10A NCAC 09 .0608 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0713 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0701 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.1102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 10/23/2025 Number Present: 42 Completed Date: 10/23/2025 Age: From 1 To 5 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator, was available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was seventy-nine percent (79%) as of 10/22/2025. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Corporation, Montessori Footprints, LLC, is current/active as of 10/22/2025. Permit type – One (1) Star Center License, 2/19/2017 Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/19/2024. The last fire drill was practiced on 10/23/2025. A fire drill was conducted during the visit at 11:40a. All staff and children evacuated the building and lined up against the back fence of the playground. The last shelter-in-place drill was practiced on 10/13/2025. The last playground inspection was documented on 9/22/2025. The last fire inspection was approved on 8/4/2025. The last sanitation inspection was conducted on 1/22/2025 with eleven (11) demerits for a superior classification. Lead water testing was completed on 3/6/2025 without hazards. Lead paint and asbestos testing was completed on 5/17/2024. The Emergency Medical Care plan was posted and current. The program does not provide transportation. Space #1 the group of three- to five-year- olds were engaged in free play with free art, math activity, puzzles, blocks, books, and soft toys. After free play, the group washed their hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with sand, trucks, and blocks. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap Space #3 the group of one- to two- year- old children were putting on their coats to go outside for gross motor play. Once outside, the group engaged in play by digging in the sand, climbing on the climber, and sliding down the slide. The staff members were frequently scanning and counting the children while engaging. While monitoring the indoor environment, I observed two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #4 the group of two- to -three-year-old children were engaged in free play with blocks, animals, and number activity. The staff member was actively engaged in play with the children while adequately supervising. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play at 11:30a. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Space #5 the group of three- to five-year-olds were engaged in free play with puzzles, literacy activity, number activity, reading, blocks, links, and train. While monitoring the indoor area, I observed the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. While monitoring medications, I observed one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. After free play, the group washed hands and prepared for snack brought from home. When snack concluded, the group prepared to go outside for gross motor play. Outside, the group engaged in play with the climber, sand, cars, trucks, and digging toys. At 11:40a, a fire drill was conducted and the group lined up on the back fence until the fire drill concluded. The children then returned to outdoor play. After outdoor play, the group transitioned indoors to wash hands and prepare for lunch and nap. Children bring their meals and snacks from home. Staff file concerns: Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. We discussed that the policy must be reviewed and signed prior to caring for children. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Five (5) children’s files were monitored and in compliance. We discussed if the health care needs questions do not pertain to the child, the parents need to document none or not applicable. QRIS modernization discussion: We discussed whether or not the program wishes to pursue the QRIS pathways. The program wishes to continue operating as a one (1) star program and will notify me if and when they would like to pursue the QRIS modernization pathways to the stars. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 705 Equipment and furnishings were not sturdy, stable and free of hazards. Space #5, the red couch located in the books center that had several tears exposing the foam. .0601(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #5, one (1) tube of sunscreen that was to be discarded. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. .0701(a) 1757 A valid qualification letter was not on file and available to review at the facility. Staff member F. AL. Abed hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. G.S. 110-90.2(b) & (d) & .2703(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. .0608(d)(1-4) 1898 Staff did not complete the health and safety training within one year of employment. Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. .1102(a) Technical assistance was provided as follows: Item 705- Space #5, the red couch located in the books center that had several tears exposing the foam. The staff attempted to add colored duct tape, but it was peeling off. The staff removed the old tape and replaced it with new tape during the visit as a temporary fix until a new couch can be ordered. Rule Reference: 10A NCAC 09 .0601(c) Item 849- Space #5, one (1) tube of sunscreen that was to be discarded. The administrator discarded the sunscreen in the outdoor dumpster during the visit. Space #3, two (2) tubes of petroleum jelly that expired 4/2025. The administrator discarded the two (2) tubes during the visit. Rule Reference: 10A NCAC 09 .0803(12) Item 1032- Staff member hired 10/22/2025, medical report was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, medical report was not completed and on file prior to the first day of employment. We discussed when a new staff member is hired a medical report must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1033- Staff member hired 10/22/2025, TB test was not completed and on file prior to the first day of employment. Staff member hired 8/4/2025, TB test was not completed prior to the first day of employment and/or within twelve (12) months of employment. The TB test on file was dated 11/27/2020. We discussed when a new staff member is hired a TB test must be completed and on file prior to the first day of employment. Rule Reference: 10A NCAC 09.0701(a) Item 1757- Staff member hired 10/22/2025, valid qualification letter was not on file and available for review at the facility. The ABCMS portal was viewed during the visit, the staff member does have a valid qualifying letter that expires 2/19/2030 but was not on file for review. We discussed when a new staff member is hired a valid qualifying letter must be on file for review the first day of employment. Rule Reference: G.S. 110-90.2 &.2703(c) Item 1874- Staff member hired 5/16/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 5/25/2025. Staff member hired 8/4/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. The Signed acknowledgement on file was dated 8/26/2025. Staff member hired 10/22/2025 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children with signed acknowledgement. We discussed that the policy must be reviewed and signed prior to caring for children. Rule Reference: 10A NCAC 09 .0608(d)(1-4) Item 1898- Staff member hired 5/14/2024, health and safety trainings were not completed within one year of employment. The completion certificates on file were dated 9/24/2025. We discussed that the health and safety trainings must be completed within one year of employment. Rule Reference: 10A NCAC 09.1102(a) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 11/6/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: - We reviewed the rule 10A NCAC 09 .0713 staff/child ratio and what documentation is needed to have on file. 10A NCAC 09 .0713 (3) a child two years of age and older may be placed with children under one year of age when a physician certifies that the developmental age of the child makes this placement appropriate; (4) when determined to be developmentally appropriate by the operator and parent, a child age two or older may be placed one age level above his or her chronological age without affecting the staff/child ratio for that group. This provision shall be limited to one child per group; - We also discussed when new items are added outdoors to ensure the climbing structures have a six (6) foot fall zone around the entire climbing structure. - Ensure a file is kept with all manufactures instructions and ASTM certification. You were able to access them through your email, but I recommend creating a file on your computer or print the documents to have in a file for review. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0604 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0510 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2506 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0604 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0803 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 4/24/2025 Number Present: 35 Completed Date: 4/24/2025 Age: From 1 To 5 Total Minutes: 210 Time In: 10:15 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/19/2024. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions The last fire drill was practiced on 4/21/2025. The last emergency drill, shelter in place drill, was practiced on 2/26/2025. The next drill will be due by 5/31/2025. The last fire inspection was approved on 8/26/2024 The program’s most recent sanitation inspection was completed on 1/22/2025 with eleven (11) demerits for a superior classification. The Emergency Medical Care Plan is posted and was updated. During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free play with water colors, manipulatives, number activity, cars, plastic eggs, and books. One (1) child was on the Ipad at 10:38a playing a game. The child got off of the Ipad at 10:45a. When I asked about the screen time log, the teacher stated she allows the children about five (5) minutes and rotate to the next child. We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). While monitoring the classroom, I observed a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. Space #2 the group of two- to three-year-old children were preparing to go outside. The children were putting on their rain coats and boots. While monitoring the classroom, I observed one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Space #3 the group of one-year- old children were engaged in gross motor play with the trikes. One (1) staff member brought a child in for a routine diaper change and another staff member stayed with the remaining children outside. The staff was observed conducting diaper change. Space #4 the group of three year old children were engaged in gross motor play with the sandbox, trucks, shovels, climber, hula hoops, and bubbles. Space #5 the group of three- to five-year-olds were engaged in free play. After free play, the children prepared for snack brought from home. All three (3) outdoor spaces were monitored. While entering the outdoor spaces from the ramp, I observed the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice will need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp, and the adult power tool will need to be locked when not in use. Also, we discussed that mulch will need to be added to the pathway on playground C or the exposed felt will need to be cut to ensure a child does not trip and fall. Children bring their meals and snacks from home. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: One (1) staff member hired 9/20/2022 First Aid and CPR training was due by 2/5/2025. Current First Aid and CPR certification was not on file for review. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. 10A NCAC 09 .0601(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. 10A NCAC 09 .0604(c) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. .1102(d) 1422 Potentially hazardous items such as archery equipment, hand and power tools, nails, chemicals, or propane stoves, were not stored in locked areas or with other safeguards, or removed from the premises. Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. .2506(c) Technical assistance was provided as follows: Item 807 Outdoors, the lattice at the end of the ramp was not secured to the base of the ramp and an adult power tool was observed sitting behind the lattice that was not secured. On playground C, I observed the black felt exposed creating a potential tripping hazard. We discussed that the lattice would need to be secured back to the base of the ramp to prevent a child from moving the lattice and getting under the ramp. On playground C, mulch would need to be added to the pathway or the exposed felt will need to be cut to ensure a child does not trip and fall. Rule Reference: 10A NCAC 09 .0601(a) Item 812 Space #1, a power strip with six (6) uncovered electrical outlets on top of the science shelf. When I spoke with the teacher about it, she stated that when they were cleaning the carpet they must have left it on the shelf because it is typically between the shelf and the wall. The teacher moved the power strip back behind the shelf during the visit. I recommend conducting a classroom check prior to children arriving to ensure that items are stored appropriately and all electrical outlets are covered. Rule Reference: 10A NCAC 09.0604(c) Item 849 Space #2, one (1) tube of Aquaphor diaper cream expired 11/2024. We discussed that staff need to check all medications at least monthly to ensure that the medication forms and medication is within in the authorized administration dates and not expired. Rule Reference: 10A NCAC 09.0803(12) Item 1048 One (1) staff member hired 9/20/2022, First Aid training was due by 2/5/2025. Current First Aid certification was not on file for review. We discussed that First Aid certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(c) Item 1049 One (1) staff member hired 9/20/2022, CPR training was due by 2/5/2025. Current CPR certification was not on file for review. We discussed that CPR certification is good for two (2) years from the date the training was taken unless otherwise stated on the certification card. I recommend documenting training due dates on a chart or noting training due dates on your calendar to remind you to when staff are due. Rule Reference: 10A NCAC 09 .1102(d) Item 1422 Outside, an adult power tool was observed sitting behind the lattice that was not secured at the end of the ramp. We discussed that adult power tools not in use must be stored in locked storage or removed from the premises. The administrator moved the power tool to locking storage during the visit. Rule Reference: 10A NCAC 09 .2506(c) Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/8/2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Screen Time- We discussed that screen time must be maintained on the activity plan or a cumulative log to show the amount of time each child spends on the Ipad or any electronic device each day to not exceed thirty (30) minutes a day and two and a half hours a week per rule 10A NCAC 09 .0510 (d)(2). Reminders: First Aid and CPR renewal is due by 7/15/25 for MM and JD, and 10/28/25 for KD. We reviewed staff on-going training hours and when they are due. The following staff On-going training hours are due by 9/20/25 for SM (8 hrs), 6/7/25 for JD (10 hrs), 6/20/25 for MM (10hrs), 8/23/25 for KD (10hrs), 11/5/25 for NT (10hrs). Lead Paint and Asbestos Testing- In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@ dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/19/2024 Number Present: 37 Completed Date: 11/19/2024 Age: From 1 To 5 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 11/18/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC, is current/active as of 11/18/2024. Permit type – One (1) Star Rated License, issued 2/19/2017. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/3/2023. The annual compliance visit was delayed due to Tropical Storm Helene. The last fire drill was practiced on 11/13/2024. The last shelter-in-place drill was practiced on 9/24/2024. Next drill is due by 12/24/2024. The last playground inspection was documented on 10/28/2024. The November playground inspection is due by 11/29/2024. The last fire inspection was approved on 8/26/2024. The last sanitation inspection was conducted on 1/25/2024 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I was greeted by the Administrator. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024 under a boil water advisory. The boil water advisory was changed to a boil water notice systemwide on 10/14/2024. The facility was given guidance to develop an Emergency Operation Plan (EOP) for boil water notice. The EOP was approved by the Division and Environmental Health on 10/28/2024. Environmental Health conducted a site visit on 10/31/2024, for continued operation. The boil water notice was lifted on 11/18/2024. The facility is currently operating with the EOP procedures in place. The administrator asked if the facility could resume normal operation. Per Environmental Health guidance the facility may resume normal operation as long as the administrator verifies that the following requirements have been completed: • Flush pipes/faucets: follow the directions of your water utility (in the newspaper, radio, or television) or, as general guidance, run cold water faucets for at least 5 minutes. • Equipment with water line connections such as post-mix beverage machines, spray misters, coffee or tea urns, ice machines, glass washers, dishwashers, and other equipment with water connections must be flushed, cleaned, and sanitized in accordance with manufacturer's instructions. Attention should be given to waterline strainers, faucet aerators and faucet screens. • Run water softeners through a regeneration cycle. • Drain reservoirs in tall buildings. • Flush hot water tank. • Flush drinking fountains: run continuously for 5 minutes. • Water Filter cartridges should be replaced and canisters sanitized. Ice Machine Sanitation: • Flush the water line to the machine inlet. • Close the valve on the water line behind the machine and disconnect the waterline from the machine inlet. • Open the valve, run 5 gallons of water through the valve and dispose of the water. • Close the valve and reconnect the line. • Discard the first three batches of ice. Please continue to stay up to date on the water status in your area as the boil water notice or advisory could be re-issued at a later date. While monitoring the indoor space, I observed the following: Space #1 the group of three- to five-year- olds were engaged in free play with letter recognition, leaf sorting, free art, books, writing, with calming music playing softly. The staff member was moving about the indoor area engaging in play and conversations with the children while actively supervising. While monitoring the room, the teacher and I discussed the need for the Purell hand sanitizer wipes to be moved up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. Space #2 the group of two- to three-year-old children were engaged in story time on the carpet. After group time, the children prepared for snack at the tables. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, one (1) Aquaphor expired 11/2024. Space #3 the group of one- to two-year- old children were preparing to transition outdoors for gross motor play. While monitoring, I observed one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. One (1) Desitin expired 10/2024. Two (2) diaper creams expire 11/2024. Space #4 the group of two to three year old children were engaged in free play with bristle blocks, magnetic tiles, matching game, blocks, and trucks. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. Space #5 the group of three- to five-year-olds were engaged in free play with free art, colors, numbers, and puzzles. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed a cabinet with hazardous products unlocked. The administrator locked the cabinet during the visit. While monitoring the outdoor space, I did observe a opening in the fence that was sustained due to Tropical Storm Helene. The facility is able to use the outdoor gross motor space. The administrator and I discussed how the facility could correct this and what the timeline would be to have this opening fixed. Children bring their meals and snacks from home. The program does not provide transportation. The staff and children’s files were monitored. A staff and training worksheet was completed for the staff files received prior to today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, one (1) sunscreen that expired 4/2024. In space #4, one (1) sunscreen that expired 6/2024. .0803(12) Technical assistance was provided as follows: Item # 840- In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. The staff and I discussed the need to move the hand sanitizer wipes up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. The staff member moved the wipes up five (5) feet to be inaccessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator locked the cabinet during the visit. Rule Reference: 10A NCAC 09.0803(12) Item #849- In space #3, one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. In space #4, one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator and I discussed the need to conduct a monthly medication check to ensure that all permission to administer medication forms and medications are valid for continue use to prevent any reoccurrences. Rule Reference: 15A NCAC 18A.2820(b) Consultation is provided as follows: We discussed that all child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. Reminders regarding staff trainings coming due: Staff member hired 6/10/2024, health and safety trainings are due by 6/10/2025. Staff member hired 5/14/2024, health and safety trainings are due by 5/14/2025. Staff member hired 2/12/2016, health and safety trainings are due by 9/27/2025. On-going training hours are due by 2/12/2025. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/19/2024 Number Present: 37 Completed Date: 11/19/2024 Age: From 1 To 5 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 11/18/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC, is current/active as of 11/18/2024. Permit type – One (1) Star Rated License, issued 2/19/2017. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/3/2023. The annual compliance visit was delayed due to Tropical Storm Helene. The last fire drill was practiced on 11/13/2024. The last shelter-in-place drill was practiced on 9/24/2024. Next drill is due by 12/24/2024. The last playground inspection was documented on 10/28/2024. The November playground inspection is due by 11/29/2024. The last fire inspection was approved on 8/26/2024. The last sanitation inspection was conducted on 1/25/2024 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I was greeted by the Administrator. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024 under a boil water advisory. The boil water advisory was changed to a boil water notice systemwide on 10/14/2024. The facility was given guidance to develop an Emergency Operation Plan (EOP) for boil water notice. The EOP was approved by the Division and Environmental Health on 10/28/2024. Environmental Health conducted a site visit on 10/31/2024, for continued operation. The boil water notice was lifted on 11/18/2024. The facility is currently operating with the EOP procedures in place. The administrator asked if the facility could resume normal operation. Per Environmental Health guidance the facility may resume normal operation as long as the administrator verifies that the following requirements have been completed: • Flush pipes/faucets: follow the directions of your water utility (in the newspaper, radio, or television) or, as general guidance, run cold water faucets for at least 5 minutes. • Equipment with water line connections such as post-mix beverage machines, spray misters, coffee or tea urns, ice machines, glass washers, dishwashers, and other equipment with water connections must be flushed, cleaned, and sanitized in accordance with manufacturer's instructions. Attention should be given to waterline strainers, faucet aerators and faucet screens. • Run water softeners through a regeneration cycle. • Drain reservoirs in tall buildings. • Flush hot water tank. • Flush drinking fountains: run continuously for 5 minutes. • Water Filter cartridges should be replaced and canisters sanitized. Ice Machine Sanitation: • Flush the water line to the machine inlet. • Close the valve on the water line behind the machine and disconnect the waterline from the machine inlet. • Open the valve, run 5 gallons of water through the valve and dispose of the water. • Close the valve and reconnect the line. • Discard the first three batches of ice. Please continue to stay up to date on the water status in your area as the boil water notice or advisory could be re-issued at a later date. While monitoring the indoor space, I observed the following: Space #1 the group of three- to five-year- olds were engaged in free play with letter recognition, leaf sorting, free art, books, writing, with calming music playing softly. The staff member was moving about the indoor area engaging in play and conversations with the children while actively supervising. While monitoring the room, the teacher and I discussed the need for the Purell hand sanitizer wipes to be moved up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. Space #2 the group of two- to three-year-old children were engaged in story time on the carpet. After group time, the children prepared for snack at the tables. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, one (1) Aquaphor expired 11/2024. Space #3 the group of one- to two-year- old children were preparing to transition outdoors for gross motor play. While monitoring, I observed one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. One (1) Desitin expired 10/2024. Two (2) diaper creams expire 11/2024. Space #4 the group of two to three year old children were engaged in free play with bristle blocks, magnetic tiles, matching game, blocks, and trucks. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. Space #5 the group of three- to five-year-olds were engaged in free play with free art, colors, numbers, and puzzles. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed a cabinet with hazardous products unlocked. The administrator locked the cabinet during the visit. While monitoring the outdoor space, I did observe a opening in the fence that was sustained due to Tropical Storm Helene. The facility is able to use the outdoor gross motor space. The administrator and I discussed how the facility could correct this and what the timeline would be to have this opening fixed. Children bring their meals and snacks from home. The program does not provide transportation. The staff and children’s files were monitored. A staff and training worksheet was completed for the staff files received prior to today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, one (1) sunscreen that expired 4/2024. In space #4, one (1) sunscreen that expired 6/2024. .0803(12) Technical assistance was provided as follows: Item # 840- In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. The staff and I discussed the need to move the hand sanitizer wipes up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. The staff member moved the wipes up five (5) feet to be inaccessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator locked the cabinet during the visit. Rule Reference: 10A NCAC 09.0803(12) Item #849- In space #3, one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. In space #4, one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator and I discussed the need to conduct a monthly medication check to ensure that all permission to administer medication forms and medications are valid for continue use to prevent any reoccurrences. Rule Reference: 15A NCAC 18A.2820(b) Consultation is provided as follows: We discussed that all child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. Reminders regarding staff trainings coming due: Staff member hired 6/10/2024, health and safety trainings are due by 6/10/2025. Staff member hired 5/14/2024, health and safety trainings are due by 5/14/2025. Staff member hired 2/12/2016, health and safety trainings are due by 9/27/2025. On-going training hours are due by 2/12/2025. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/19/2024 Number Present: 37 Completed Date: 11/19/2024 Age: From 1 To 5 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 11/18/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC, is current/active as of 11/18/2024. Permit type – One (1) Star Rated License, issued 2/19/2017. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/3/2023. The annual compliance visit was delayed due to Tropical Storm Helene. The last fire drill was practiced on 11/13/2024. The last shelter-in-place drill was practiced on 9/24/2024. Next drill is due by 12/24/2024. The last playground inspection was documented on 10/28/2024. The November playground inspection is due by 11/29/2024. The last fire inspection was approved on 8/26/2024. The last sanitation inspection was conducted on 1/25/2024 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I was greeted by the Administrator. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024 under a boil water advisory. The boil water advisory was changed to a boil water notice systemwide on 10/14/2024. The facility was given guidance to develop an Emergency Operation Plan (EOP) for boil water notice. The EOP was approved by the Division and Environmental Health on 10/28/2024. Environmental Health conducted a site visit on 10/31/2024, for continued operation. The boil water notice was lifted on 11/18/2024. The facility is currently operating with the EOP procedures in place. The administrator asked if the facility could resume normal operation. Per Environmental Health guidance the facility may resume normal operation as long as the administrator verifies that the following requirements have been completed: • Flush pipes/faucets: follow the directions of your water utility (in the newspaper, radio, or television) or, as general guidance, run cold water faucets for at least 5 minutes. • Equipment with water line connections such as post-mix beverage machines, spray misters, coffee or tea urns, ice machines, glass washers, dishwashers, and other equipment with water connections must be flushed, cleaned, and sanitized in accordance with manufacturer's instructions. Attention should be given to waterline strainers, faucet aerators and faucet screens. • Run water softeners through a regeneration cycle. • Drain reservoirs in tall buildings. • Flush hot water tank. • Flush drinking fountains: run continuously for 5 minutes. • Water Filter cartridges should be replaced and canisters sanitized. Ice Machine Sanitation: • Flush the water line to the machine inlet. • Close the valve on the water line behind the machine and disconnect the waterline from the machine inlet. • Open the valve, run 5 gallons of water through the valve and dispose of the water. • Close the valve and reconnect the line. • Discard the first three batches of ice. Please continue to stay up to date on the water status in your area as the boil water notice or advisory could be re-issued at a later date. While monitoring the indoor space, I observed the following: Space #1 the group of three- to five-year- olds were engaged in free play with letter recognition, leaf sorting, free art, books, writing, with calming music playing softly. The staff member was moving about the indoor area engaging in play and conversations with the children while actively supervising. While monitoring the room, the teacher and I discussed the need for the Purell hand sanitizer wipes to be moved up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. Space #2 the group of two- to three-year-old children were engaged in story time on the carpet. After group time, the children prepared for snack at the tables. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, one (1) Aquaphor expired 11/2024. Space #3 the group of one- to two-year- old children were preparing to transition outdoors for gross motor play. While monitoring, I observed one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. One (1) Desitin expired 10/2024. Two (2) diaper creams expire 11/2024. Space #4 the group of two to three year old children were engaged in free play with bristle blocks, magnetic tiles, matching game, blocks, and trucks. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. Space #5 the group of three- to five-year-olds were engaged in free play with free art, colors, numbers, and puzzles. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed a cabinet with hazardous products unlocked. The administrator locked the cabinet during the visit. While monitoring the outdoor space, I did observe a opening in the fence that was sustained due to Tropical Storm Helene. The facility is able to use the outdoor gross motor space. The administrator and I discussed how the facility could correct this and what the timeline would be to have this opening fixed. Children bring their meals and snacks from home. The program does not provide transportation. The staff and children’s files were monitored. A staff and training worksheet was completed for the staff files received prior to today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, one (1) sunscreen that expired 4/2024. In space #4, one (1) sunscreen that expired 6/2024. .0803(12) Technical assistance was provided as follows: Item # 840- In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. The staff and I discussed the need to move the hand sanitizer wipes up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. The staff member moved the wipes up five (5) feet to be inaccessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator locked the cabinet during the visit. Rule Reference: 10A NCAC 09.0803(12) Item #849- In space #3, one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. In space #4, one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator and I discussed the need to conduct a monthly medication check to ensure that all permission to administer medication forms and medications are valid for continue use to prevent any reoccurrences. Rule Reference: 15A NCAC 18A.2820(b) Consultation is provided as follows: We discussed that all child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. Reminders regarding staff trainings coming due: Staff member hired 6/10/2024, health and safety trainings are due by 6/10/2025. Staff member hired 5/14/2024, health and safety trainings are due by 5/14/2025. Staff member hired 2/12/2016, health and safety trainings are due by 9/27/2025. On-going training hours are due by 2/12/2025. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09.0803 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/19/2024 Number Present: 37 Completed Date: 11/19/2024 Age: From 1 To 5 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was left on-site with you. Krysty Marcus, Administrator was on-site and available during the visit. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-two percent (82%) as of 11/18/2024. The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC, is current/active as of 11/18/2024. Permit type – One (1) Star Rated License, issued 2/19/2017. Special Services/Restrictions – first shift, meets enhanced space. The last annual compliance visit was conducted on 11/3/2023. The annual compliance visit was delayed due to Tropical Storm Helene. The last fire drill was practiced on 11/13/2024. The last shelter-in-place drill was practiced on 9/24/2024. Next drill is due by 12/24/2024. The last playground inspection was documented on 10/28/2024. The November playground inspection is due by 11/29/2024. The last fire inspection was approved on 8/26/2024. The last sanitation inspection was conducted on 1/25/2024 with six (6) demerits for a superior classification. The Emergency Medical Care plan was posted and current. Upon arrival, I was greeted by the Administrator. The facility closed on 9/27/2024 due to Tropical Storm Helene and re-opened after Tropical Storm Helene on 10/7/2024 under a boil water advisory. The boil water advisory was changed to a boil water notice systemwide on 10/14/2024. The facility was given guidance to develop an Emergency Operation Plan (EOP) for boil water notice. The EOP was approved by the Division and Environmental Health on 10/28/2024. Environmental Health conducted a site visit on 10/31/2024, for continued operation. The boil water notice was lifted on 11/18/2024. The facility is currently operating with the EOP procedures in place. The administrator asked if the facility could resume normal operation. Per Environmental Health guidance the facility may resume normal operation as long as the administrator verifies that the following requirements have been completed: • Flush pipes/faucets: follow the directions of your water utility (in the newspaper, radio, or television) or, as general guidance, run cold water faucets for at least 5 minutes. • Equipment with water line connections such as post-mix beverage machines, spray misters, coffee or tea urns, ice machines, glass washers, dishwashers, and other equipment with water connections must be flushed, cleaned, and sanitized in accordance with manufacturer's instructions. Attention should be given to waterline strainers, faucet aerators and faucet screens. • Run water softeners through a regeneration cycle. • Drain reservoirs in tall buildings. • Flush hot water tank. • Flush drinking fountains: run continuously for 5 minutes. • Water Filter cartridges should be replaced and canisters sanitized. Ice Machine Sanitation: • Flush the water line to the machine inlet. • Close the valve on the water line behind the machine and disconnect the waterline from the machine inlet. • Open the valve, run 5 gallons of water through the valve and dispose of the water. • Close the valve and reconnect the line. • Discard the first three batches of ice. Please continue to stay up to date on the water status in your area as the boil water notice or advisory could be re-issued at a later date. While monitoring the indoor space, I observed the following: Space #1 the group of three- to five-year- olds were engaged in free play with letter recognition, leaf sorting, free art, books, writing, with calming music playing softly. The staff member was moving about the indoor area engaging in play and conversations with the children while actively supervising. While monitoring the room, the teacher and I discussed the need for the Purell hand sanitizer wipes to be moved up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. Space #2 the group of two- to three-year-old children were engaged in story time on the carpet. After group time, the children prepared for snack at the tables. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, one (1) Aquaphor expired 11/2024. Space #3 the group of one- to two-year- old children were preparing to transition outdoors for gross motor play. While monitoring, I observed one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. One (1) Desitin expired 10/2024. Two (2) diaper creams expire 11/2024. Space #4 the group of two to three year old children were engaged in free play with bristle blocks, magnetic tiles, matching game, blocks, and trucks. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. Space #5 the group of three- to five-year-olds were engaged in free play with free art, colors, numbers, and puzzles. The staff was moving about the indoor area engaging in conversations while actively supervising the children. While monitoring, I observed a cabinet with hazardous products unlocked. The administrator locked the cabinet during the visit. While monitoring the outdoor space, I did observe a opening in the fence that was sustained due to Tropical Storm Helene. The facility is able to use the outdoor gross motor space. The administrator and I discussed how the facility could correct this and what the timeline would be to have this opening fixed. Children bring their meals and snacks from home. The program does not provide transportation. The staff and children’s files were monitored. A staff and training worksheet was completed for the staff files received prior to today’s visit. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3, one (1) sunscreen that expired 4/2024. In space #4, one (1) sunscreen that expired 6/2024. .0803(12) Technical assistance was provided as follows: Item # 840- In space #1, two (2) Purell hand sanitizer wipes were on the counter accessible to the children. The staff and I discussed the need to move the hand sanitizer wipes up five (5) feet inaccessible to the children. We reviewed that all hand sanitizers should be inaccessible to the children on or the staff members person when not in use. When using hand sanitizers, the staff member should be actively supervising the children to ensure that the hand sanitizer is rubbed in and dry. The staff member moved the wipes up five (5) feet to be inaccessible to the children. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator locked the cabinet during the visit. Rule Reference: 10A NCAC 09.0803(12) Item #849- In space #3, one (1) sunscreen that expired 4/2024. The administrator removed it during the visit. In space #4, one (1) sunscreen that expired 6/2024. The administrator removed the sunscreen during the visit. In space #5, one (1) cabinet containing hand sanitizer wipes was unlocked. The administrator and I discussed the need to conduct a monthly medication check to ensure that all permission to administer medication forms and medications are valid for continue use to prevent any reoccurrences. Rule Reference: 15A NCAC 18A.2820(b) Consultation is provided as follows: We discussed that all child care facility administrators are required to complete the new ABCMS criminal background check portal training on Moodle. Once the training is complete, the administrator will need to log into the ABCMS system to review the staff roster to ensure that all current staff members are listed. When someone is hired or terminated, the administrator will need to log into the ABCMS system to indicate the hire or termination date. Reminders regarding staff trainings coming due: Staff member hired 6/10/2024, health and safety trainings are due by 6/10/2025. Staff member hired 5/14/2024, health and safety trainings are due by 5/14/2025. Staff member hired 2/12/2016, health and safety trainings are due by 9/27/2025. On-going training hours are due by 2/12/2025. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0302 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/20/2024 Number Present: 43 Completed Date: 5/20/2024 Age: From 1 To 5 Total Minutes: 90 Time In: 12:05 PM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to follow up on the nurture and care violation that was cited during a routine unannounced visit on 5/6/2024, and complaint visit on 5/15/2024. Please refer to the visits dated 5/6/2024 and 5/15/2024 for full details regarding the violation cited. Upon arrival, I was greeted by Megan Marcus, Lead Teacher and Krysty Marcus, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left with you. Group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. Additionally, I observed the indoor and outdoor space used by the children. Space #4 group of three- to four-year-olds were transitioning to lunch. After lunch, the children transitioned to nap. Space #5 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #1 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #2 group of two- to three-year-old children were transitioning from lunch to nap. Staff were actively supervising the children while assisting the children with calming down to rest. During nap time, one (1) staff member sat with a child to assist them with calming down by rubbing their back while the other staff member provided assistance in the restroom and supervised the children. Space #3 group of one- to two-year-old children were finishing lunch and transitioning to their cots for nap time. While one (1) staff member was assisting the children still eating at the table, the other staff member was reading a book to the children that were finished with lunch. While observing and monitoring the classroom, I observed the attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. Space #6 currently not in use. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. The violation cited during the 5/6/2024 visit is in compliance based on the observations today and the administrative measures taken below have been implemented. Since the incident on 5/6/2024 and 5/15/2024, the following measure have been put into place: - Staff action place was developed and implemented. - Reviewed the school discipline procedures. - Reviewed the glueing technique where you keep the child close to you if there is a challenging behavior situation. - Reviewed positive redirection and individual activities. - Steps for asking for assistance: walkie talkie first, call into the doorway, and send a message on Brightwheel. - Mentored by a veteran teacher with ten (10) years’ experience. - Use the staff split schedule. - Staff member has been reassigned to another classroom with smaller group size. ** All the steps listed above were observed in use today. - The staff involved in the incident observed during the 5/6/2024 visit, the administrator has developed an action plan for the staff member. The administrator and staff member will follow up regarding the measures put in place during the June 10-14 teacher work week and the week of July 15-19. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the photo provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** The violation cited during the 5/15/2024 visit is in compliance based on the observations today. The staff member identified in the picture is no longer employed at the facility. The administrator stated that a all staff meeting is scheduled for 5/21/2024 to review and refresh all staff members on the school discipline procedures, safe sleep policies, and developmentally appropriate care. The following violation was documented: Violation Number Comment Rule 1301 Center did not maintain a record of daily attendance. In space #3 the daily attendance was not completed for May 17th and May 20th. GS 110-91(9) Technical Assistance Item 1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; - In space #3 the daily attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. I recommend reviewing with staff the importance of completing the daily attendance when the children arrive. Consultation We discussed the following: - Because a violation regarding nurture and care was cited during the 5/6/24 and 5/15/24 visits, it could result in an Administrative Action. Refer to SECTION .2200 ADMINISTRATIVE ACTIONS AND CIVIL PENALTIES regarding Administrative Actions. - Continue to enforce the measure put in place that is documented in the staff action plan. - Separation barriers pay close attention to staff supervising the children at all times. "10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request." Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/20/2024 Number Present: 43 Completed Date: 5/20/2024 Age: From 1 To 5 Total Minutes: 90 Time In: 12:05 PM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to follow up on the nurture and care violation that was cited during a routine unannounced visit on 5/6/2024, and complaint visit on 5/15/2024. Please refer to the visits dated 5/6/2024 and 5/15/2024 for full details regarding the violation cited. Upon arrival, I was greeted by Megan Marcus, Lead Teacher and Krysty Marcus, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left with you. Group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. Additionally, I observed the indoor and outdoor space used by the children. Space #4 group of three- to four-year-olds were transitioning to lunch. After lunch, the children transitioned to nap. Space #5 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #1 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #2 group of two- to three-year-old children were transitioning from lunch to nap. Staff were actively supervising the children while assisting the children with calming down to rest. During nap time, one (1) staff member sat with a child to assist them with calming down by rubbing their back while the other staff member provided assistance in the restroom and supervised the children. Space #3 group of one- to two-year-old children were finishing lunch and transitioning to their cots for nap time. While one (1) staff member was assisting the children still eating at the table, the other staff member was reading a book to the children that were finished with lunch. While observing and monitoring the classroom, I observed the attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. Space #6 currently not in use. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. The violation cited during the 5/6/2024 visit is in compliance based on the observations today and the administrative measures taken below have been implemented. Since the incident on 5/6/2024 and 5/15/2024, the following measure have been put into place: - Staff action place was developed and implemented. - Reviewed the school discipline procedures. - Reviewed the glueing technique where you keep the child close to you if there is a challenging behavior situation. - Reviewed positive redirection and individual activities. - Steps for asking for assistance: walkie talkie first, call into the doorway, and send a message on Brightwheel. - Mentored by a veteran teacher with ten (10) years’ experience. - Use the staff split schedule. - Staff member has been reassigned to another classroom with smaller group size. ** All the steps listed above were observed in use today. - The staff involved in the incident observed during the 5/6/2024 visit, the administrator has developed an action plan for the staff member. The administrator and staff member will follow up regarding the measures put in place during the June 10-14 teacher work week and the week of July 15-19. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the photo provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** The violation cited during the 5/15/2024 visit is in compliance based on the observations today. The staff member identified in the picture is no longer employed at the facility. The administrator stated that a all staff meeting is scheduled for 5/21/2024 to review and refresh all staff members on the school discipline procedures, safe sleep policies, and developmentally appropriate care. The following violation was documented: Violation Number Comment Rule 1301 Center did not maintain a record of daily attendance. In space #3 the daily attendance was not completed for May 17th and May 20th. GS 110-91(9) Technical Assistance Item 1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; - In space #3 the daily attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. I recommend reviewing with staff the importance of completing the daily attendance when the children arrive. Consultation We discussed the following: - Because a violation regarding nurture and care was cited during the 5/6/24 and 5/15/24 visits, it could result in an Administrative Action. Refer to SECTION .2200 ADMINISTRATIVE ACTIONS AND CIVIL PENALTIES regarding Administrative Actions. - Continue to enforce the measure put in place that is documented in the staff action plan. - Separation barriers pay close attention to staff supervising the children at all times. "10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request." Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1801 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/20/2024 Number Present: 43 Completed Date: 5/20/2024 Age: From 1 To 5 Total Minutes: 90 Time In: 12:05 PM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to follow up on the nurture and care violation that was cited during a routine unannounced visit on 5/6/2024, and complaint visit on 5/15/2024. Please refer to the visits dated 5/6/2024 and 5/15/2024 for full details regarding the violation cited. Upon arrival, I was greeted by Megan Marcus, Lead Teacher and Krysty Marcus, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left with you. Group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. Additionally, I observed the indoor and outdoor space used by the children. Space #4 group of three- to four-year-olds were transitioning to lunch. After lunch, the children transitioned to nap. Space #5 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #1 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #2 group of two- to three-year-old children were transitioning from lunch to nap. Staff were actively supervising the children while assisting the children with calming down to rest. During nap time, one (1) staff member sat with a child to assist them with calming down by rubbing their back while the other staff member provided assistance in the restroom and supervised the children. Space #3 group of one- to two-year-old children were finishing lunch and transitioning to their cots for nap time. While one (1) staff member was assisting the children still eating at the table, the other staff member was reading a book to the children that were finished with lunch. While observing and monitoring the classroom, I observed the attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. Space #6 currently not in use. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. The violation cited during the 5/6/2024 visit is in compliance based on the observations today and the administrative measures taken below have been implemented. Since the incident on 5/6/2024 and 5/15/2024, the following measure have been put into place: - Staff action place was developed and implemented. - Reviewed the school discipline procedures. - Reviewed the glueing technique where you keep the child close to you if there is a challenging behavior situation. - Reviewed positive redirection and individual activities. - Steps for asking for assistance: walkie talkie first, call into the doorway, and send a message on Brightwheel. - Mentored by a veteran teacher with ten (10) years’ experience. - Use the staff split schedule. - Staff member has been reassigned to another classroom with smaller group size. ** All the steps listed above were observed in use today. - The staff involved in the incident observed during the 5/6/2024 visit, the administrator has developed an action plan for the staff member. The administrator and staff member will follow up regarding the measures put in place during the June 10-14 teacher work week and the week of July 15-19. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the photo provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** The violation cited during the 5/15/2024 visit is in compliance based on the observations today. The staff member identified in the picture is no longer employed at the facility. The administrator stated that a all staff meeting is scheduled for 5/21/2024 to review and refresh all staff members on the school discipline procedures, safe sleep policies, and developmentally appropriate care. The following violation was documented: Violation Number Comment Rule 1301 Center did not maintain a record of daily attendance. In space #3 the daily attendance was not completed for May 17th and May 20th. GS 110-91(9) Technical Assistance Item 1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; - In space #3 the daily attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. I recommend reviewing with staff the importance of completing the daily attendance when the children arrive. Consultation We discussed the following: - Because a violation regarding nurture and care was cited during the 5/6/24 and 5/15/24 visits, it could result in an Administrative Action. Refer to SECTION .2200 ADMINISTRATIVE ACTIONS AND CIVIL PENALTIES regarding Administrative Actions. - Continue to enforce the measure put in place that is documented in the staff action plan. - Separation barriers pay close attention to staff supervising the children at all times. "10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request." Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/20/2024 Number Present: 43 Completed Date: 5/20/2024 Age: From 1 To 5 Total Minutes: 90 Time In: 12:05 PM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to follow up on the nurture and care violation that was cited during a routine unannounced visit on 5/6/2024, and complaint visit on 5/15/2024. Please refer to the visits dated 5/6/2024 and 5/15/2024 for full details regarding the violation cited. Upon arrival, I was greeted by Megan Marcus, Lead Teacher and Krysty Marcus, Administrator. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A signed copy of the visit summary was left with you. Group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. Additionally, I observed the indoor and outdoor space used by the children. Space #4 group of three- to four-year-olds were transitioning to lunch. After lunch, the children transitioned to nap. Space #5 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #1 group of four- to five-year-old children were engaged in outdoor gross motor play when I arrived with the sand, swings, and climber. When outdoor play concluded, the group transitioned indoors to wash hands and prepare for lunch. Space #2 group of two- to three-year-old children were transitioning from lunch to nap. Staff were actively supervising the children while assisting the children with calming down to rest. During nap time, one (1) staff member sat with a child to assist them with calming down by rubbing their back while the other staff member provided assistance in the restroom and supervised the children. Space #3 group of one- to two-year-old children were finishing lunch and transitioning to their cots for nap time. While one (1) staff member was assisting the children still eating at the table, the other staff member was reading a book to the children that were finished with lunch. While observing and monitoring the classroom, I observed the attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. Space #6 currently not in use. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. The violation cited during the 5/6/2024 visit is in compliance based on the observations today and the administrative measures taken below have been implemented. Since the incident on 5/6/2024 and 5/15/2024, the following measure have been put into place: - Staff action place was developed and implemented. - Reviewed the school discipline procedures. - Reviewed the glueing technique where you keep the child close to you if there is a challenging behavior situation. - Reviewed positive redirection and individual activities. - Steps for asking for assistance: walkie talkie first, call into the doorway, and send a message on Brightwheel. - Mentored by a veteran teacher with ten (10) years’ experience. - Use the staff split schedule. - Staff member has been reassigned to another classroom with smaller group size. ** All the steps listed above were observed in use today. - The staff involved in the incident observed during the 5/6/2024 visit, the administrator has developed an action plan for the staff member. The administrator and staff member will follow up regarding the measures put in place during the June 10-14 teacher work week and the week of July 15-19. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the photo provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** The violation cited during the 5/15/2024 visit is in compliance based on the observations today. The staff member identified in the picture is no longer employed at the facility. The administrator stated that a all staff meeting is scheduled for 5/21/2024 to review and refresh all staff members on the school discipline procedures, safe sleep policies, and developmentally appropriate care. The following violation was documented: Violation Number Comment Rule 1301 Center did not maintain a record of daily attendance. In space #3 the daily attendance was not completed for May 17th and May 20th. GS 110-91(9) Technical Assistance Item 1301 Center did not maintain a record of daily attendance. 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (3) daily attendance records; - In space #3 the daily attendance was not completed for May 17th and May 20th. The staff member completed the attendance during the visit. I recommend reviewing with staff the importance of completing the daily attendance when the children arrive. Consultation We discussed the following: - Because a violation regarding nurture and care was cited during the 5/6/24 and 5/15/24 visits, it could result in an Administrative Action. Refer to SECTION .2200 ADMINISTRATIVE ACTIONS AND CIVIL PENALTIES regarding Administrative Actions. - Continue to enforce the measure put in place that is documented in the staff action plan. - Separation barriers pay close attention to staff supervising the children at all times. "10A NCAC 09 .1801 SUPERVISION IN CHILD CARE CENTERS (a) Children shall be adequately supervised at all times in child care centers. Adequate supervision shall mean that: (1) staff must be positioned in the indoor and outdoor environment to maximize their ability to hear or see the children at all times and render assistance; (2) staff must interact with the children while moving about the indoor or outdoor area; (3) staff must know where each child is located and be aware of the children's activities at all times; (4) staff must provide supervision appropriate to the individual age, needs, and capabilities of each child; and (5) staff must be able to see and hear children aged birth to five years old while the children are eating. All of the conditions in this Paragraph shall apply except when emergencies necessitate that adequate supervision is impossible. Documentation of emergencies shall be maintained and available for review by Division representatives upon request." Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-106 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/15/2024 Number Present: 44 Completed Date: 5/15/2024 Age: From 1 To 5 Total Minutes: 185 Time In: 11:40 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 5/7/24 and sent to Karla Terry, Child Care Consultant, on 5/7/24. The reported concern is regarding nurture and care. Krysty Marcus, Administrator was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. During today’s visit, I observed the indoor and outdoor space used by the children. During the observation, I observed the children engaged in outdoor gross motor play, transitioning indoors to prepare for lunch, handwashing prior to lunch, routine diapering, lunch, and nap. Space #1 was outside engaged in gross motor play when I arrived. After gross motor play, the group of four- to five-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. Space #2 was eating lunch. After lunch, the children used the restroom, washed their hands and transitioned to their cots for nap. One (1) assisted the children who were having a hard time calming down by rubbing their back and sitting with them. One (1) staff member was assisting the children with using the restroom. Children were nurtured and cared for in an appropriate manner. Space #3 was preparing for nap time. Once on their cots, the children were given a book and soft animal to assist with calming down to prepare for nap. Calming music was play. Space #4 was outside engaged in gross motor play when I arrived. After gross motor play, the group of three- to four-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. After lunch, the children used the restroom, washed their hands, and prepared for nap. Space #5 was outside engaged in gross motor play when I arrived. After gross motor play, the group of four- to five-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. Space #6 was currently not in use. I interviewed one (1) staff member regarding the allegations. Staff member interviewed identified the staff member in the supporting document provided and stated that she was not made aware of this incident. However, she stated that she did see the staff members leg was laid across the child’s lower back and two (2) other children in the supporting document were not made to lay down one (1) child was sitting up on their cot and one (1) child was sitting in the floor across from the other staff member. The staff member identified in the supporting document is no longer employed with the facility. Based on the information received on 5/7/2024, staff interview, and the supporting document provided, a two-year-old child was not nurtured and cared for appropriately. The finding regarding the allegation of nurture and care was substantiated. Additionally, I followed up regarding violation #902 that was cited during the 5/6/24 routine unannounced visit. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. On 5/6/2024, in space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. During today’s visit, the staff member present during the 5/6/2024 visit was off this week. The staff members present during today’s visit provided a nurturing and developmentally age-appropriate environment for the children present. One (1) staff member assisted the children with diapering and potty training prior to nap time, and one (1) staff member assisted the children with calming down on their cots prior to nap by rubbing their back. The administrator provided documentation of the staff members action plan. The action plan documented why the action plan was taken regarding the staff member picking the child up by their arms. The administrator reviewed the school discipline procedures, glueing technique where you keep the child close to you if there is a challenging behavior situation, positive redirection, and individual activities. They also reviewed the steps for asking for assistance walkie talkie first, call into doorway, and message with brightwheel. Then discussed that the staff member would be mentored by a veteran teacher with ten (10) years of experience, and staff split schedule to follow. The plan also states that the plan will be reviewed during the teacher work week June 10-14 and the week of July 15-19. The following violation was documented: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the supporting document provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** G.S. 110-91(10) Item 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - Based on the supporting document provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** I suggest conducting a staff meeting to discuss developmentally appropriate nurture and care, along with requesting technical assistance from Buncombe County Partnership for Children. Also, look at registering the staff member for training focusing on developmentally appropriate care and how to handle challenging behaviors. Corrective Action Plan All violations are required to be corrected immediately. Due to the nature of violation cited during today’s visit, an unannounced follow-up visit will be conducted. Please note that you must be in compliance with Child Care rules at all times. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/28/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: Today, we discussed the following: - We discussed that all staff must adhere to the requirements in NC Child Care rule at all times. Compliance must be maintained even when state representatives are not present at the facility. These rules are in place to ensure the safety and health of children in your care and are, therefore, required to be followed at all times. - I recommend reaching out to Buncombe County Partnership for Children to request technical assistance and to register the staff member for training. - During your next staff meeting to review developmentally age appropriate care. - Due to the substantiation of nurture and care concerns, a follow-up visit may be made. - Due to the substantiation of nurture and care concerns, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. A computerized generated report of today’s visit was completed. The report was reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/15/2024 Number Present: 44 Completed Date: 5/15/2024 Age: From 1 To 5 Total Minutes: 185 Time In: 11:40 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 5/7/24 and sent to Karla Terry, Child Care Consultant, on 5/7/24. The reported concern is regarding nurture and care. Krysty Marcus, Administrator was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. During today’s visit, I observed the indoor and outdoor space used by the children. During the observation, I observed the children engaged in outdoor gross motor play, transitioning indoors to prepare for lunch, handwashing prior to lunch, routine diapering, lunch, and nap. Space #1 was outside engaged in gross motor play when I arrived. After gross motor play, the group of four- to five-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. Space #2 was eating lunch. After lunch, the children used the restroom, washed their hands and transitioned to their cots for nap. One (1) assisted the children who were having a hard time calming down by rubbing their back and sitting with them. One (1) staff member was assisting the children with using the restroom. Children were nurtured and cared for in an appropriate manner. Space #3 was preparing for nap time. Once on their cots, the children were given a book and soft animal to assist with calming down to prepare for nap. Calming music was play. Space #4 was outside engaged in gross motor play when I arrived. After gross motor play, the group of three- to four-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. After lunch, the children used the restroom, washed their hands, and prepared for nap. Space #5 was outside engaged in gross motor play when I arrived. After gross motor play, the group of four- to five-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. Space #6 was currently not in use. I interviewed one (1) staff member regarding the allegations. Staff member interviewed identified the staff member in the supporting document provided and stated that she was not made aware of this incident. However, she stated that she did see the staff members leg was laid across the child’s lower back and two (2) other children in the supporting document were not made to lay down one (1) child was sitting up on their cot and one (1) child was sitting in the floor across from the other staff member. The staff member identified in the supporting document is no longer employed with the facility. Based on the information received on 5/7/2024, staff interview, and the supporting document provided, a two-year-old child was not nurtured and cared for appropriately. The finding regarding the allegation of nurture and care was substantiated. Additionally, I followed up regarding violation #902 that was cited during the 5/6/24 routine unannounced visit. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. On 5/6/2024, in space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. During today’s visit, the staff member present during the 5/6/2024 visit was off this week. The staff members present during today’s visit provided a nurturing and developmentally age-appropriate environment for the children present. One (1) staff member assisted the children with diapering and potty training prior to nap time, and one (1) staff member assisted the children with calming down on their cots prior to nap by rubbing their back. The administrator provided documentation of the staff members action plan. The action plan documented why the action plan was taken regarding the staff member picking the child up by their arms. The administrator reviewed the school discipline procedures, glueing technique where you keep the child close to you if there is a challenging behavior situation, positive redirection, and individual activities. They also reviewed the steps for asking for assistance walkie talkie first, call into doorway, and message with brightwheel. Then discussed that the staff member would be mentored by a veteran teacher with ten (10) years of experience, and staff split schedule to follow. The plan also states that the plan will be reviewed during the teacher work week June 10-14 and the week of July 15-19. The following violation was documented: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the supporting document provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** G.S. 110-91(10) Item 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - Based on the supporting document provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** I suggest conducting a staff meeting to discuss developmentally appropriate nurture and care, along with requesting technical assistance from Buncombe County Partnership for Children. Also, look at registering the staff member for training focusing on developmentally appropriate care and how to handle challenging behaviors. Corrective Action Plan All violations are required to be corrected immediately. Due to the nature of violation cited during today’s visit, an unannounced follow-up visit will be conducted. Please note that you must be in compliance with Child Care rules at all times. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/28/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: Today, we discussed the following: - We discussed that all staff must adhere to the requirements in NC Child Care rule at all times. Compliance must be maintained even when state representatives are not present at the facility. These rules are in place to ensure the safety and health of children in your care and are, therefore, required to be followed at all times. - I recommend reaching out to Buncombe County Partnership for Children to request technical assistance and to register the staff member for training. - During your next staff meeting to review developmentally age appropriate care. - Due to the substantiation of nurture and care concerns, a follow-up visit may be made. - Due to the substantiation of nurture and care concerns, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. A computerized generated report of today’s visit was completed. The report was reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: 0524-090L Visit Date: 5/15/2024 Number Present: 44 Completed Date: 5/15/2024 Age: From 1 To 5 Total Minutes: 185 Time In: 11:40 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a complaint received by the Division of Child Development and Early Education (DCDEE) on 5/7/24 and sent to Karla Terry, Child Care Consultant, on 5/7/24. The reported concern is regarding nurture and care. Krysty Marcus, Administrator was present and available to ask and answer questions throughout the visit today. Applicable child care requirements were monitored today including Staff/child ratio, group size, supervision, use of licensed space, space capacity, license restrictions, and nurture and care were monitored. The license and emergency care plan were posted. During today’s visit, I observed the indoor and outdoor space used by the children. During the observation, I observed the children engaged in outdoor gross motor play, transitioning indoors to prepare for lunch, handwashing prior to lunch, routine diapering, lunch, and nap. Space #1 was outside engaged in gross motor play when I arrived. After gross motor play, the group of four- to five-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. Space #2 was eating lunch. After lunch, the children used the restroom, washed their hands and transitioned to their cots for nap. One (1) assisted the children who were having a hard time calming down by rubbing their back and sitting with them. One (1) staff member was assisting the children with using the restroom. Children were nurtured and cared for in an appropriate manner. Space #3 was preparing for nap time. Once on their cots, the children were given a book and soft animal to assist with calming down to prepare for nap. Calming music was play. Space #4 was outside engaged in gross motor play when I arrived. After gross motor play, the group of three- to four-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. After lunch, the children used the restroom, washed their hands, and prepared for nap. Space #5 was outside engaged in gross motor play when I arrived. After gross motor play, the group of four- to five-year-old children transitioned indoors to wash hands and prepare for lunch. Children bring their meals from home. Space #6 was currently not in use. I interviewed one (1) staff member regarding the allegations. Staff member interviewed identified the staff member in the supporting document provided and stated that she was not made aware of this incident. However, she stated that she did see the staff members leg was laid across the child’s lower back and two (2) other children in the supporting document were not made to lay down one (1) child was sitting up on their cot and one (1) child was sitting in the floor across from the other staff member. The staff member identified in the supporting document is no longer employed with the facility. Based on the information received on 5/7/2024, staff interview, and the supporting document provided, a two-year-old child was not nurtured and cared for appropriately. The finding regarding the allegation of nurture and care was substantiated. Additionally, I followed up regarding violation #902 that was cited during the 5/6/24 routine unannounced visit. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. On 5/6/2024, in space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. During today’s visit, the staff member present during the 5/6/2024 visit was off this week. The staff members present during today’s visit provided a nurturing and developmentally age-appropriate environment for the children present. One (1) staff member assisted the children with diapering and potty training prior to nap time, and one (1) staff member assisted the children with calming down on their cots prior to nap by rubbing their back. The administrator provided documentation of the staff members action plan. The action plan documented why the action plan was taken regarding the staff member picking the child up by their arms. The administrator reviewed the school discipline procedures, glueing technique where you keep the child close to you if there is a challenging behavior situation, positive redirection, and individual activities. They also reviewed the steps for asking for assistance walkie talkie first, call into doorway, and message with brightwheel. Then discussed that the staff member would be mentored by a veteran teacher with ten (10) years of experience, and staff split schedule to follow. The plan also states that the plan will be reviewed during the teacher work week June 10-14 and the week of July 15-19. The following violation was documented: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on the supporting document provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** G.S. 110-91(10) Item 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - Based on the supporting document provided and administrator identifying the staff member, in space # 2, a two-year-old child was made to stay on their cot by a staff member laying their leg on top of the child’s back while the child was laying on its stomach on its cot. ** REPEAT VIOLATION.** I suggest conducting a staff meeting to discuss developmentally appropriate nurture and care, along with requesting technical assistance from Buncombe County Partnership for Children. Also, look at registering the staff member for training focusing on developmentally appropriate care and how to handle challenging behaviors. Corrective Action Plan All violations are required to be corrected immediately. Due to the nature of violation cited during today’s visit, an unannounced follow-up visit will be conducted. Please note that you must be in compliance with Child Care rules at all times. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/28/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Consultation: Today, we discussed the following: - We discussed that all staff must adhere to the requirements in NC Child Care rule at all times. Compliance must be maintained even when state representatives are not present at the facility. These rules are in place to ensure the safety and health of children in your care and are, therefore, required to be followed at all times. - I recommend reaching out to Buncombe County Partnership for Children to request technical assistance and to register the staff member for training. - During your next staff meeting to review developmentally age appropriate care. - Due to the substantiation of nurture and care concerns, a follow-up visit may be made. - Due to the substantiation of nurture and care concerns, an Administrative Action may be recommended. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. A computerized generated report of today’s visit was completed. The report was reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. A copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0607 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0801 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .2830 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-106 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 5/6/2024 Number Present: 41 Completed Date: 5/6/2024 Age: From 1 To 5 Total Minutes: 245 Time In: 09:55 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Upon arrival, the purpose of today’s visit was reviewed with you, Krysty Marcus, Administrator. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. Krysty Marcus, Administrator, was available to assist with questions. The program’s annual compliance visit was conducted on 11/3/2023. The following items were monitored today: Supervision Staff / Child Ratio CPR / First Aid Special Training CBC Qualification ITS – SIDS Emergency Medical Care Plan Administration of Medication Storage of Hazardous Products Storage of Medication General Safety Discipline Adequate / Approved Space Program Records License Posted Permit Restrictions During the visit, the indoor and outdoor space was monitored. Space #1 the group of three- to five-year- olds were engaged in free choice center play with free art, books, puzzles, matching, and map. After free choice center play, the children cleaned up and transitioned to snack. When snack concluded, the group prepared to go outside for gross motor play. Space #2 the group of two- to three-year-old children were outside engaged in gross motor play with the swings, balls, and sand box. After outside gross motor play, the children transitioned indoors to wash hands and prepare for lunch. While monitoring medications, I observed an Epi Pen located in the closet not stored in the original packaging with the pharmacy label, and the action plan did not have a signature or date from the parent or doctor. While observing the class during lunch, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. Space #3 the group of one- to two-year- old children were engaged in snack. After snack, the children transitioned to free play with free art and books. Space #4 was closed today due to staff shortage, the children enrolled were separated into space #5 and #1. Space #5 the group of three- to five-year-olds were engaged in free choice center play with free art, blocks, and puzzles. After free choice center play, the children cleaned up and prepared for snack. The children washed hands, got their snack brought from home, and went to the table. When snack concluded, the children prepared to go outside. While monitoring the indoor space, I observed one (1) child’s Ventolin inhaler medication permission form expired on 2/28/2024. One (1) child’s Epi Pen medication permission form expired 4/22/2024, Epi Pen expired on 4/1/2024, and the Epi Pen was not stored in the original container with the pharmacy label. All three (3) outdoor spaces were monitored. The walkway down to space A, I observed lattice under the deck that was splintering. Children bring their meals and snacks from home. The last fire drill was practiced on 4/17/2024. The last emergency drill, lockdown drill, was practiced on 4/11/2024 The last fire inspection was approved on 7/19/2023. The program’s most recent sanitation inspection was completed on 1/25/2024 with six (6) demerits for a superior classification. Sanitation inspection was received during the visit. The Emergency Preparedness and Response (EPR) plan was last reviewed on 2/22/2023. The EPR plan was due to be reviewed on or before 2/22/2024. The Emergency Medical Care Plan is posted and was updated. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. Staff file concerns: First Aid and CPR was not on file for review for staff member hired 8/21/2023 and was due by 11/19/2023, staff member hired 10/23/2023 and was due by 1/21/2024, staff member hired 11/6/2023 First Aid and CPR certification was not completed through an approved training agency. Child Maltreatment training for staff member hired 8/21/2023 was due by 11/19/2023, staff member hired 10/23/2023 was due by 2/4/2024, staff member hired 10/23/2023 was due by 1/21/2024. The following violations of child care requirements were observed today: Violation Number Comment Rule 807 A safe indoor and outdoor environment was not provided for the children. Outside, lattice located under the ramp was splintering. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. .0803(12) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. G.S. 110-91(10) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. .1102(d) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. .0607(e) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. .0801(b) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. .1102(g) Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 5/20/2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance for Correction Plan: Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Outside, lattice located under the ramp was splintering. I suggest sanding the lattice to smooth it down so that a child does not get a splinter or cut. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #2 an Epi Pen located in the closet not stored in the original packaging with the pharmacy label. Space #5 an Epi Pen for child enrolled 6/20/2022 was not stored in the original packaging with the pharmacy label. I recommend when parents bring in medication for staff to ensure that they are in the original packaging prior to allowing the medication to go to the classroom for use. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 5, child enrolled 10/6/2021 Ventolin inhaler medication permission form expired on 2/28/2024. Child enrolled 6/20/2022 Epi Pen expired 4/2024. I recommend conducting a monthly medication check to ensure all medications and forms are still in date. Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child’s developmental needs. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (10) Each operator or staff member shall attend to any child in a nurturing and appropriate manner, and in keeping with the child's developmental needs. Each child care facility shall have a written policy on discipline, describing the methods and practices used to discipline children enrolled in that facility. This written policy shall be discussed with, and a copy given to, each child's parent prior to the first time the child attends the facility. Subsequently, any change in discipline methods or practices shall be communicated in writing to the parents prior to the effective date of the change. The use of corporal punishment as a form of discipline is prohibited in child care facilities and may not be used by any operator or staff member of any child care facility, except that corporal punishment may be used in religious sponsored child care facilities as defined in G.S. 110-106, only if (i) the religious sponsored child care facility files with the Department a notice stating that corporal punishment is part of the religious training of its program, and (ii) the religious sponsored child care facility clearly states in its written policy of discipline that corporal punishment is part of the religious training of its program. The written policy on discipline of nonreligious sponsored child care facilities shall clearly state the prohibition on corporal punishment. - In space #2, I observed a staff member not attending to the children in a nurturing and appropriate manner. At lunch, a child was observed to be finished with lunch and went to the book center. The staff member asked the child to return to the table and when the child did not return. The staff member picked the child up by the arms and returned the child to the table. I suggest having another staff member in the classroom to support the staff during meals and snacks. Then ensure there are activities available for the children to engage in when they are finished with their meal or snack. Item #1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete First Aid training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website at http://ncchildcare.nc.gov/providers/pv_sn2_ov_pd.asp. - Staff member hired 8/21/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 11/19/2023. Staff member hired 10/23/23, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate was not on file for review and was due to be completed by 1/21/2024. Staff member hired 11/6/2023, did not complete CPR training within the first ninety (90) days of employment. The training completion certificate on file was not completed through an approved training organization. I recommend documenting all training due dates on a training calendar to assist with tracking when each staff members training is due. Item #1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. 10A NCAC 09 .0607 EMERGENCY PREPAREDNESS AND RESPONSE IN CHILD CARE CENTERS (e) The trained staff shall review the Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. - Trained staff did not review the EPR plan annually. The EPR plan was last reviewed on 2/22/2023 and was due to be updated on or before 2/22/2024. I recommend noting on your calendar when the EPR plan is due to be reviewed as a reminder to update the EPR plan. Item #1835 The medical action plan did not contain the required information and/or was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. The medical action plan shall be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. Sample medical action plans may be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp; - In space #2, child enrolled 1/2/2023 food allergy action plan was not signed and dated by the child’s parent or health care professional. I suggest reviewing all medical action plans prior to medication being released to the classroom to ensure that all forms are signed and dated by the parent or doctor. Item #1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. - Staff member hired 8/21/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 10/23/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. Staff member hired 11/6/2023, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within ninety (90) days of employment. A completion certificate was not on file for review. I recommend documenting each staff members due date on a training calendar to ensure that the staff complete their training within ninety (90) days of their employment date. Consultation: Today, we discussed the following: - Health and Safety training due date reminder: staff member hired 8/21/23 is due by 8/21/24, staff member hired 10/23/23 is due by 10/23/24, and staff member hired 11/6/2023 is due by 11/6/2024. - Review with staff developmentally appropriate expectations for the children enrolled. - A follow-up visit may be conducted. