10A NCAC 09 .1719 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 11/10/2025 Number Present: 1 Completed Date: 11/10/2025 Age: From 2 To 2 Total Minutes: 180 Time In: 10:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Family CC Home 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. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age The last annual compliance visit was conducted 5/5/25. The center's compliance history was reviewed with the operator. The program’s compliance history was eighty eight percent as of 11/6/25. The NC Secretary of State website was reviewed on 11/6/25 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. All indoor and outdoor areas were monitored. Upon arrival, the operator and child in attendance were building structures with magnet tiles. Next, the operator completed a fire drill and documented it on the drill log. After the drill was completed, personal care routines were completed before sitting at the table to eat a lunch that consisted of meatloaf, mashed potatoes, peas, and milk. The outdoor space was observed to have a portable house, basketball goal, riding toys, and balls for the children to engage in gross motor activities. The following violation was documented. Violation Number Comment Rule 1409 Operator did not provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of the children in care. In the bathroom that is used by children, a container of Lysol wipes was observed on a shelf. There were sharp nails exposed on the stairway leading from the outdoor space to the home. 10A NCAC 09 .1719 (a) 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. Technical assistance With Violations: Safe environment: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. In the bathroom that is used by children, a container of Lysol wipes was observed on a shelf. We discussed that cleaners that have additional warnings with keep out of reach of children must be locked. There were sharp nails exposed on the stairway leading from the outdoor space to the home. During the visit, you used a hammer to fix or remove the nails and placed the Lysol wipes in locked storage to correct the violation. Check all learning environments before children arrive to ensure that all hazardous materials are removed and locked away if necessary. Additional Comments: Capacity Increase: Today, I monitored your family child care home to verify compliance with the five building code requirements outlined in SL 2025-36 to increase your capacity and issue a new permit. 1. Rooms and areas within a family child care home where occupants receive care shall be on the same level of exit discharge. This was found to be in compliance. 2. Rooms and areas within a family child care home where occupants receive care shall be located on the same level with, and within a maximum of 40 feet travel distance to, at least one 2A:10B:C fire extinguisher. Your fire extinguisher is located in the kitchen and was found to be in compliance with this requirement. 3. A family child care home shall have and maintain a Fire Safety, Evacuation, and Lockdown Plan compliant with Section 404 of the North Carolina Fire Code. I reviewed your Emergency Preparedness and Response Plan and found it to meet the requirements. 4. A family child care home shall have carbon monoxide alarm and detection systems compliant with Section 915 of the North Carolina Building Code and Section R315 of the North Carolina Residential Code. Your home does not have a fuel fired appliance, nor does it have an attached garage. This requirement has been met. 5. A family child care home shall have smoke alarms compliant with Section R907 of the North Carolina Building Code and Section R314 of the North Carolina Residential Code. A wired smoke detector and a battery operated smoke detector is located in the caregiving space and a wired smoke detector is located in the hallway beside the bathroom that the children use. This requirement is met. 6. You are going to contact the Pamlico County Zoning Office to ensure that there are no restrictions or ordinances from the County preventing an increase in childcare capacity on the property. Once you send me documentation of this, this requirement will be met. Once this requirement is met, a new license will be issued and mailed to you. QRIS (Quality Rating Improvement System) Technical Assistance: T. Jones, FCCH Operator and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Your QRIS assessment is due by 12/31/2026. You have decided to follow Pathway #2: Classroom and Instructional Quality Pathway. We reviewed all forms for pathway #2 and accessed them at https://ncchildcare.ncdhhs.gov. Invoices for the annual license fees were emailed to facilities subject to license fees on November 3, 2025. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. Payment Information: Payments are due by December 3, 2025. All payments must be submitted through our website using a Mastercard or Visa debit/credit card or via e-check. Payments may not be dropped off or mailed to the Division or the Department of Health & Human Services. The Division cannot guarantee timely receipt or deposit of paper checks. NCID: Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. Outdoor Learning Environments Work Plan: Bring nature to children by naturalizing childcare centers and family child care homes, schools, residential neighborhoods, parks and greenways, community centers, cultural facilities, botanical gardens, museums and other nonformal education institutions. Today, we discussed adding a science center to your outdoor learning environment by adding a garden, thermometer, and rain gauge. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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.

NC GS 110-90 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 11/10/2025 Number Present: 1 Completed Date: 11/10/2025 Age: From 2 To 2 Total Minutes: 180 Time In: 10:45 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Family CC Home 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. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age The last annual compliance visit was conducted 5/5/25. The center's compliance history was reviewed with the operator. The program’s compliance history was eighty eight percent as of 11/6/25. The NC Secretary of State website was reviewed on 11/6/25 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. All indoor and outdoor areas were monitored. Upon arrival, the operator and child in attendance were building structures with magnet tiles. Next, the operator completed a fire drill and documented it on the drill log. After the drill was completed, personal care routines were completed before sitting at the table to eat a lunch that consisted of meatloaf, mashed potatoes, peas, and milk. The outdoor space was observed to have a portable house, basketball goal, riding toys, and balls for the children to engage in gross motor activities. The following violation was documented. Violation Number Comment Rule 1409 Operator did not provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of the children in care. In the bathroom that is used by children, a container of Lysol wipes was observed on a shelf. There were sharp nails exposed on the stairway leading from the outdoor space to the home. 10A NCAC 09 .1719 (a) 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. Technical assistance With Violations: Safe environment: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. In the bathroom that is used by children, a container of Lysol wipes was observed on a shelf. We discussed that cleaners that have additional warnings with keep out of reach of children must be locked. There were sharp nails exposed on the stairway leading from the outdoor space to the home. During the visit, you used a hammer to fix or remove the nails and placed the Lysol wipes in locked storage to correct the violation. Check all learning environments before children arrive to ensure that all hazardous materials are removed and locked away if necessary. Additional Comments: Capacity Increase: Today, I monitored your family child care home to verify compliance with the five building code requirements outlined in SL 2025-36 to increase your capacity and issue a new permit. 