HS REVIEW HARNETT COUNTY CHILD CARE CENTER PLAN REVIEW
APPLICATION
* The application will be reviewed using 15A NCAC 18A .2800 "Rules Governing the
Sanitation of Child Care Facilities."
Plans must be submitted and approved prior to construction, renovation, modification, or upon
the change of ownership of such facilities. Submit plans to the Harnett County Central
Permitting Office located at 108 East Front St., Lillington, NC 27546 or by mail at PO Box 65,
Lillington, NC 27546. You may contact the Central Permitting Office at 910-893-7525, Ext. 2. If
you have questions regarding this application, contact one of the following people listed below at
910-893-7547
Gale Violette Greene, RS Jamie Turlington, RS
Food and Lodging Program Specialist Environmental Health Specialist
Cindy Pierce, RS
Environmental Health Specialist
Y Plans must include drawings showing placement of equipment in the facility,
including storage, food service areas, diaper changing areas, can wash facilities,
along with general plumbing, electrical, mechanical, and lighting plans. You
must also submit equipment and finish schedules.
✓ Each child care classroom should be identified by age group(s) that will be using
the room.
Plans must have a proposed menu provided listing the foods to be served at the
child care center
✓ Plans must include a site plan locating exterior equipment such as dumpsters or
compactors and indicating the proposed connections to approved sewer and water.
In addition, please complete the following information to identify the child care facility and
who to contact about questions regarding the review of this establishment:
/ NEW REMODEL CONVERSION/ADDITION
NAME OF CHILD CARE CENTER: F i r S -V- S4-e p5 L earnrvi nC,C n er
9
CHILD CARE CENTER'S ADDRESS: 942 Joe.) Joh
e rishin ReJ, L;/I,1-65, 0n5V1h0
PHONE: FAX:
NAME OF OWNER: Fa y In4 (CO.X /L;%/,.e, Mae.. l3a i I.e.
y
MAILING ADDRESS: //f ,Sfp�1Je. C4-5-e- 1.1-;,ice [ LII111 NC X33;
PHONE: (I/0) 5/9— 779 EMAIL: run e 1-4e .2 act r ( M
APPLICANT'S NAME: Fa y E. 14) i co2(
MAILING ADDRESS: /// 5.�eep/e- kilos flri
PHONE: ('1l0) 5J`f- 7'7'/ EMAIL: rl.[y►ej4 14 cwt C:-om
TITLE (MANAGER, ARCHITECT, DIRECTOR): Di redo,-
NUMBER OF CHILDREN FOR WHICH FACILITY WILL BE LICENSED: 16
If this is a remodel or a change of ownership, what is the age of the building? AO/
Main Food Service
Meals prepared on site or catered meals? (With catered meals you are still required to have the
minimum requirements in the kitchen) M e_,a j 5 t c)L -DrG fGr.J s i
Where will the children eat meals? (Family style, tables in classrooms, dining area, etc...)
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Will multi-use utensils, silverware, sippy cups, etc... be used or disposable utensils?
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Can the kitchen door be locked?Is there a barrier to keep children out of the kitchen?
77 /(i--- , c aQ r u);.// ,6 e /D c,4j
Please list all e'uipment to be used in the kitchen and include specification sheets: aytkie s f, ;
5 i4 5 ' / /a vaI 1 6 �.l c%�dt.
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Do you have a thermometer available to monitor food temperatures? Ye 5 Do you
have thermometers in the refrigerators? Ye..3
Will leftovers be served? Ve.,5 Will meals be prepared 12 or more hours in advance? NC
Infant Food Service
Will bottles be stored, prepared, warmed, served, etc... in the infant room or in the kitchen?
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Describe your irocedures for handling breast milk: is -mss vY. ozevl , y .rte ul �.zr
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Does the infant room have countertop space for warming bottles? 1 ...S
What method will be used to warm bottles? o t.✓arrfrte/
Is there a refrigerator for bottle storage? ye3 Is there a thermometer? Ye-S
Is there a separate sink used exclusively for bottle/food preparation? Ye...s
Diaper Changing
Are diaper changing stations in each age appropriate room? Ye-s
Where will diaper changing supplies be kept? /ies iii/ 6e, ;6e-17e-;.� .wk- 1:T 111 a�c� x,64
car •
Is there a dirty diaper receptacle with a lid? re--s.
Can the caregiver view the children while changing diapers? ��e.S
Where and how will soapy water, sanitizers and disinfectants be stored?
la' i
;, 16, 54viroje., area, a csz4'a�j" whe "ofri aSe /,
Is there a separate hand wash lavatory used exclusively for diaper ch'nging hand washing?
Are diaper changing signs provided? •Picri r eJia?;,, Sioin5 jv,'/✓ L ie- et s
Cubbies and Storage
How and where will cubbies be arranged? . -r,c/,'✓,d a/ c 4.66;e s t // (re,, / cQ4J
A -e__aC. -- cJct55 . "TA y t r // bee /cheje
Are coat hooks spaced at least 12" apart? Ye.-3
Is all storage in all closets stored off floor (recommend 12") to facilitate cleaning? jle.S
Will toothbrushes be used at the center? 'e Will they be labeled?