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Challenging behaviors helpline can be reached at 1-888-600-1685 Option 1. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic copy of the visit summary was left with you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0304 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0605 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0701 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1703 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: MONTESSORI FOOTPRINTS LEARNING CENTER Facility ID: 11000861 Consultant: KARLA TERRY Operation Type: Center Case Number: Visit Date: 11/3/2023 Number Present: 42 Completed Date: 11/3/2023 Age: From 1 To 5 Total Minutes: 260 Time In: 09:25 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. Krysty Marcus, Administrator was on-site and available during the visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Karla Terry, Child Care Consultant and also signed by Krysty Marcus, Administrator, during the visit. An electronic signed copy of the visit summary was electronically emailed to you. The facilities compliance history was reviewed prior to the visit on 10/27/2023 and reviewed with the administrator during the visit. The facilities compliance history was seventy-nine percent (79%). The North Carolina Secretary of State website was viewed prior to today’s visit and the Limited Liability Company, Montessori Footprints, LLC., is current/active as of 10/27/2023. The facility operates with a One (1) Star Rated License, issued on 2/19/2017 with restrictions as follows: first (1st) shift (daytime care), meets enhanced space. The last annual compliance visit was conducted on 11/16/2022. The last fire drill was practiced on 10/24/2023. The last lockdown drill was practiced on 9/12/2023. The last playground inspection was documented on 10/24/2023. The last fire inspection was approved on 7/19/2023. The last sanitation inspection was conducted on 6/23/2023 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The Emergency Preparedness and Response plan was reviewed on 10/2/2023. The indoor and outdoor areas were monitored today, including supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. Upon arrival I introduced myself to the Administrator. In space #5, the group of three- to five-year-olds were engaged in free choice center play with legos, puzzles, writing, and drums. The staff member was circulating the room supervising and engaging in play with the children. In space #4, the group of two- to three-year-old children were engaged in free choice center play with plastic farm animals, shapes, cars, acorn sorting, gears, creating a turkey using feathers, and blocks. The staff member was engaging in play and conversations while supervising the children. In space # 3, the group of one- to two-year-old children were washing hands and preparing for snack. The staff members were assisting the children with washing hands and preparing snack. In space #2, the group of two- to three-year-old children were having snack. After the snack, the children washed hands and prepared to go outside. The staff member was meeting the individual needs of the children by conducting routine diaper changing and assisting with putting on gloves and coats. In space #1, the group of three- to five-year-olds were engaged in free choice center play with number game, puzzles, and free drawing. The staff members were engaging in conversations regarding play and supervising the children. The children enrolled bring all their meals and snacks from home, and have a Nutritional Opt-Out form on their file. All medications were monitored. The program does not provide transportation. During the visit, three (3) new staff file and one (1) existing staff file and five (5) children’s files were monitored. While reviewing the staff files, staff member MK hired 10/19/2023 confidential file did not contain a medical report. While reviewing the children’s files, child NH enrolled 8/21/2023 a medical report was not submitted within thirty (30) days of enrollment. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The following violations were documented during today’s visit: Violation Number Comment Rule 714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). .0605(g) 807 A safe indoor and outdoor environment was not provided for the children. Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. .0803(2)(a) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. 10A NCAC 09 .0701(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. GS110-91(1) Technical assistance was provided as follows: Item #714 Openings in equipment, steps, decks, handrails, and fencing were not less than 3 1/2 inches or greater than 9 inches. 10A NCAC 09 .0605 OUTDOOR LEARNING ENVIRONMENT IN CHILD CARE CENTERS (g) Any openings in equipment, steps, decks, handrails, and fencing shall be smaller than 3 ½ inches or greater than 9 inches to prevent entrapment. - Playground A toddler space at the base of the wooden deck, the lattice was broken creating an opening below the deck that was greater than three and a half inches (3 ½”). I suggest replacing the broken lattice with a new piece of lattice or plywood. Item # 807 A safe indoor and outdoor environment was not provided for the children. 10A NCAC 09 .0601 SAFE ENVIRONMENT (a) A safe indoor and outdoor environment shall be provided for the children in care in accordance with rules in this Section. - Playground A toddlers playground, at the base of the fence post near the gate, there was concrete footings exposed at the bottom of the right fence posts. I suggested adding dirt, or mulch surfacing to cover the exposed concrete. Since this is an area that this will be an on-going issue, I recommend looking into a more permanent fix to ensure the concrete will be covered at all times. Item #844 Prescribed medicine was not in original pharmacy labeled container. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (2) Prescribed medications: (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels; - In space #5, Epi Pen for child L was not stored in the original pharmacy labeled container. I suggested you have the parent bring in the original pharmacy container with label or have the parent ask the pharmacy to re-print the label and attach it to the pharmacy bag that the medications are received in. Item #849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (12) Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. - In space # 2, five (5) over the counter diaper creams permission to administer medication forms have expired. Child RP Destin permission form expired 8/2/2023, child JK Aquaphor permission form expired 8/23/2023, child BL Butt paste and A & D ointment permission forms expired 9/12/2023. I stated to return the medications back to the parents or have the parent or guardians update the permission to administer medication forms. Item #1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Item 1032 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Required for: Child care providers and uncompensated providers who are not substitute providers or volunteers as defined in 10A NCAC 09 .0102, including the director. Item Requirements: Medical Report A statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. Due Date: Prior to employment. When submitted, the medical statement shall not be older than 12 months. - Staff member MK hired 10/19/2023 did not have a medical report on file prior to their first day of employment. I suggested to review the requirements for medical forms during the interview process so that the potential staff member can begin working on obtaining the required documents. Item #1321 Medical exam or health assessment was not on file before or within 30 days after admission. § 110-91. Mandatory standards for a license. All child care facilities shall comply with all State laws and federal laws and local ordinances that pertain to child health, safety, and welfare. Except as otherwise provided in this Article, the standards in this section shall be complied with by all child care facilities. However, none of the standards in this section apply to the school-age children of the operator of a child care facility but do apply to the preschool-age children of the operator. Children 13 years of age or older may receive child care on a voluntary basis provided all applicable required standards are met. The standards in this section, along with any other applicable State laws and federal laws or local ordinances, shall be the required standards for the issuance of a license by the Secretary under the policies and procedures of the Commission except that the Commission may, in its discretion, adopt less stringent standards for the licensing of facilities which provide care on a temporary, part-time, drop-in, seasonal, after-school or other than a full-time basis. (1) Medical Care and Sanitation. – The Commission for Public Health shall adopt rules which establish minimum sanitation standards for child care centers and their personnel. The sanitation rules adopted by the Commission for Public Health shall cover such matters as the cleanliness of floors, walls, ceilings, storage spaces, utensils, and other facilities; adequacy of ventilation; sanitation of water supply, lavatory facilities, toilet facilities, sewage disposal, food protection facilities, bactericidal treatment of eating and drinking utensils, and solid-waste storage and disposal; methods of food preparation and serving; infectious disease control; sleeping facilities; and other items and facilities as are necessary in the interest of the public health. The Commission for Public Health shall allow child care centers to use domestic kitchen equipment, provided appropriate temperature levels for heating, cooling, and storing are maintained. Child care centers that fry foods shall use commercial hoods. These rules shall be developed in consultation with the Department. The Commission shall adopt rules for child care facilities to establish minimum requirements for child and staff health assessments and medical care procedures. These rules shall be developed in consultation with the Department. Each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. However, no health assessment shall be required of any staff or child who is and has been in normal health when the staff, or the child's parent, guardian, or full-time custodian objects in writing to a health assessment on religious grounds which conform to the teachings and practice of any recognized church or religious denomination. Organizations that provide prepared meals to child care centers only are considered child care centers for purposes of compliance with appropriate sanitation standards. - Child NH enrolled 8/21/2023 did not have a medical report on file within thirty (30) days of enrollment. The medical report on file was dated 10/20/2023. I suggested during enrollment, review with the parents the required medical documents that must be on-site within thirty (30) days. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by 11/17/2023. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: karla.terry@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Karla Terry PO Box 552 Ellenboro, NC 28040 Please call me at 828-200-9952, or email karla.terry@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: Today, we discussed the following: - Reviewing medications and forms on a monthly basis to ensure expiration dates and permission forms are still current and up to date. - Ensure medication forms are completed in it’s entirety before accepting to be administered on-site. Be sure to look closely at the dosage, this needs to have a specific amount, parent signature, begin and end dates, etc. - I recommend having the staff look closely at the additional toys that are added like the balls to ensure they are pumped and ready for the children to use. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828-713-8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at karla.terry@dhhs.nc.gov or 828-200-9952, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times