1. Rooms and areas within a family child care home where occupants receive care shall be on the same level of exit discharge. This was found to be in compliance. 2. Rooms and areas within a family child care home where occupants receive care shall be located on the same level with, and within a maximum of 40 feet travel distance to, at least one 2A:10B:C fire extinguisher. Your fire extinguisher is located in the kitchen and was found to be in compliance with this requirement. 3. A family child care home shall have and maintain a Fire Safety, Evacuation, and Lockdown Plan compliant with Section 404 of the North Carolina Fire Code. I reviewed your Emergency Preparedness and Response Plan and found it to meet the requirements. 4. A family child care home shall have carbon monoxide alarm and detection systems compliant with Section 915 of the North Carolina Building Code and Section R315 of the North Carolina Residential Code. Your home does not have a fuel fired appliance, nor does it have an attached garage. This requirement has been met. 5. A family child care home shall have smoke alarms compliant with Section R907 of the North Carolina Building Code and Section R314 of the North Carolina Residential Code. A wired smoke detector and a battery operated smoke detector is located in the caregiving space and a wired smoke detector is located in the hallway beside the bathroom that the children use. This requirement is met. 6. You are going to contact the Pamlico County Zoning Office to ensure that there are no restrictions or ordinances from the County preventing an increase in childcare capacity on the property. Once you send me documentation of this, this requirement will be met. Once this requirement is met, a new license will be issued and mailed to you. QRIS (Quality Rating Improvement System) Technical Assistance: T. Jones, FCCH Operator and I discussed the facility’s plan for completing a rated license assessment using the new QRIS rules found in Section .3200 of the NC Child Care Rules. All information on the QRIS rated license assessments and documents will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. During the visit we completed the QRIS Conversation Template with a focus on the selected pathway. Your QRIS assessment is due by 12/31/2026. You have decided to follow Pathway #2: Classroom and Instructional Quality Pathway. We reviewed all forms for pathway #2 and accessed them at https://ncchildcare.ncdhhs.gov. Invoices for the annual license fees were emailed to facilities subject to license fees on November 3, 2025. Please note that annual license fees do not apply to state or public school-operated child care facilities, or to religious-sponsored facilities operating under a Notice of Compliance. Payment Information: Payments are due by December 3, 2025. All payments must be submitted through our website using a Mastercard or Visa debit/credit card or via e-check. Payments may not be dropped off or mailed to the Division or the Department of Health & Human Services. The Division cannot guarantee timely receipt or deposit of paper checks. NCID: Did you know that if you do not login on any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. Pro Tip: Set your calendar to remind you every 6 months to login and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. Outdoor Learning Environments Work Plan: Bring nature to children by naturalizing childcare centers and family child care homes, schools, residential neighborhoods, parks and greenways, community centers, cultural facilities, botanical gardens, museums and other nonformal education institutions. Today, we discussed adding a science center to your outdoor learning environment by adding a garden, thermometer, and rain gauge. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 09.1721 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 5/5/2025 Number Present: 2 Completed Date: 5/5/2025 Age: From 2 To 3 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age. The last annual compliance visit was conducted on 5/17/24. The center's compliance history was reviewed with the operator. The program’s compliance history was ninety percent as of 4/17/25. The NC Secretary of State website was reviewed on 4/17/25 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. We reviewed your facility contact information listed on the Division of Child Development and Early Education (DCDEE) website and you requested for me to update the facility’s email address to tenderlovingjewels@gmail.com. All indoor and outdoor spaces were monitored. Upon arrival, the children were engaged in free play in activity centers. The operator conducted a fire alarm during the visit and documented the drill on the fire drill log. The children colored pictures of panda bears while the operator read the book You Are My Little Busy Bee. Before lunch, the children completed personal care routines and washed their hands. The outdoor space was observed to have a portable house, riding toys, wagon, balls, and hula hoops for the children to engage in gross motor activities. Lunch was observed and consisted of turkey sandwiches on whole wheat bread, peaches, collard greens, and milk. The following violation(s) were documented. Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. In the children’s bathroom, a container of Lysol Disinfecting wipes and La bottle of Lysol Disinfectant spray were located on a shelf above the toilet. .1719 (a)(7) 910 Copy of each child's health assessment, including the operator's own preschool child(ren), was not on file within 30 days of enrollment. A child enrolled on 4/29/24 did not have a medical report on file. GS 110-91(1); 10A NCAC 09.1721(a)(1) 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. On or before 5/19/25, 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Children's Records: Children are required to have a medical exam by a doctor and a copy of their immunization record no later than 30 days from their first day of attendance. Immunization records are required for all children; however, a medical exam is required for all children from birth to five, that have not started Kindergarten. A medical exam can be accepted if completed within the last 12 months prior to enrollment. A child enrolled on 4/29/24 did not have a medical report on file. You stated that you thought that you had received the medical report and will request the parent to bring you one. If you do not receive immunization records or medical reports on the first day of enrollment, set