SKYERS CHILD DEVELOPMENT CENTER

15A NCAC 18A .2806 (d) Specialty bulk milk that is sent from home for consumption by a child while at the child care center may be stored as set forth in the 2800 rules when the child's parent or guardian provides written permission and the specialty bulk milk is sent to the child care center at the beginning of each week unopened, labeled with the date received by the child care center, and labeled with the name of the child to whom the bulk specialty milk belongs. Any remaining bulk specialty milk shall be sent home at the end of the week with the child to whom the bulk specialty milk belongs.- Observed speciality milks in the kitchen refrigerator, without name and date and the other one with date 2/29. EHS and director discussed proper way to handle specialty milks at the time of inspection. Ensure to receive the unopened container of specialty milks at the beginning of the week, put name and date that was received, send home or discard at the end of the week either opened or unopened containers.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed disrepair hand sink in 1’s classroom need repair. Observed several hand sinks in some classrooms need new caulking to seal the gap between the wall. Keep all hand sinks in good repair.

General Comment: 15A NCAC 18A .2825 (a) In child care centers, the walls and ceilings, including doors and windows, of all rooms and areas, shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint.- Observed dead bugs inside light shields in some classrooms need cleaning and keep clean.

REPEAT 15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed sanitizer solution measured at 500ppm. Provide correct chlorine sanitizer concentration between 50-200 ppm at anytime.

REPEAT 15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed disinfectant solution measured at 1000ppm. Provide correct chlorine disinfectant concentration between 500-800 ppm at anytime.

General Comment: 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed hand lotion on a desk in older preschool less than 5ft. Ensure to keep items at 5ft or higher at all time.

15A NCAC 18A .2820 (f) A child's coats, hats, bags, and other items or accessories belonging to a child that are stored using cubicles, lockers, or coat hooks shall not come into contact with stored items belonging to other children.- Observed children jackets and book bags stored in their cubby, overlapping/touching each other. Ensure to keep each individual items separate and not allow contact anytime while storing.

General Comment: 15A NCAC 18A .2824 (b). Floors and floor coverings in sleeping and play areas shall be kept clean and in good repair- Observed flooring in infant room around food prep area, under cribs, along side wall at hand sinks need cleaning and keep clean.

General Comment: 15A NCAC 18A .2804 (d) All human milk, formula, and other bottled beverages, including beverages in sippy cups, that are sent from home shall be fully prepared and labeled with the date received at the child care center and the name of the child to whom the milk, formula, or beverage belongs before being brought to the child care center.- Observed one milk in sippy cup with date on 5/24 from yesterday. Every one else is correct dates. Ensure to label both name and correct date on items send from home.

15A NCAC 18A .2812 (g) A testing method or equipment shall be used in accordance with the product manufacturer's instructions to test the strengths of sanitizing solutions to ensure the prescribed concentrations are met.- Observed sanitizer solution measured at 500ppm. Ensure to provide correct sanitizer concentration between 50-200 ppm at all time.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed toys in dirty bucket stored in restroom 1’. Only toileting related items can be stored in the restroom.

15A NCAC 18A .2812 (i) An approved disinfectant shall be provided for cleaning purposes. When a chlorine solution is prepared by a child care center employee for use as an approved disinfectant, then the solution shall be prepared for use within 24 hours, and a testing method shall be used to ensure compliance with the prescribed chlorine concentration (500 -800 ppm).- Observed disinfectant solution measured at 1000ppm. Ensure to provide correct disinfectant concentration between 500-800 ppm at all time.

General Comment: 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users.- Observed damaged cot in 4’ classroom. Repair or replacement needed. Keep all cots in good repair.

REPEAT 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed baby snacks sent from home in cabinet infant room with name and no date, some without both name and date. Ensure to put both name and date that was received on items send from home.

REPEAT 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed Vaseline container stored in top of diaper table in restroom, less than 5ft in 1’s classroom. Ensure to put non hazardous item at 5ft or higher at all time.

General Comment: 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users.- Observed cuts and tears at the corners on mattresses in infant room. Repair or replace needed.

15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day.- Observed baby foods in cabinet in infant room with name and no date that was received at the center. Ensure to put both name and date that was received on items send from home.

General Comment: 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key.- Observed lip/hand balm stored in cabinet less than 5ft in 1’s classroom. Ensure to put non hazardous item at 5ft or higher at all time.

