BRIGHT FUTURE EARLY LEARNING CENTER

Observed child turn off faucet without using paper towel. Redirected by director. 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 no thermometer in the refrigerator in infant 2. Provided. **15A NCAC 18A .2806 (j) (1) Each refrigerator shall be provided with a numerically scaled indicating thermometer that is accurate to ± 3 degrees Fahrenheit and located to measure the air temperature in the warmest part of the refrigerator. Recording thermometers that are accurate to ± 3 degrees Fahrenheit may be used in lieu of indicating thermometers.

Spoke with staff who informed me that the tray was washed in the classroom. Informed staff that it should be taken to the kitchen. 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.

Observed chlorine disinfectant below 500ppm. Disinfectant was replaced during the inspection. **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 children napping too close together. **15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children.

Observed dust build up on vent cover in the hallway restroom. **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 outdoor dumpster doors open. **15A NCAC 18A .2830 (c) Dumpsters and other containerized systems shall be kept clean and covered.

Observed gap between the two doors at the entrance. Some type of weather stripping is needed. GENERAL COMMENT **15A NCAC 18A .2831 (c). All openings to the area outside of the child care center shall be protected against the entrance of flying pests.

Observed chlorine disinfectant below 500ppm. Disinfectant was replaced during the inspection. GENERAL COMMENT **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 touch up paint needed during the inspection. **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.

General Comment: 15A NCAC 18A .2803 (a) and (c), .2836 (15).Child care center employees and children shall wash their hands when required. Observed child enter classroom upon arrival and not wash their hands before going to play area. Needs to wash hands upon arrival.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed infant food prep sink at 113F. Observed pre-toddler 2 right bathroom handsink at 118F. Observed pre toddler 1 food prep sink at 114. Needs to be 80-110F. REPEAT.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed infant food prep sink is leaking. Observed spring loaded faucet leaking in Toddler classroom. Needs repair. REPEAT. No points deducted due to plumber had already been scheduled for repairs today.

General comment: 15A NCAC 18A .2819 (b). Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair. Observed tears in diaper pad in Infant 2. Needs removal/repair.

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 bottles missing date received and some with date received written as 5/7 in Infant 1 classroom. Needs correct date received.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed infant food prep sink at 113F. Observed pre-toddler 2 right bathroom handsink at 117F. Observed pre toddler 1 food prep sink at 114. Needs to be 80-110F. REPEAT.

General Comment: 15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed infant food prep sink is leaking. Needs repair.

General Comment: 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 at Infant 2 food prep sink. Needs paper towels at both handsinks in classroom.

General Comment: 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 employee performing a diaper change skip step 4 and 5 in procedure in Infant 2. Needs to follow correct procedure.

15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed aerosols, other sprays, and powder labeled “Keep out of reach of children” with additional warnings stored in unlocked cabinets in Pre toddler 2. Needs to be in locked cabinet. REPEAT. PROVISIONAL ITEM.

15A NCAC 18A .2822 (a) Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. Observed chair part of high chairs with build up in infant 2. Observed build up on diaper table under pad in Pre toddler 2. Needs cleaning. REPEAT.

15A NCAC 18A .2806 (a) Once pre-packaged food has been opened, the food shall be stored in clean, resealable bags or containers made of plastic or glass that are tightly covered and manufactured for the purpose of food storage. Observed grits and dry pasta stored in nonresealable containers in kitchen. Needs to be in resealable bags/containers.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed hot water at 112 at pretoddler 1 food prep sink, at 114 in Toddler bathroom, at 114/116 in hallway bathrooms, at 112 at Infant 1 food prep, at 112 at infant 2 sink, and at 112 at Pre toddlers 2 sink. Needs to be 80-110F. REPEAT.

General Comment: 15A NCAC 18A .2817 (a. All toilet fixtures shall be kept clean and in good repair. Observed loose toilet seat in hall womens bathroom. Needs tightening.

General Comment: 15A NCAC 18A .2818 (a). In child care centers lavatories shall not be used for storage. Observed green bin in Toddler 2 handsinks. Lavatories shall not be used for storage.

General Comment: 15A NCAC 18A .2819 (a) In child care centers, children in diapers shall be changed at stations designated for diapering or toileting. Each diaper changing station shall include a handwash lavatory. Observed Infant 1 changing table had been relocated away from the handsink. Diaper changing station shall include a handwash lavatory. CDI - Diaper changing table was moved back to original position.

15A NCAC 18A .2819 (b) Nothing shall be placed on the diapering surface except for those items required for diapering and the child whose diaper will be changed. Observed posters on diaper surface in Pretoddlers 2. Nothing shall be stored on the surface of the diaper changing table.

General Comment: 15A NCAC 18A .2820 (b). All hazardous items must be stored behind lock and key. Observed dry erase board spray stored unlocked in Infant 2. Needs to be locked.

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 sanitizer on key chain stored less than 5ft up in Infant 1 and lotion stored less than 5ft up in cabinet in Infant 2. Needs to be stored 5ft up or locked.

General Comment: 15A NCAC 18A .2822 (a) Toys, equipment, furniture, and any other items accessible to the children shall be kept clean and in good repair. Observed hole in back of red couch in Toddler 1. Couch was removed from room during inspection.

15A NCAC 18A .2806 (f) Food and containers of food shall not be stored under exposed sewer lines. Food shall not be stored in toilet or laundry rooms, except that child care centers licensed for fewer than 13 children and located in a residence may store food in laundry rooms if the food is stored and protected as required in rule 2806 (g). Observed rice and cereal stored under sink in infant 2 classroom. Food and containers of food shall not be stored under exposed sewer lines.