a reminder in your calendar to remind you to receive the documents before 30 days have passed. Storage of Hazardous Items: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. In the children’s bathroom, a container of Lysol Disinfecting wipes and Lysol Disinfectant spray were located on a shelf above the toilet. We discussed that these products are labeled to keep out of reach of children and an additional warning, so they need to be stored in locked storage. During the visit, you printed out the flyer for Hazardous Items Storage in Child Care and stated that you will laminate and post. You immediately moved the items into locked storage when it was brought to your attention to correct the violation. Post the Hazardous Storage flyer and review to ensure that items are stored correctly. Additional Comments: Moving Forward With QRIS Modernization: The Child Care Commission has taken the next step in the journey to meet the North Carolina General Assembly’s mandate in Session Law 2024-34 to modernize the state’s Quality Rating and Improvement System, voting to adopt the Quality Rating Improvement System (QRIS) Modernization Proposed Rule Amendments and Adoptions. Next, the QRIS rules will go to the Rules Review Commission (RRC) for review and approval. It is important to note that the new QRIS rules are not yet effective. However, the Division is preparing for a gradual transition to the new requirements. Resources, forms, and training will be provided to support transition to the new pathways to earn your Two- through Five-Star Rated License. All the newest information will be posted at QRIS Modernization and will also be provided through emails and Raise NC newsletters. Natural Learning Initiative: https://naturalearning.org/resources/ Resources are created, often in collaboration with the Natural Learning Initiative’s interdisciplinary partners, to support technical assistance, professional development, and generally to promote the importance of the natural environment in the daily experience of all children. North Carolina Rated License Assessment Project: NCRLAP’s mission is to promote the quality of child care by consistently and reliably assessing environments for the North Carolina Star Rated License. We collaborate with professionals in the early childhood education field to foster the development and learning of young children. The website ncrlap.org offers resources, trainings, videos, worksheets, and getting ready for FCCRS-3. Pamlico Partnership for Children is also able to provide you with resources and information, training opportunities, technical assistance on childcare issues. Their phone number is (252) 745-7850 or check out their website at www.pamlicopartnership.org. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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.

GS 110-91 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 5/5/2025 Number Present: 2 Completed Date: 5/5/2025 Age: From 2 To 3 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age. The last annual compliance visit was conducted on 5/17/24. The center's compliance history was reviewed with the operator. The program’s compliance history was ninety percent as of 4/17/25. The NC Secretary of State website was reviewed on 4/17/25 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. We reviewed your facility contact information listed on the Division of Child Development and Early Education (DCDEE) website and you requested for me to update the facility’s email address to tenderlovingjewels@gmail.com. All indoor and outdoor spaces were monitored. Upon arrival, the children were engaged in free play in activity centers. The operator conducted a fire alarm during the visit and documented the drill on the fire drill log. The children colored pictures of panda bears while the operator read the book You Are My Little Busy Bee. Before lunch, the children completed personal care routines and washed their hands. The outdoor space was observed to have a portable house, riding toys, wagon, balls, and hula hoops for the children to engage in gross motor activities. Lunch was observed and consisted of turkey sandwiches on whole wheat bread, peaches, collard greens, and milk. The following violation(s) were documented. Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. In the children’s bathroom, a container of Lysol Disinfecting wipes and La bottle of Lysol Disinfectant spray were located on a shelf above the toilet. .1719 (a)(7) 910 Copy of each child's health assessment, including the operator's own preschool child(ren), was not on file within 30 days of enrollment. A child enrolled on 4/29/24 did not have a medical report on file. GS 110-91(1); 10A NCAC 09.1721(a)(1) 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. On or before 5/19/25, 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Children's Records: Children are required to have a medical exam by a doctor and a copy of their immunization record no later than 30 days from their first day of attendance. Immunization records are required for all children; however, a medical exam is required for all children from birth to five, that have not started Kindergarten. A medical exam can be accepted if completed within the last 12 months prior to enrollment. A child enrolled on 4/29/24 did not have a medical report on file. You stated that you thought that you had received the medical report and will request the parent to bring you one. If you do not receive immunization records or medical reports on the first day of enrollment, set a reminder in your calendar to remind you to receive the documents before 30 days have passed. Storage of Hazardous Items: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. In the children’s bathroom, a container of Lysol Disinfecting wipes and Lysol Disinfectant spray were located on a shelf above the toilet. We discussed that these products are labeled to keep out of reach of children and an additional warning, so they need to be stored in locked storage. During the visit, you printed out the flyer for Hazardous Items Storage in Child Care and stated that you will laminate and post. You immediately moved the items into locked storage when it was brought to your attention to correct the violation. Post the Hazardous Storage flyer and review to ensure that items are stored correctly. Additional Comments: Moving Forward With QRIS Modernization: The Child Care Commission has taken the next step in the journey to meet the North Carolina General Assembly’s mandate in Session Law 2024-34 to modernize the state’s Quality Rating and Improvement System, voting to adopt the Quality Rating Improvement System (QRIS) Modernization Proposed Rule Amendments and Adoptions. Next, the QRIS rules will go to the Rules Review Commission (RRC) for review and approval. It is important to note that the new QRIS rules are not yet effective. However, the Division is preparing for a gradual transition to the new requirements. Resources, forms, and training will be provided to support transition to the new pathways to earn your Two- through Five-Star Rated License. All the newest information will be posted at QRIS Modernization and will also be provided through emails and Raise NC newsletters. Natural Learning Initiative: https://naturalearning.org/resources/ Resources are created, often in collaboration with the Natural Learning Initiative’s interdisciplinary partners, to support technical assistance, professional development, and generally to promote the importance of the natural environment in the daily experience of all children. North Carolina Rated License Assessment Project: NCRLAP’s mission is to promote the quality of child care by consistently and reliably assessing environments for the North Carolina Star Rated License. We collaborate with professionals in the early childhood education field to foster the development and learning of young children. The website ncrlap.org offers resources, trainings, videos, worksheets, and getting ready for FCCRS-3. Pamlico Partnership for Children is also able to provide you with resources and information, training opportunities, technical assistance on childcare issues. Their phone number is (252) 745-7850 or check out their website at www.pamlicopartnership.org. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 5/5/2025 Number Present: 2 Completed Date: 5/5/2025 Age: From 2 To 3 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age. The last annual compliance visit was conducted on 5/17/24. The center's compliance history was reviewed with the operator. The program’s compliance history was ninety percent as of 4/17/25. The NC Secretary of State website was reviewed on 4/17/25 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. We reviewed your facility contact information listed on the Division of Child Development and Early Education (DCDEE) website and you requested for me to update the facility’s email address to tenderlovingjewels@gmail.com. All indoor and outdoor spaces were monitored. Upon arrival, the children were engaged in free play in activity centers. The operator conducted a fire alarm during the visit and documented the drill on the fire drill log. The children colored pictures of panda bears while the operator read the book You Are My Little Busy Bee. Before lunch, the children completed personal care routines and washed their hands. The outdoor space was observed to have a portable house, riding toys, wagon, balls, and hula hoops for the children to engage in gross motor activities. Lunch was observed and consisted of turkey sandwiches on whole wheat bread, peaches, collard greens, and milk. The following violation(s) were documented. Violation Number Comment Rule 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. In the children’s bathroom, a container of Lysol Disinfecting wipes and La bottle of Lysol Disinfectant spray were located on a shelf above the toilet. .1719 (a)(7) 910 Copy of each child's health assessment, including the operator's own preschool child(ren), was not on file within 30 days of enrollment. A child enrolled on 4/29/24 did not have a medical report on file. GS 110-91(1); 10A NCAC 09.1721(a)(1) 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. On or before 5/19/25, 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Children's Records: Children are required to have a medical exam by a doctor and a copy of their immunization record no later than 30 days from their first day of attendance. Immunization records are required for all children; however, a medical exam is required for all children from birth to five, that have not started Kindergarten. A medical exam can be accepted if completed within the last 12 months prior to enrollment. A child enrolled on 4/29/24 did not have a medical report on file. You stated that you thought that you had received the medical report and will request the parent to bring you one. If you do not receive immunization records or medical reports on the first day of enrollment, set a reminder in your calendar to remind you to receive the documents before 30 days have passed. Storage of Hazardous Items: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. In the children’s bathroom, a container of Lysol Disinfecting wipes and Lysol Disinfectant spray were located on a shelf above the toilet. We discussed that these products are labeled to keep out of reach of children and an additional warning, so they need to be stored in locked storage. During the visit, you printed out the flyer for Hazardous Items Storage in Child Care and stated that you will laminate and post. You immediately moved the items into locked storage when it was brought to your attention to correct the violation. Post the Hazardous Storage flyer and review to ensure that items are stored correctly. Additional Comments: Moving Forward With QRIS Modernization: The Child Care Commission has taken the next step in the journey to meet the North Carolina General Assembly’s mandate in Session Law 2024-34 to modernize the state’s Quality Rating and Improvement System, voting to adopt the Quality Rating Improvement System (QRIS) Modernization Proposed Rule Amendments and Adoptions. Next, the QRIS rules will go to the Rules Review Commission (RRC) for review and approval. It is important to note that the new QRIS rules are not yet effective. However, the Division is preparing for a gradual transition to the new requirements. Resources, forms, and training will be provided to support transition to the new pathways to earn your Two- through Five-Star Rated License. All the newest information will be posted at QRIS Modernization and will also be provided through emails and Raise NC newsletters. Natural Learning Initiative: https://naturalearning.org/resources/ Resources are created, often in collaboration with the Natural Learning Initiative’s interdisciplinary partners, to support technical assistance, professional development, and generally to promote the importance of the natural environment in the daily experience of all children. North Carolina Rated License Assessment Project: NCRLAP’s mission is to promote the quality of child care by consistently and reliably assessing environments for the North Carolina Star Rated License. We collaborate with professionals in the early childhood education field to foster the development and learning of young children. The website ncrlap.org offers resources, trainings, videos, worksheets, and getting ready for FCCRS-3. Pamlico Partnership for Children is also able to provide you with resources and information, training opportunities, technical assistance on childcare issues. Their phone number is (252) 745-7850 or check out their website at www.pamlicopartnership.org. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 .1719 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: 0924-034L Visit Date: 9/6/2024 Number Present: 4 Completed Date: 9/6/2024 Age: From 1 To 3 Total Minutes: 195 Time In: 11:00 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The allegations are as follows: 1. There is a concern that children were not being adequately supervised. 2. There is a concern that children were in an unsafe environment. 