General Comment: 15A NCAC 18A .2821 (f) Linens shall be large enough to cover the bed, cot, or mat's sleeping surface.- Observed children are sleeping on cots without sheet cover. Provide the sheet.

General Comment: 15A NCAC 18A .2822 (a). In rooms designated for children who are not toilet trained, toys and other mouth-contact surfaces that are used by children shall be cleaned and then sanitized after each use and when visibly dirty. Toys and other mouth-contact surfaces shall be cleaned and sanitized as follows: (1) the items shall be scrubbed in warm, soapy water, using a brush to reach into any crevices; (2) the items shall be rinsed in clean water; (3) the items shall be submerged in a sanitizing solution for at least two minutes or in accordance with the instructions on the label of the sanitizing solution; and (4) the items shall be air dried. -According to teacher in classroom where mouthing/dirty toys present. The dirty toys were collected and put in dirty bin and get clean at the end of the day. Teacher spray sanitizer solution on toys and let them air dry. Proper toys cleaning discussed with teacher and director at the time of inspection. All dirty toys shall be washed/rinsed/sanitized properly in the kitchen at the three compartment sinks. Or 3 step bins suggested, label (wash/rinse/sanitize). Some toys that cannot not be submerged in water after washed and rinsed, the sanitizer spray can be used. All toys that can be in the water shall be submerged in sanitizer solution for at least 2 minutes and let air dry after. Ensure to use/provide the correct strength of sanitizer solution in the bin for cleaning toys each day and ensure to store the sanitizer bin at 5ft or higher.

General Comment: 15A NCAC 18A .2816 (b) (1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation. Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets. The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection. - Observed the facility last water testing for lead was 10/06/2020. The director was able to registered and sing up for water testing during the last inspection. The facility will follow the procedure to get water tested as required. The updated results will be provided at the later time.

REPEAT 15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users. - Observed cuts and tears at the corner of the mattresses in the infant room, need replacement.

General Comment: 15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. - Observed teacher after cleaning the diaper changing table, not wash her hands before cleaning child #1 and #2 dirty noses. Teacher shall wash hands between task and after cleaning each children’s nose.

General Comment: 15A NCAC 18A .2804 (k) Lunches, snacks, and other meals containing potentially hazardous foods shall be refrigerated at 45 degrees Fahrenheit or below and stored in the child care center kitchen or approved food preparation area. - Observed ham sandwich in a child’s lunch box in 2’s classroom temperature measured at 65F. 15A NCAC 18A .2804 (k) Hot foods that a child brings from home to the child care center in double-walled, insulated thermos containers may be stored outside of refrigerator at the child care center with the written permission of the child’s parent or guardian. - Observed foods in thermos container in children’s lunch boxes without parent/guardian written permission. EHS discussed procedure with director during the inspection.

15A NCAC 18A .2804 (k) Lunches, snacks, and other meals that a child brings from home to the child care center shall be labeled with the date on which the food is brought to the child care center and the name of the child to whom the food belongs at the child's home and shall be returned to the child's home or discarded at the end of each day. - Observed children’s lunch boxes without date that was received at the center. Children’s name was on lunch boxes to indicate whom it belongs to. Each lunch box shall have name and date that was receive at the center. 15A NCAC 18A .2806 (d) Specialty bulk milk that is sent from home for consumption by a child while at the child care center may be stored as set forth in the 2800 rules when the child's parent or guardian provides written permission and the specialty bulk milk is sent to the child care center at the beginning of each week unopened, labeled with the date received by the child care center, and labeled with the name of the child to whom the bulk specialty milk belongs. Any remaining bulk specialty milk shall be sent home at the end of the week with the child to whom the bulk specialty milk belongs. - Observed a container of specialty milk that belong to a child brought from home to the center, without a date that was received inside refrigerator in the kitchen. According to the director, milk was there over a week. Ensure to have name and date on the unopened container and send home at the end of the week with child. 15A NCAC 18A .2810 (f) Water from a handwashing lavatory shall not be used for bottle warming or to prepare, mix dry cereals, or other foods. - According to teacher in infant room, teacher uses water from food prep hand washing sink to warm the bottle in the warmer. Water needs to come from the kitchen or water bottle, not from the hand sink.

