HomeMy WebLinkAboutBlackburn Elementary Kid Connection 420097 11 20 12.ls.pdfN.C. Department afEmAroacne nt and Natural Resourers Demerits 2 H earth D ep aftm ent 18
Dio-ision of Emrinnuientil Health
Sardtation Stwidards E%-alualdon Date oflneptChig i 1 1 a 0 / J 0 1 '2 Current Facility ID 2018420097
Forrollior Chfld Can Centers StatusCodeA 0 1 d F acility ID
Classification: [ESuperior DApproved Dprovjsjonai F—] Disc p proved Water sample taken today? oYes [E No
Water Supply- [j]community Mr,lon-Transient Non -Community fflinspecuon Name Change
[I]Transient Non-corrimunity ®Non-Pubfic Water Supply MRe-inspectron Verification of 0 lo su re
Wastewater System; [I]Community n-site System RV visit Status Change
LiceirounglD Na. M aximum Capacity 0 Comment Sheet Attiached0Yes 91 No
N am, e of F dolityr BLACKBURN ELEM KID CONNECTION Operator: COMMUNITY SCHOOLS
Street Address: 4377 W NC 10 HWY City: NEWTON Mate NC zip: 28658
HANDWASH ING: .2803,.2836 Demerits Demerits
1, Handwashing when required 05 30, Non -hazardous products property stored
2, Proper handwashing procedure '5 31, Facilities provided for proper storage, used and kept dean
FOOD: 2804,2806,2807,2808,2836 BEDS, COTS, MATS AND LlNENS:.282I,.i836 *2
*3From approved sources, no spoilage, noadulteralron 06 32. tndividual linen provided, adequate beds, cots, or mats provided, 0:3
*4- Potentially hazardous foods meet storage and holding 06 in good repair, properly stored, labeled, spaced during use
temperatures; bottles, lunches refrigerated at 451) F or below 33. Linen, bedding, wash cloths, bilk burping cloths laundered, and 0:3
5. Food property stored, thawed, prepared, cooked cooled, in good repair
handled, served, trinspoded, packaged and Identified only 05 TOYS, EQUIPMENT, FURNITURE:.2822,.2836
supervised children in k itch en 34. Clean and in good repair, water play centers cleaned,sanitized 04
6. Not re -served 03 and maintained
T Thermometers provided, accurate 02 3Mouth-contact sutfaces cleaned and sanitized in rooms where 04
FOOD SERVICE EQUIPMENT& UTENSILS: 2809, 2810, 2812,.2814 children who are, not toilet trained are caredfor
S. Meets specifications for refrigeration, sinks, lavatories and 06 P ERS 0 INN E L: . 2808-2823
dishwashing equipment 36, Approved hygienic practices, clean clothes, hair restraints where 02
9. Meets specifications for other equipment and utensils, required; no evidence of tobacco use where prohibited
approved material and construction 04 FLOORS, WALLS &CEILINGS.,.2824,.2825,.2832,2836
10. Food contact surfaces properly washed; rinsed, sanitized 37, Easily cleanable, clean, and in good repair; carpets vacuumed 04
and air dried, single -service articles not, re -used 05 as required and extraction cleaned, date cleanedc.