Beds, Cots,Mats, Cribs, and Linens
Will cribs have the capability of being spaced 18" apart while in use? (if not, crib dividers and
partitions are acceptable) ( ri rn 1.J;// be- ac /r" part" r,Jhele, ,,ti aSC
iow and where.will cots.and/or 17�ats,be stored? Cc-�s ce/n c� o r me ,
RA!' s to does n0�' -�'rniCI - Y �1�ep/47 5•d e, s M -/-ka,r 127 /Y1�rGl�Cy
where will rib cot, and mat sheets be stored?
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Where is there a designated sick area with cot/mat? /, . .Y 5., e
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Is linen being provided by the center or the parents? 4L ea1 s (4..)//7 provided 4y /4.-
How often will infant sheets be changed? ,1 ),-4rti1>" 51� i,041/ k c �ed 4 /74
50,beef aria crJ ciao >t,
How often will sheets be laundered? 6A444-45 i1j // be' /a u.1£/�ecl t the i.
and / r c4 �i5�' ✓►c e- p rte/ ,� ,
Cleaning, Sanitizing and Disinfecting
Is all furniture in the center of a smooth, washable finish? YES
How will toys in infant and toddler rooms be washed and sanitized? Where? How often? T s art()vi ,✓
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Please explain what type of sanitizer will be used to sanitize toys, food areas, furnituf e, etc.:
5ani ftze (:u3?// - GJ, !n 442. ?re-se4 `d cc ce,t/i-,a7 ;en.
Please explain what type of disinfectant w ll be used to sanitize toilets, lavatories and diaper
changing tables: 77-e, prescrklbee/ 1Y/ u, e4
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Do you have appropriate test strips for the types of sanitizer and disinfectant you are using?
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Where is the can wash facility for cleanin4 trash cans dumping mop water, e c...?
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Will water play centers be used? Ye)
Hand wash lavatories
Does each toilet area have a hand wash lavatory? $ 5
Does the diaper changing station have a hand wash lavatory exclusively for diaper changing?
eta
Does the fo d service area in the infant and toddler room have a lavatory exclusively for food
service? 7c
Does the kitchen have a hand sink that is separate from the 2 or 3 compartment sink for hand
washing only? '(e3
What types of faucets are at all hand wash lavatories (please note that metering type is not
allowed unless they can retain warm water for at least 20 secongs at the first pressing):
2 rn =�erl✓i 5 ype- a);// A Uf eese¢,
Are handwashing signs provided? ye 3
Locked Items
Please indicate where the following type of locked items will be stored and what type of lock:
Medicines (both refrige ated and non refrigerated)
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,
Cleaning supplies and all types of chemicals ,
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Personal b//eloo/ngings (purses, keys, emplo ee it ms) i /
Aerosols and all other toxic products
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Mildly Ill Children
Will you be licensed to care for mildly ill children pursuant to 10A NCAC 09 .2400? ClIl>
Please include your protocols for this type of care.
Water Supply
Is the child care center on a well or provided with county water? n;,t,-)
/7
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Sewage Disposal
Is disposal through an onsite septic system or county sewer? On s i sph'c- sysfkm
Grease trap provided? /y O J
Hot Water Supply
The kitchen hot water temperature will need to be a minimum of 120 degrees Fahrenheit. All
other sinks that are accessible to children and the can wash facility must be maintained between
80-110'Fahrenheit. Using two separate water heaters may be the best option since it is often
difficult to obtain two separate temperatures with one water heater. Mixing valves installed on
sinks have a high failure rate and are not very dependable.
Explain what the specifications of your water heater(s) are. (For example, if you are using two
water heaters, indicate which one is for the kitchen and which one if for the classrooms). It
is recommended that the minimum water heater size be 50 gallons.
j J 60,7/ be- a si`i.) a/-tee?s/ 02- wait t{ups i^ W.-e- h di jc.vss;vn,
Tank Manufacturer and Model #
Storage tank size GPH recovery Additional tank size
Lighting
Do all light fixtures have shatterproof or shielded bulbs? yea
Will lighting illuminate 50 ft. candles at all work areas? i S
and 10 ft. candles at all other areas, including storage closets? e.a.
Finishes
Please describe the finishes/construction material in the following areas:
_ Floors Walls Baseboards Ceilings
Kitchen `
Bathrooms l ev:;utd V1 5TT-i j75 771
Infant Room �/
Toddler Room /
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// // // //
Other Rooms /
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Staff Room/Office /1 -
Storeroom // — - _
Other /1
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*Wall to wall carpets must be cleaned at least every six months
Animals
What type of animals will be on the premises? WA'
Outside premises
Please describe the playground area (size, type of play equipment, type of fence, water activities,
etc...) IL 1 a u / cc e w' • -ears
/'zt5 5 Sur^ •inc/ l Q. S' -Z:v •-n e ��1
Is there chromated copper arsenate (CCA) pressure-treated wood in the play ground area?
Na
What methods will you use to make this inaccessible to the children? NA
Is the can wash facility located outside? ye..S
If yes, is there a fence and lock around it so it is not accessible to children? Y
Is the HVAC, mechanical equipment, etc... locked with a fence around it so it is not accessible
to children? Ncr oc cc-e s sr'14-e-- --le Civ.`diems. (ce-e- 5 1/1?/7 )
Attach additional sheets if necessary.
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8/06
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