General Comment: 15A NCAC 18A .2812 (e) Multi-service articles, including highchair feeding trays, shall be washed, rinsed and sanitized in the child care center kitchen after each use. - According to teacher highchair trays and spoons in infant classroom and rubber bibs in several classrooms get clean at the sink in the classroom. All multi-service articles need to be wash, rinse, and sanitize properly in the kitchen after each use.

General Comment: 15A NCAC 18A .2816 (b) (1) Child care operators, as defined under G.S. 110-86(7), shall test, once every three years, all water outlets used for drinking or food preparation. Samples shall also be collected and tested within 30 calendar days of completion of any renovations or repairs that may impact the facility's drinking water infrastructure, such as repair or replacement of all or part of drinking water service lines or faucets, at impacted outlets. The operator shall provide documentation of testing results for review by the Department during each unannounced routine sanitation inspection. - Observed the facility last water testing for lead was 10/06/2020. The director was able to registered and sing up for water testing during the inspection and will follow the procedure to get water tested as required.

15A NCAC 18A .2819 (c) and 15A NCAC 18A .2819 (d) (10). Diapering surfaces shall be disinfected using an approved disinfectant by spraying the entire diapering surface with an approved disinfectant and allowing to remain on the surface for two minutes or as specified by the manufacturer, or air dry. - Observed teacher in infant room spray the disinfectant solution on the changing surface and wipe dry immediately. The solution needs to stay on the surface at least 2 minutes before wipe dry. PROVISIONAL ITEM.

15A NCAC 18A .2819 (d) Use approved diapering methods as follows: 1) gather supplies, 2) wear disposable gloves (if needed), 3) use a disposable moist towelette to clean child, wiping front to back, 4) dispose of gloves if used and soiled towelettes, 5) wiping the employee's hands and the child's hands with a separate disposable towelette, 6) slide clean diaper under child and apply diapering products if needed using approved methods, 7) fasten diaper and place clothing on child, 8) wash child's hands, 9) and 10) clean and disinfect diapering surface using approved methods, 11) employee washes their hands. - Observed teacher is changing diapers incorrectly/missing step #3, 4, 5. Proper diaper changing procedures discussed with teacher at the time of inspection.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. -Observed super glue inside the pens container stored on top of the table in 2’s classroom, the directors took item and discarded it. Observed several chemicals inside the kitchen stored on top of the 3 compartment sinks. The director placed all the chemicals in the lock storage room inside the kitchen during the inspection. (B): Keys shall not be stored in the locks. Observed key stored in the lock in the 4’s classroom which stored shaving aerosol cans, disinfectant aerosol spray, and other chemicals. The teacher locked the storage and put key away at the time of inspection. PROVISIONAL ITEM.

General Comment: 15A NCAC 18A .2820 (c). Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use by storing the items 5 ft above the floor or behind lock and key. - Observed diapering cream inside the drawer in the locked bathroom in 1’s classroom. (Teacher takes multiple students in the restroom at a time). The cream was put away 5ft and above at the time of inspection.

15A NCAC 18A .2821 (a). In child care centers, beds, cribs, cots, mats, and play pens shall be kept clean and in good repair, stored to prevent contamination, and cleaned and sanitized between users. - Observed cuts and tears at the corner of the mattresses in the infant room, need replacement.

General Comment: 15A NCAC 18A .2826 (b).Windows and window treatments shall be kept clean and in good repair. All ventilation equipment, including air supply diffusers, return grilles, and fans shall be kept clean and in good repair. - Observed ceiling vents inside the restroom in several classroom covered with dusts, need detail cleaning.

General Comment: 15A NCAC 18A .2827 (d). The child care center shall have written procedures that employees shall follow when responding to vomiting or diarrheal events that involve the discharge of vomitus or fecal matter onto surfaces in the center. The procedures shall address the specific actions employees must take to minimize the spread of contamination and the exposure of employees, children, food, and surfaces to vomitus or fecal matter. - Observed the facility without written procedures of vomiting and diarrhea. EHS provided the poster and plan to the director, the procedures discussed at the time of inspection.

All cribs, beds, cots and mats must be labeled with each individual child's name. 15A NCAC 18A .2821 (c ). Observed some cots sporadically throughout center not individually labeled with child’s name. Keep all mats, cots, and cribs clean and in good repair. 15A NCAC 18A .2821 (a). Observed some crib mattresses in disrepair around on the edges of mattresses. EHS advises center to have mattresses repaired/replaced where needed.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed touch up paint needed to doors frames and walling throughout center.

