KIDS R KIDS LAKE NORMAN

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 one speciality milk in kitchen RIC with no date. Ensure all speciality milks are labeled with the date brought in to center.

General Comment: 15A NCAC 18A .2820 (d) Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use but are not required to be in locked storage. A product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. Observed several diaper creams stored in unlocked cabinet below 5ft in room 250. Ensure diaper creams are stored at least 5ft up or behind lock and key.

15A NCAC 18A .2831 (b). (b) Pests shall be excluded from the child care center. Traps set for pests shall only be placed in areas that are inaccessible to children.- Observed several small flies in kitchen. Ensure no pests are present in 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 milk in the kitchen refrigerator dated 3/9. EHS, kitchen staff, 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 .2809 (3) Other surfaces that do not come into contact with food shall be kept clean and in good repair.- Observed soiled refrigerator need cleaning in 200. Keep clean.

15A NCAC 18A .2817 (a). Storage in toilet rooms shall be limited to toileting and diapering supplies.- Observed balls basket and chair in restroom 250. Only toilet related items to be stored or kept in the restroom at anytime.

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 in the spray bottles measured less than 250ppm. Ensure to provide correct concentration of chlorine disinfectant between 500-800 ppm at all time.

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 water damage ceiling tiles in 200 and 550. Check for leaks, repair if needed. Replace the ceiling tiles.

General Comment: 15A NCAC 18A .2831 (b). (b) Pests shall be excluded from the child care center. Traps set for pests shall only be placed in areas that are inaccessible to children.- Observed drain flies in the kitchen need attention. Keep flies away from the center.

15A NCAC 18A.2803 (e). Handwashing procedures shall include: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands.- Observed teacher in suite 300 washing her hands and turn off the faucet knob with bare, dry her hands with paper towels and then went and touch the lid of trashcan to throw away paper towel. Ensure to follow correct hand washing procedures and keep hand clean when already washed.

General Comment: 15A NCAC 18A .2817 (a) In child care centers, toilet tissue paper shall be provided in each toilet room and stored in a clean, dry place.- Observed no toilet tissues in dispenser in gym restroom. Ensure keep toilet tissues available and accessible in the restroom. 15A NCAC 18A .2818 (d). Liquid soap and disposable towels or other hand-drying devices shall be provided at every handwash lavatory area.- Observed no paper towels available in the dispenser in gym restroom. Ensure to provide hand washing supplies at all hand sinks at all time.

General Comment: 15A NCAC 18A .2820 (d).Medications, including prescription and non-prescription items, shall be stored in a locked cabinet or other locked container and shall not be stored above food. -Observed in outside bag, Benadryl medication store along with EpiPen in suite 100 and 150. All medications except emergency medication shall to kept in lock storage at anytime.

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 in spray bottle measured at 250 ppm. Ensure to provide correct concentration of chlorine sanitizer solution between 50- 200 ppm.

REPEAT 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 book bags, individual items hanging on hooks touching each other in classroom 550, 400. Ensure to keep all individual items separate and not allow contact while storing them at anytime.

REPEAT 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 light dust cover AC vents in several classrooms and one thicker in 500. Observed debris cover on base board where wall and floor connect in 350. Keep all wall, base board, ceiling clean and good repair.

General Comment: 15A NCAC 18A.2803 (e). Handwashing procedures shall include: (1) using liquid soap and tempered water; (2) rubbing hands vigorously with soap and tempered water for 15 seconds; (3) washing all surfaces of the hands, to include the backs of hands, palms, wrists, under fingernails and between fingers; (4) rinsing the hands under tempered water for 10 seconds; (5) drying hands with a paper towel or other hand-drying device; and (6) turning off faucet with a paper towel or other method without recontaminating hands.- Observed teacher in infant and student in 400, washing their hands and turn off the faucet knobs with bare hands. The classroom has hand washing signs posted. Please follow proper hand washing procedures at all time.

REPEAT 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 date received. 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 end either opened or unopened containers.

General Comment: 15A NCAC 18A .2812 b) Except for fixed equipment and utensils too large to be cleaned in sink compartments, equipment and utensils that are cleaned manually instead of in a dishwasher shall be washed, rinsed, and sanitized.- Observed soiled refrigerator in TK needs detail cleaning and keep clean. 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.- Observed teacher in infant clean/rinse the high chair tray/ rubber bib in a hand sink in classroom. Proper cleaning discussed in detail with teacher and director assistant at the time of inspection. All multi-service articles (high chair trays, spoons, plates/bowls, rubber bibs) shall be only wash, rinse and sanitize properly in the kitchen after each use. NOTE: Every sinks in the classroom are hand washing sinks, only hand washing according to appropriate purpose. (Diaper, food prep)

General Comment: 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair.- Observed soiled toilet in women restroom, cleaning needed. 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair- Observed hand sink in 200 needs better cleaning, or need new caulking. Clean and keep clean.