2 TING ENV RON ME NT:.286
11. Approved sanifizer provided,, test kit available U2 LIGH38, Roam AND tempTHERMAL erature between 65' Fad R5" F 03
12- Equipment, non-food contact surfaces clean, in good repair 04 39. Equipment dean and in good repair; maintained as required 02
Ia. Proper storage and handing of clean equipment, utensils COMMUNICABLE DISEASE CONTROL .2827,1836
and single servi ce articles 03
*40, Persons with a communicable disease or condition excluded in
WATER SUPPLY & DRINKING, WATER FACILITIES: .2815,2836 accordance with 1 OA NCAC 4 1 A,0200
*14, Water supply meets 15A NCAC 18A 1700 and 15A NCAC 06 41 � Persons caring for sick or and
ill children exduded from 04
180 it applicable docuimritation provided situalions in which disease transmission likely to occur
*15. Hot water supplied and maintained in the kitchen 06 42. Designated area for sick children,- maintained as required 02
16. Hot water supplied and tempered water maintained as 04 WASTEWATER:.2829
required in all other areas *43, Approved wastewater dispos a] in accordance with 16A NCAC 0 6
*17. Hot water in excess of 12VF not allowed in areas 06 18A .1900
accessible to children SOLID WASTE: 2830,2836
18. Backflow prevention provided no cross connections 03 4 Solid waste property handled,, containers and cleaning 0:2
119, Approved drinking fountains, pressure regulated, cleans equipment kept dean can cleaning facilities adequate
LEAD POISONING HAZARDS: .2816 ANIMAL& VERMIN CONTROL, OUTDOOR LEARNING ENVIRONMENT
*20, No identified lead poisoning hazards in accordance with 6 & PREMISES- .28311, 2832
NCGS 1SOA-131,7(7) *45. Pesticides properly used, no new CCA pressure -treated wood
TOILET AND LAVATORY FACILITIES: 2817, 2818,2836 46CCA pressure -treated wood sealed, date sealed 2
21, Property sized, located, accessible, and in good repair, 04 soil covered or inaccessible,
sinks, toilets and pottychairs cleaned and disinfected 47 No animals in toodprepairation areas and no unrestrained C"3
22, Soap, approved hand drying devices, toilet tissue available 03 animals except as allowed,, no prohibited an [mats,, required
23. Approved storage in toilet rooms, lavatories free of storage 02 vetminaryrecords available and current
hand wash: signs posted 48, Ell edive control of rodents, insects, and other vermin,, premises
DIAPER CHANGING FACILITIES: 2817, 2818,2819;.2820,.2834 free of vermin harborage and breeding areas (_)3
*24. Approved facilities as needed 06 49, Premises clean and drained,, equipment in good repair; 02
*2Diapering surfaces cleaned and disinfected after each use 06 sandboxes properly constructed and clean; adherence to air
26 Approved cleaning and disinfecting solutions provided, test 02 qualityforecast outdoor actiNAty restrictions when applicable
kit available when required SWIMMING &WADING POOLS:.2833
27, Free of storage and in good repair,, cleaning and disinfecting *50, Designed, constru operated and maintained in accordance
04 Designed, ' 'aretr operated and maintain, 016
solutions labeled, approrved diapering methods used, diaper with 16A NCAC .25
chan " " n d harickyrash signs posted
STORAGE-380
*28, Medications properly stored 0 6 E Sjgnature� 1896
*29, Hazardous products properly stored and locked 0 EHS
P �"*sc This fom is used to in plemerd 63 o hild cam t edfAs to srihm d evidem e of m edrs sanbter, A& in 1, pr"epar4dko"' cram star qompleteci by IeW during eath
6 "
k
mspedon, The crioiral 4 sait 611he DWon of Child Dewelopiwk, KC, MRS, om copy 6 givetito the child can ocenbr andihe odtltertcpy 6 kart 6ythe 16tai heath deent, Clic%A 0,15 demeri no fipoiwt dem ent Approved • MSO clemerits,
nay -point demerik lcrwisiimad - 31-45 demetits, orany S-pmt demei# Disapproned - 46 ormore cl�erits, orlaNum to improve Prcou" classfficatkn, rarposdionMis tom may be d�"d in mmydame wilh Standad.81.6., Inspe'diom Retards atria, Records
Retetton and Nspc,4m S ohe*le for rrmmh Defeft*45 wfikh is pt"shed by the NC Nuis ion of Amriu es and rfirtoy. - iWAronanams may NC 2709-102(Counw
N,C, Department of Environment and Natural Resourses Name: BLACKBURN ELEM KID Time Im 0 4 4 Elam
k-UNNIEL, I ION L --- j P M
Division of Environmental Health ID: 2018420097 Time Out: A a F-1 a rn
Street!: 4377 W NC 10 HWY
Total Time: 1 minute P M
General Comment? EjYes