Keep the premises clean and free of dilapidated structures and broken play equipment. 15A NCAC 18A .2832 (a). Observed dilapidated toys and furniture stored within dumpster area. Per assistant director, center is aware and is in the works of having items removed. *NOTE: Assistant Director, Tiffany Skyer, was present during time of inspection. Report emailed to center at: skyerscdc@bellsouth.net

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed toilet seat in need of repair inside (pre-k 4) classroom group bathroom.

REPEAT Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b). Observed table edges inside (Infant, 2's) classrooms having build-up in need of general cleaning. Observed card board based blocks damaged in need of replacing inside (waddlers) classroom.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed wall having scuffs and areas of sheetrock plaster showing in need of touch-up painting and repair inside (waddlers) classroom.

Observed no stem probe thermometer that can read cold temps. Only stem probe thermometer present is a high temp one. Provide a stem probe thermometer that reads from 0F-220F. Facilities shall maintain an accurate and calibrated metal stem thermometer. 15A NCAC 18A .2807 (h) and .2809 (12).

Observed the sanitizer >1000ppm chlorine. Explained the violation and the correction. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed heavy buildup in the bottle warmer in the infant room. Per the teacher, she cleans it weekly. She was informed to clean daily and as needed. Cleaned during the inspection. Bottle warming equipment shall be cleaned and sanitized at least daily and when visibly soiled. 15A NCAC 18A .2810 (f) (1) and .2804 (d).

Observed the disinfectant >1000ppm chlorine. Disinfectant may be higher during Covid times, but may not exceed 1000ppm chlorine. Explained the violation to the employees and the correction. Prepare disinfectant between 500-800 ppm chlorine daily. 15A NCAC 18A .2819 (c ) and .2801 (7).

Observed an employee not wipe her hands nor the child's hands after discarding the soiled items but before placing on the clean diaper and clothes. Explained the violation and the correction. Follow the correct diaper changing procedure as described in 15A NCAC 18A .2819 (d).

-Observed buildup on toys in 1's, 2's, and 3's class. Clean all toys. A small brush may help get in the small areas of toys. Also, ensure toys are scrubbed when in the soapy water- not just dumped. This will help with the dirt buildup. -Observed sticky residue on toy shelves in classes. Clean all sticky residue and repaint if needed. Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed high grass in the playground area, vines and trees growing through the fence, and higher grass in the area where the children do not play (far end of the playground). Cut all areas so that no animal harborages can develop (bees, wasps, snakes, etc). Keep the property free of high vegetation. 15A NCAC 18A .2831 (i).

Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d). Observed diaper creams stored below 5 ft and not behind lock and key; CDI diaper creams placed at 5ft or above during inspection.

Label all baby bottles, sippy-cups, and bottled beverages sent from home with the child's name and date it was brought into the facility. 15A NCAC 18A .2804 (d) Observed all baby bottles missing dates on labels (name only) inside (Infant) room. CDI dates placed on labels.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed walls behind trash cans damaged in need of repair; recommendation of installation of wall covering that is scracth resistant example; (FRP) picture sent to director.

Keep toilets and urinals clean and in good repair. 15A NCAC 18A .2817 (a). Observed loose toilet seat in need of tightening inside (pre-k) bathroom.

Purses, that do not contain hazardous items, must be stored 5 ft above the floor, behind lock and key, or behind a child safety lock. 15A NCAC 18A .2820 (f).Observed purse stored inside unlock cabinet below 5 ft inside (pre-K) classroom. Approved non-hazardous products must be stored 5 ft above the floor or behind lock and key. 15A NCAC 18A .2820 (b), (c ) and (d).Observed sanitizer and sunsreen stored below 5 ft inside (2's) classroom.

Observed sanitizer 1000ppm in 1s class. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed damaged blocks in 4s. Observed shelving with tape residue/ staining in infants and oven/kitchen set with debris build up in crevices. Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. 15A NCAC 18A .2822 (a), (b).

Observed sanitizer 1000ppm in Pre K and 2s classes. Prepare a wipe-on or spray-on sanitizer daily at 50 to 200 ppm chlorine. 15A NCAC 18A .2812 (d)

Observed toys stored in hand sinks in waddlers and 2s classrooms. Discontinue storing items in hand sink. Keep handwashing sinks clean and in good repair. 15A NCAC 18A .2818 (a).