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 spray bottle measure less than 500 ppm. Ensure to provide correct concentration of chlorine solution between 500- 800 at all time.

PROVISIONAL ITEM: 15A NCAC 18A .2820 (b) (c). All hazardous items must be stored behind lock and key. A locked kitchen is not considered to be a locked storage room or cabinet for the purpose of this rule - Observed Clorox/ chemical containers store in dry storage in kitchen and detergent pods container on stairway to the office upstairs, door left unlock. Observed glass cleaner spray bottle in unlock drawer in 400. Observed air freshener aerosol can in men restroom unlock. Ensure to keep all hazardous items that has label “Keep out of reach of children “ and extra/other “warning/caution” in lock cabinet or storage at all time. According to chef and director assistant, currently the cabinet lock in the kitchen is broken. NOTE: **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. And keep keys 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 book bags, individual items hanging on hooks touching each other in several classrooms. Ensure to keep all individual items separate and not allow contact while storing them at anytime.

General Comment: 15A NCAC 18A .2821 (g). Wash cloths, bibs, and burping cloths shall be laundered after each use. Each time a wash cloth, bib, or burping cloth is used, it shall be used for only one child.- Observed black cloth sitting on the sink wet. According to teacher, the cloth use for wiping water. If use cloth for cleaning, it shall be used once at each cleaning session and laundry after each use.

15A NCAC 18A .2824 (a). Floors and floor coverings in food preparation, food storage, utensil washing, toilet rooms, and laundry areas shall be constructed of nonabsorbent material and shall be kept clean and in good repair.- Observed soiled/full of debris on flooring underneath refrigerator in the kitchen. Detail cleaning needed. Keep clean. 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 throughout the center, dust cover AC vents, stained ceiling tiles in 200, 550, disrepair hood vent ceiling tile in restroom 450. Keep all wall and ceiling clean and good repair.

15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required.- Observed children were dropped off in the morning, didn’t get hand washing before going on and engaged in classroom activities. Ensure to wash hands when required per sanitation rule.

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, some with date 11/11, 11/19, 11/22. EHS, kitchen staff, director assistant 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 end either opened or unopened containers. 15A NCAC 18A .2804 (h) After the completion of each feeding, any leftover formula, human milk, or other bottled beverages used during the feeding shall be discarded or sent home with the child whose name is on the label for the formula, human milk, or bottled beverage at the end of each day. Feeding is complete when the child care center employee has stopped feeding the child and the child has been removed from the feeding area in the child care center and returned to other activities. Bottles previously used for feeding shall not be returned to communal mechanical refrigeration.- Observed water in sippy cups in younger classrooms refrigerator. According to teacher children were offered water in the same sippy cup throughout the day, so as a result the sippy cup was going in and out refrigerator and cups get clean at the end of the day. Proper sanitation rule about previously used cup/bottle for feeding shall not be returned to refrigerator discussed in detail with teachers and director assistant at the time of inspection. 15A NCAC 18A .2806 (d) Bulk food stored in a refrigerator shall be stored in the child care center's kitchen or in an approved food preparation area equipped with a full-size refrigerator.- Observed a gallon of milk and a carton of specialty milk the center offers store in a dorm refrigerator in toddler room. Proper size item and refrigerator, where and how to store them discussed with teachers and director assistant at the time of inspection.

REPEAT 15A NCAC 18A .2810 (f) A classroom food preparation area countertop shall be kept clean and in good repair. All equipment shall be kept clean.- Observed refrigerator in 200 need cleaning and keep clean.

General Comment: 15A NCAC 18A .2815 (f).Drinking fountains, if provided, shall be separate from handwash lavatories and kept clean.- Observed the water fountain in TK, and hallway need detail cleaning all around drain, surfaces, crevices, spouts. Keep clean.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key.- Observed Clorox containers store in dry storage in kitchen and stairway to the office upstairs, door left unlock. Ensure to keep all hazardous items that has label “Keep out of reach of children “ and extra/other “warning/caution” in lock cabinet or storage at all time. Currently the cabinet lock in the kitchen is broken and in the process of fixing it. NOTE: Currently the cabinet lock in the kitchen is broken and in the process of fixing it. **Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. And keep keys at 5ft or higher at all time.**