3. There is a concern that documentation was not provided when a child was injured in care. T. Jones, Operator, assisted me with today’s visit. Upon arrival, the children were engaged in free play in activity centers. After completing personal care routines, the children transitioned to the table to have lunch. While the food finished cooking, the operator read books to the children. Lunch was observed and included chicken nuggets, broccoli, applesauce, rolls, and milk. Regarding the concern that children were not being adequately supervised, I interviewed the operator and observed interactions with the children. It was reported that a child was playing with a beaded necklace that became tangled in the child’s hair and when the child removed the necklace from her neck a braided piece of hair was pulled out with the necklace. The operator stated that she was in the recliner across the child care space from the dramatic play center when the incident occurred and immediate assistance was not rendered before the child's hair was pulled from the head. During the visit, based on this information, the allegation was confirmed. Regarding the allegation that children were in an unsafe environment, I monitored the indoor and outdoor spaces. I observed a plastic bag hanging in a child’s cubby and on a shelf below the changing table below 5 feet from the ground. All three bedrooms in the home were unlocked and accessible to the children to open. I observed two bottles of hand sanitizer and Cutter bug spray located on a shelf below 5 feet in the kitchen beside the table where children eat. You stated that you burn incense in the evenings when children are not in care, and I observed an incense burner with ashes. Based on this information, the allegation was confirmed. Regarding the allegation that documentation was not provided when a child was injured in care, I reviewed incident reports and the incident log. I also interviewed the operator. It was reported that an incident did occur, and an incident report was not prepared and given to the parent on the day of the incident. An incident log was not on file but during the visit the operator printed an incident log and documented the incident. Based on information above, the allegation was confirmed. The following violation(s) were observed. Violation Number Comment Rule 720 Adequate supervision was not provided for children in the Family Child Care Home. Due to a lack of supervision, a child's braid was pulled from her head. .1711(a) 1409 Operator did not provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of the children in care. One bedroom in the home was unlocked and accessible to the children. Several bottles of Bath and Body Works lotion and body spray were located on a table below five feet from the ground in the unlocked bedroom directly across the hallway from the bathroom that the children use. 10A NCAC 09 .1719 (a) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. A plastic bag hanging in a child’s cubby and another plastic bag was located on a shelf below the changing table below five (5) feet from the ground. .1719(a)(18) 1940 Hazardous cleaning supplies and other items that might be poisonous e.g. toxic plants, were not out of reach or in locked storage when children were in care. Two (2) bottles of hand sanitizer and a bottle of Cutter bug spray was located on a shelf below 5 feet in the kitchen beside the table where children eat. .1719(a)(6) 2047 Incident logs were not completed and maintained as required. An incident log was not on file for review. 10A NCAC 09 .1721(e)(4) 2052 A copy of the incident report was not given to the parent. An incident report was not prepared and given to the parent on the day of the incident. .1721(e)(3) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS110-90(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. On or before 9/20/24, 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 considered 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Supervision: Supervision is basic to safety and the prevention of injury and maintaining quality child care. Parents/guardians have a contract with caregivers/teachers to supervise their children. To be available for supervision or rescue in an emergency, an adult must be able to hear and see the children and be able to render immediate assistance. It was reported to me that the operator was sitting in the recliner within the child care giving space across the room from the dramatic play center where the incident occurred. We discussed that active supervision requires constantly moving around the space and staying in close proximity to the children to be able to give assistance immediately. Position yourself to be beside the children in the activity center that they are playing in so that you can remain close to the children. Incident Reports: An incident report should be completed and logged each time a child is injured, regardless of whether medical care is needed. It is helpful to remember the “three B’s”: bumps, bruises, and blood, as a reminder of when to complete incident reports. The incident report should specify what happened to cause the injury and then by reviewed with the parent before the parent signs the report. It was reported that a child was playing with a beaded necklace that became tangled in the child’s hair and when the child removed the necklace from her neck a braided piece of hair was pulled out with the necklace. An incident report was not prepared to give to the parent on the afternoon of the incident. I reviewed a completed incident report from the day in question that had not been signed by the parent. We discussed the process of completing an incident report any time an incident occurs immediately following the incident to have ready for the parent to sign when they arrive. You stated that you usually call the parent when an incident occurs but did not for that incident and will in the future. Attend to the child’s medical needs before attempting to write an incident report. Write the report after the incident is over and the medical needs of the child have been addressed. When you write the story of the incident, you should put the information that you have into chronological order, so others reading your report will be able to clearly picture what happened. Safe environment: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. There were 2 plastic bags observed below five feet from the ground that the children could reach. On a shelf in the kitchen below 5 feet, there was a bottle of Cutter bug spray and two bottles of hand sanitizer. You removed the plastic and the bottles and placed them above 5 feet from the ground to correct these violations. Three bedroom doors were unlocked and the children could have opened them. We discussed that it is important to check the child care space every morning before the children arrive and remove hazardous items. I observed an incense burner with ashes in the living room directly beside the child care space. Many chemicals are sold to cover up noxious odors or ward off pests. Many of these chemicals are hazardous. As an alternative, caregivers/teachers should remove the source of noxious odors to the extent possible by dissipating noxious odors through cleaning and ventilation (e.g., opening windows) and controlling pests using nontoxic methods. Additional Comments: Additional Caregiver: An individual who provides care for five hours or more in a week during planned absences of the family child care home operator must be 21 years old, have a high school diploma or GED; have completed a First Aid and cardiopulmonary resuscitation (CPR) course within 12 months prior to caring for children; have completed a health questionnaire; have proof of negative results of a tuberculosis test or screening completed within 12 months prior to the first day of providing care; have submitted criminal background check forms as required in Rule .2703 of this Chapter; have documentation of annual on-going training as described in Rule .1703(d) of this Section after the first year of employment; have completed ITS-SIDS training, if licensed to care for infants; have completed Recognizing and Responding to Suspicions of Child Maltreatment training; and have documentation that the operator has reviewed the requirements found in this Chapter, including the Emergency Preparedness and Response Plan, and in G.S. Chapter 110, Article 7. We discussed that if an additional caregiver is hired that they will need to complete all of these items. Violations were documented for failure to maintain compliance with supervision requirements. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that repeated violations of this nature during consecutive visits may lead to an administrative action against your license. A follow up visit may be conducted in the near future to monitor compliance with child care requirements. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 .1721 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: 0924-034L Visit Date: 9/6/2024 Number Present: 4 Completed Date: 9/6/2024 Age: From 1 To 3 Total Minutes: 195 Time In: 11:00 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The allegations are as follows: 1. There is a concern that children were not being adequately supervised. 2. There is a concern that children were in an unsafe environment. 3. There is a concern that documentation was not provided when a child was injured in care. T. Jones, Operator, assisted me with today’s visit. Upon arrival, the children were engaged in free play in activity centers. After completing personal care routines, the children transitioned to the table to have lunch. While the food finished cooking, the operator read books to the children. Lunch was observed and included chicken nuggets, broccoli, applesauce, rolls, and milk. Regarding the concern that children were not being adequately supervised, I interviewed the operator and observed interactions with the children. It was reported that a child was playing with a beaded necklace that became tangled in the child’s hair and when the child removed the necklace from her neck a braided piece of hair was pulled out with the necklace. The operator stated that she was in the recliner across the child care space from the dramatic play center when the incident occurred and immediate assistance was not rendered before the child's hair was pulled from the head. During the visit, based on this information, the allegation was confirmed. Regarding the allegation that children were in an unsafe environment, I monitored the indoor and outdoor spaces. I observed a plastic bag hanging in a child’s cubby and on a shelf below the changing table below 5 feet from the ground. All three bedrooms in the home were unlocked and accessible to the children to open. I observed two bottles of hand sanitizer and Cutter bug spray located on a shelf below 5 feet in the kitchen beside the table where children eat. You stated that you burn incense in the evenings when children are not in care, and I observed an incense burner with ashes. Based on this information, the allegation was confirmed. Regarding the allegation that documentation was not provided when a child was injured in care, I reviewed incident reports and the incident log. I also interviewed the operator. It was reported that an incident did occur, and an incident report was not prepared and given to the parent on the day of the incident. An incident log was not on file but during the visit the operator printed an incident log and documented the incident. Based on information above, the allegation was confirmed. The following violation(s) were observed. Violation Number Comment Rule 720 Adequate supervision was not provided for children in the Family Child Care Home. Due to a lack of supervision, a child's braid was pulled from her head. .1711(a) 1409 Operator did not provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of the children in care. One bedroom in the home was unlocked and accessible to the children. Several bottles of Bath and Body Works lotion and body spray were located on a table below five feet from the ground in the unlocked bedroom directly across the hallway from the bathroom that the children use. 10A NCAC 09 .1719 (a) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. A plastic bag hanging in a child’s cubby and another plastic bag was located on a shelf below the changing table below five (5) feet from the ground. .1719(a)(18) 1940 Hazardous cleaning supplies and other items that might be poisonous e.g. toxic plants, were not out of reach or in locked storage when children were in care. Two (2) bottles of hand sanitizer and a bottle of Cutter bug spray was located on a shelf below 5 feet in the kitchen beside the table where children eat. .1719(a)(6) 2047 Incident logs were not completed and maintained as required. An incident log was not on file for review. 10A NCAC 09 .1721(e)(4) 2052 A copy of the incident report was not given to the parent. An incident report was not prepared and given to the parent on the day of the incident. .1721(e)(3) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS110-90(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. On or before 9/20/24, 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 considered 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Supervision: Supervision is basic to safety and the prevention of injury and maintaining quality child care. Parents/guardians have a contract with caregivers/teachers to supervise their children. To be available for supervision or rescue in an emergency, an adult must be able to hear and see the children and be able to render immediate assistance. It was reported to me that the operator was sitting in the recliner within the child care giving space across the room from the dramatic play center where the incident occurred. We discussed that active supervision requires constantly moving around the space and staying in close proximity to the children to be able to give assistance immediately. Position yourself to be beside the children in the activity center that they are playing in so that you can remain close to the children. Incident Reports: An incident report should be completed and logged each time a child is injured, regardless of whether medical care is needed. It is helpful to remember the “three B’s”: bumps, bruises, and blood, as a reminder of when to complete incident reports. The incident report should specify what happened to cause the injury and then by reviewed with the parent before the parent signs the report. It was reported that a child was playing with a beaded necklace that became tangled in the child’s hair and when the child removed the necklace from her neck a braided piece of hair was pulled out with the necklace. An incident report was not prepared to give to the parent on the afternoon of the incident. I reviewed a completed incident report from the day in question that had not been signed by the parent. We discussed the process of completing an incident report any time an incident occurs immediately following the incident to have ready for the parent to sign when they arrive. You stated that you usually call the parent when an incident occurs but did not for that incident and will in the future. Attend to the child’s medical needs before