15A NCAC 18A .2815 (e) (e) Hot water used for cleaning and sanitizing utensils and laundry shall be provided at a minimum temperature of 120 degrees Fahrenheit at the point of use. Observed hot water at 118F in kitchen. Needs to be 120F. Water was adjusted.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed hot water at 113 at sink in womens and mens hall bathroom. Needs to be 80-100F. REPEAT.

15A NCAC 18A .2821 (e). When in use, cribs, cots, mats and play pens shall be placed at least 18 inches apart or separated by partitions that prevent physical contact between children. Observed cots less than 18 inches apart when in use in Pre-Toddler 1 classroom. Needs to be 18 inches apart.

15A NCAC 18A .2810 (f) Bottle warming equipment shall be cleaned and sanitized per rule .2812 and the manufacturer's instructions. Observed build up in bottle warmers in infant 2. Needs cleaning. REPEAT.

15A NCAC 18A .2815 (e) Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. Observed hot water in infant room 2 at diapering handsink at 112F. REPEAT.

15A NCAC 18A .2818 (a). Lavatories shall be kept clean and in good repair. Observed hot faucet at sink furthest from door leaking in Toddler 1.

15A NCAC 18A .2819 (b). Diapering surfaces shall be made of smooth, intact, nonabsorbent material and shall be kept clean and in good repair. Observed small tear in diaper pad in Infant 2 classroom.

No points deducted. 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 chemical ice packs in first aid boxes in Toddler 2 and Toddler 1. CDI - Ice packs were moved to be locked in office.

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 items in infant 2 hanging on coat hooks less than 12 inches apart from different children with no partition in between. Needs to be store on hooks 12 inches apart.

15ANCAC18A.2810(f) all equipment shall be cleaned at least daily. Warming equipment shall be cleaned and sanitized. Observed bottling warmer in the infant 1 and infant 2 room in need of cleaning. Keep clean even if not in use. Multi-service articles, including Highchair feeding trays, shall be washed, rinsed, and sanitized after each use. 15A NCAC 18A .2812 (e) Observed caregiver rinse baby bottle after feeding in the Infant 2 room. Provided education to the caregiver on where to wash and sanitizer baby bottles. Provided education on where feeding chair trays shall be clean and sanitized in the kitchen. Infant 2 stated they wash and sanitize in the classroom. 15A NCAC 18A .2812 (d) For utensils and equipment which are either too large or impractical to sanitize in a dishwashing machine or dishwashing sink, a spray on or wipe on sanitizer of sufficient chemical strength shall be used. Observed the ice machine chute accumulating pink and black residue. Clean and maintain.

Provide sanitizer test kit. 15A NCAC 18A .2812 (g) Observed no chlorine test kit for the sanitizer.

GENERAL COMMENT: Hot water shall be maintained between 80°F and 110°F at handwashing sinks accessible to children. 15A NCAC 18A .2815 (e). Observed hot water in the infant 1 food prep handwashing sink temped at 118F. Observed all the other classroom handsinks get to 112F, but then would drop at or below 110F. Maintain hot water between 80F and 110F. Repair.

GENERAL COMMENT: The diaper changing surface shall be properly disinfected between each child. 15A NCAC 18A .2819 (c ). Observed caregiver use sanitizer instead of disinfectant after diaper changing. Provided education to the caregiver. EHS was able to observe another diaper change procedure in the room and the caregiver properly cleaned and disinfected the diaper changing pad.

Provide test strips for the chlorine disinfectant. 15A NCAC 18A .2819 (c ) Observed no disinfectant test kit.

GENERAL COMMENT: All hazardous items must be stored behind lock and key. 15A NCAC 18A .2820 (b). Observed hazardous items such as aerosol spray and Lysol cleaner in the director’s office, which is also utilized as the ill children area when needed. No children using the space at the time.

GENERAL COMMENT: Wash cloths, bibs, and burping clothes shall be laundered after each use. 15A NCAC 18A .2821 (g). Observed wet towels on the counter in the infant1 room used to wipe tables, Observed wet towel on the faucet in the infant 2 room and observed towel on soap dispenser in Toddler 1 room.

GENERAL COMMENT: 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 some tape residue on shelving in the Toddler 1 room and PreK Toddler 2 room. Clean and maintain.

GENERAL COMMENT: In areas where children are not toilet trained, small mouth contact toys shall be washed, rinsed, sanitized (submerged for 2 minutes), and allowed to air dry, after use and more frequently when visibly dirty. 15A NCAC 18A .2822 (a). When EHS inquired about toy washing and sanitizing in all the classrooms, caregivers stated that the diaper changing handsink was utilized to wash toys. Provided education and where to properly wash and sanitize toys. Options for washing hard toys would be: food prep sink, 3 containers (wash, rinse and sanitizer, air dry) or kitchen.

Keep all floors, walls, and ceilings, clean and in good repair. 15A NCAC 18A .2824 and .2825. Observed area rug in the PreToddler 1 room stained. Clean or replace. Observed peeling paint on the window sills in the following rooms: PreToddler 2, Toddler 2, Toddler 1, and PreToddler 1. Repaint.

Observed diaper changing pad torn in Infant 2 and Pre Toddler 1. Needs to be replaced. **Diaper changing surface must be easily cleanable, non-absorbent, smooth, and intact. 15A NCAC 18A .2819 (b).