (7) two-year-old children. Through interview with a staff, the surveyor learned that the child is in the mixed-age group for longer than one (1) hour. The staff-to-child ratio was exceeded by two (2) children.

Open Not marked corrected in the state record

Category: ratio. Open / not marked corrected.

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

General: Based on observation, the surveyor found that a staff person was providing care for a twenty-three-month-old child (DOE: 09/17/14) along with seven (7) two-year-old children. Through interview with a staff, the surveyor learned that the child is in the mixed-age group for longer than one (1) hour.

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, the surveyor found that a staff person was providing care for a twenty-three-month-old child (DOE: 09/17/14) along with seven (7) two-year-old children; thus, the staff-to-child-ratio was exceeded by two (2) children. Through interview with a staff, the surveyor learned that the child is in the mixed-age group for longer than one (1) hour and a transition plan had not been completed. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 9 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 child care center, the surveyor found the following: 1. A staff's purse had been placed on a table beside the teacher's desk located in the Toddler's Room. The purse was accessible to the children. 2. A staff's purse had been placed on a chair located in the dining area and was accessible to the children.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that the child care center's changing table is made of a hard plastic on which disposable sanitary liners are placed prior to each diaper change. The disposable liners are made of a thin material and do not provide a padded surface.

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 learned that staff do not use a brush when cleaning and sanitizing the mouth contact toys. First Aid/Medication

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on observation, the surveyor found that a step was broken on a plastic climbing toy located on the playground.

Open Not marked corrected in the state record

Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that the file for a staff (DOH: 09/05/13) did not contain an out-of state criminal records check as the staff had resided in Colorado within the past five (5) years.

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 all staff files, the surveyor found that the file for a staff (DOH: 08/01/13) did not contain verification that six (6) hours of cabinet- approved orientation training had been obtained within the first three (3) months of employment. 345 - Driver Requirements Not Applicable 922 KAR 2:120. Section 12. Transportation. (18) A driver of a vehicle transporting a child for a center shall: (a) Be at least twenty-one (21) years old; (b) Complete: 1. The background checks as described in 922 KAR 2:110; and 2. An annual check of the: a. Kentucky driver history records in accordance with KRS 186.018; or b. Driver history records through the state transportation agency that issued the driver’s license; (c) Hold a current driver’s license which has not been suspended or revoked during the last five (5) years; and (d) Not caused an accident which resulted in the death of a person. Programming

Open Not marked corrected in the state record

Category: recordkeeping. Open / not marked corrected.

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

General: Based on review of documentation, the surveyor found that two (2) of the children's (DOE: 09/12/13) files contained immunization certificates that lacked expiration dates; therefore, the children’s immunization status could not be determined.

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on review of documentation, ten (10) of the staff files presented for review did not contain documentation of a high school diploma, GED, or Commonwealth Child Care Credential as per regulatory educational 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, the following was found: 1. An employee's (DOH 08/01/13) file presented for review on 08/27/13, did not contain any documentation of negative TB verification. 2. An employee's (DOH 08/30/13) file presented for review on 08/27/13, did not contain any documentation of negative TB verification.

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 water temperature of all restroom sinks was 123 degrees Fahrenheit on 08/27/13. The current sink water temperature exceeds the regulatory maximum of 120 degrees Fahrenheit.

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.

Based on observation, the first aid kit presented on 08/27/13 was missing the following required supplies: liquid soap, flashlight, CPR mouthpiece protector, scissors, and a first aid booklet. 660 - Medication Administration Discussed 922 KAR 2:120. Section 7. First Aid and Medicine. (4) Prescription and nonprescription medication shall be administered to a child in care: (a) With a daily written request of the child’s parent. (b) According to the directions or instructions on the medication’s label. 665 - Administration Record Discussed 922 KAR 2:120. Section 7. First Aid and Medicine. (5) The child-care center shall keep a written record of the administration of medication, including: (a) Time of each dosage; (b) Date; (c) Amount; (d) Name of staff person giving the medication; (e) Name of the child; and (f) Name of the medication. 670 - Medication Discussed 922 KAR 2:120. Section 7. First Aid and Medicine. (6) 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. (7) Medication shall not be given to a child if the expiration date on the bottle has passed. Outdoor Play Area

Open Not marked corrected in the state record

Category: health medication. Open / not marked corrected.

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

General: Based on observation, the Toddler playground gate was not locked with a padlock or similar locking device on 08/27/13. This gate is adjacent to the outer property of the child care center and leading to the center parking lot.

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, five (5) cribs were located in infant room on 08/27/13. Four (4) cribs were compliant with the regulatory standard 16 C.F.R. 1219-1220. One crib was found noncompliant and accordingly dismantled and removed from child care center while the surveyor was present.

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, there were no thermometers in three (3) freezers located in the child care center on 08/27/13; therefore, the required temperature range of zero (0) degrees Fahrenheit or below for frozen food items could not be confirmed.

Open Not marked corrected in the state record

Category: nutrition. Open / not marked corrected.

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

General: Based on observation, proper handwashing procedures were not posted in the diaper changing area on 08/27/13. An Equal Opportunity Employer M/F/D Cabinet For Health and Family Services Page 26 of 27 Web site: http://chfs.ky.gov/ Inspection Report Animals 1175 - Animals in the Presence of Children Discussed 922 KAR 2:120. Section 13. Animals. (1) An animal shall not be allowed in the presence of a child in care: (a) Unless: 1. The animal is under the supervision and control of an adult; 2. Written parental consent has been obtained; and 3. The animal is certified as vaccinated against rabies; or (b) Except in accordance with subsection (3) of this section.

Open Not marked corrected in the state record

Category: physical safety. Open / not marked corrected.