attempting to write an incident report. Write the report after the incident is over and the medical needs of the child have been addressed. When you write the story of the incident, you should put the information that you have into chronological order, so others reading your report will be able to clearly picture what happened. Safe environment: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. There were 2 plastic bags observed below five feet from the ground that the children could reach. On a shelf in the kitchen below 5 feet, there was a bottle of Cutter bug spray and two bottles of hand sanitizer. You removed the plastic and the bottles and placed them above 5 feet from the ground to correct these violations. Three bedroom doors were unlocked and the children could have opened them. We discussed that it is important to check the child care space every morning before the children arrive and remove hazardous items. I observed an incense burner with ashes in the living room directly beside the child care space. Many chemicals are sold to cover up noxious odors or ward off pests. Many of these chemicals are hazardous. As an alternative, caregivers/teachers should remove the source of noxious odors to the extent possible by dissipating noxious odors through cleaning and ventilation (e.g., opening windows) and controlling pests using nontoxic methods. Additional Comments: Additional Caregiver: An individual who provides care for five hours or more in a week during planned absences of the family child care home operator must be 21 years old, have a high school diploma or GED; have completed a First Aid and cardiopulmonary resuscitation (CPR) course within 12 months prior to caring for children; have completed a health questionnaire; have proof of negative results of a tuberculosis test or screening completed within 12 months prior to the first day of providing care; have submitted criminal background check forms as required in Rule .2703 of this Chapter; have documentation of annual on-going training as described in Rule .1703(d) of this Section after the first year of employment; have completed ITS-SIDS training, if licensed to care for infants; have completed Recognizing and Responding to Suspicions of Child Maltreatment training; and have documentation that the operator has reviewed the requirements found in this Chapter, including the Emergency Preparedness and Response Plan, and in G.S. Chapter 110, Article 7. We discussed that if an additional caregiver is hired that they will need to complete all of these items. Violations were documented for failure to maintain compliance with supervision requirements. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that repeated violations of this nature during consecutive visits may lead to an administrative action against your license. A follow up visit may be conducted in the near future to monitor compliance with child care requirements. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 GS110-90 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: 0924-034L Visit Date: 9/6/2024 Number Present: 4 Completed Date: 9/6/2024 Age: From 1 To 3 Total Minutes: 195 Time In: 11:00 AM Time Out: 02:15 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The allegations are as follows: 1. There is a concern that children were not being adequately supervised. 2. There is a concern that children were in an unsafe environment. 3. There is a concern that documentation was not provided when a child was injured in care. T. Jones, Operator, assisted me with today’s visit. Upon arrival, the children were engaged in free play in activity centers. After completing personal care routines, the children transitioned to the table to have lunch. While the food finished cooking, the operator read books to the children. Lunch was observed and included chicken nuggets, broccoli, applesauce, rolls, and milk. Regarding the concern that children were not being adequately supervised, I interviewed the operator and observed interactions with the children. It was reported that a child was playing with a beaded necklace that became tangled in the child’s hair and when the child removed the necklace from her neck a braided piece of hair was pulled out with the necklace. The operator stated that she was in the recliner across the child care space from the dramatic play center when the incident occurred and immediate assistance was not rendered before the child's hair was pulled from the head. During the visit, based on this information, the allegation was confirmed. Regarding the allegation that children were in an unsafe environment, I monitored the indoor and outdoor spaces. I observed a plastic bag hanging in a child’s cubby and on a shelf below the changing table below 5 feet from the ground. All three bedrooms in the home were unlocked and accessible to the children to open. I observed two bottles of hand sanitizer and Cutter bug spray located on a shelf below 5 feet in the kitchen beside the table where children eat. You stated that you burn incense in the evenings when children are not in care, and I observed an incense burner with ashes. Based on this information, the allegation was confirmed. Regarding the allegation that documentation was not provided when a child was injured in care, I reviewed incident reports and the incident log. I also interviewed the operator. It was reported that an incident did occur, and an incident report was not prepared and given to the parent on the day of the incident. An incident log was not on file but during the visit the operator printed an incident log and documented the incident. Based on information above, the allegation was confirmed. The following violation(s) were observed. Violation Number Comment Rule 720 Adequate supervision was not provided for children in the Family Child Care Home. Due to a lack of supervision, a child's braid was pulled from her head. .1711(a) 1409 Operator did not provide a physically safe and healthy indoor and outdoor environment that meets the developmental needs of the children in care. One bedroom in the home was unlocked and accessible to the children. Several bottles of Bath and Body Works lotion and body spray were located on a table below five feet from the ground in the unlocked bedroom directly across the hallway from the bathroom that the children use. 10A NCAC 09 .1719 (a) 1922 Plastic bags, toys, and toy parts small enough to be swallowed, including but not limited to materials that can be easily torn apart such as foam rubber and styrofoam, were accessible to children under the age of three. A plastic bag hanging in a child’s cubby and another plastic bag was located on a shelf below the changing table below five (5) feet from the ground. .1719(a)(18) 1940 Hazardous cleaning supplies and other items that might be poisonous e.g. toxic plants, were not out of reach or in locked storage when children were in care. Two (2) bottles of hand sanitizer and a bottle of Cutter bug spray was located on a shelf below 5 feet in the kitchen beside the table where children eat. .1719(a)(6) 2047 Incident logs were not completed and maintained as required. An incident log was not on file for review. 10A NCAC 09 .1721(e)(4) 2052 A copy of the incident report was not given to the parent. An incident report was not prepared and given to the parent on the day of the incident. .1721(e)(3) Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS110-90(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. On or before 9/20/24, 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 considered 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Supervision: Supervision is basic to safety and the prevention of injury and maintaining quality child care. Parents/guardians have a contract with caregivers/teachers to supervise their children. To be available for supervision or rescue in an emergency, an adult must be able to hear and see the children and be able to render immediate assistance. It was reported to me that the operator was sitting in the recliner within the child care giving space across the room from the dramatic play center where the incident occurred. We discussed that active supervision requires constantly moving around the space and staying in close proximity to the children to be able to give assistance immediately. Position yourself to be beside the children in the activity center that they are playing in so that you can remain close to the children. Incident Reports: An incident report should be completed and logged each time a child is injured, regardless of whether medical care is needed. It is helpful to remember the “three B’s”: bumps, bruises, and blood, as a reminder of when to complete incident reports. The incident report should specify what happened to cause the injury and then by reviewed with the parent before the parent signs the report. It was reported that a child was playing with a beaded necklace that became tangled in the child’s hair and when the child removed the necklace from her neck a braided piece of hair was pulled out with the necklace. An incident report was not prepared to give to the parent on the afternoon of the incident. I reviewed a completed incident report from the day in question that had not been signed by the parent. We discussed the process of completing an incident report any time an incident occurs immediately following the incident to have ready for the parent to sign when they arrive. You stated that you usually call the parent when an incident occurs but did not for that incident and will in the future. Attend to the child’s medical needs before attempting to write an incident report. Write the report after the incident is over and the medical needs of the child have been addressed. When you write the story of the incident, you should put the information that you have into chronological order, so others reading your report will be able to clearly picture what happened. Safe environment: Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. There were 2 plastic bags observed below five feet from the ground that the children could reach. On a shelf in the kitchen below 5 feet, there was a bottle of Cutter bug spray and two bottles of hand sanitizer. You removed the plastic and the bottles and placed them above 5 feet from the ground to correct these violations. Three bedroom doors were unlocked and the children could have opened them. We discussed that it is important to check the child care space every morning before the children arrive and remove hazardous items. I observed an incense burner with ashes in the living room directly beside the child care space. Many chemicals are sold to cover up noxious odors or ward off pests. Many of these chemicals are hazardous. As an alternative, caregivers/teachers should remove the source of noxious odors to the extent possible by dissipating noxious odors through cleaning and ventilation (e.g., opening windows) and controlling pests using nontoxic methods. Additional Comments: Additional Caregiver: An individual who provides care for five hours or more in a week during planned absences of the family child care home operator must be 21 years old, have a high school diploma or GED; have completed a First Aid and cardiopulmonary resuscitation (CPR) course within 12 months prior to caring for children; have completed a health questionnaire; have proof of negative results of a tuberculosis test or screening completed within 12 months prior to the first day of providing care; have submitted criminal background check forms as required in Rule .2703 of this Chapter; have documentation of annual on-going training as described in Rule .1703(d) of this Section after the first year of employment; have completed ITS-SIDS training, if licensed to care for infants; have completed Recognizing and Responding to Suspicions of Child Maltreatment training; and have documentation that the operator has reviewed the requirements found in this Chapter, including the Emergency Preparedness and Response Plan, and in G.S. Chapter 110, Article 7. We discussed that if an additional caregiver is hired that they will need to complete all of these items. Violations were documented for failure to maintain compliance with supervision requirements. Violations of this nature directly impact the safety of the children while in your care. In addition, these types of violations have the greatest negative impact on your compliance history. During the visit, we discussed that repeated violations of this nature during consecutive visits may lead to an administrative action against your license. A follow up visit may be conducted in the near future to monitor compliance with child care requirements. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 .1720 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 5/17/2024 Number Present: 4 Completed Date: 5/17/2024 Age: From 1 To 3 Total Minutes: 280 Time In: 08:50 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age. The last annual compliance visit was conducted 6/2/23. The center's compliance history was reviewed with the operator. The program’s compliance history was eighty six percent as of 5/7/24. The NC Secretary of State website was reviewed on 5/7/24 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. We reviewed your facility contact information listed on the Division of Child Development and Early Education (DCDEE) website and all information is current. Contact me if you need to make any changes to your contact information, e.g., phone numbers, mailing address. All indoor and outdoor spaces were monitored. Upon arrival, the children were engaged in free play in activity centers. T. Jones, Operator arrived during the visit. Before lunch, the children completed personal care routines before the operator read them a story about parts of the body. The outdoor space was observed to have a portable house, riding toys, wagon, balls, and hula hoops for the children to engage in gross motor activities. Lunch was observed and consisted of pepperoni pizza, salad, pineapples, and milk. The following violation(s) were documented. Violation Number Comment Rule 417 Individual providing care during unplanned absences of the operator, such as medical emergencies, was not at least 21 years of age. Upon arrival, an 18-year-old was caring for four (4) children, one (1) to three (3) years of age. 10A NCAC 09.1701(e) 543 Screen time was not prohibited for children under the age of three. The operator did not offer alternative activities for children under the age of three years. Children, one (1)-three (3) years of age, were watching cartoons on the television in the childcare space. .1718(c) 606 Each child was not held or placed in an appropriate feeding chair or other age appropriate seating apparatus to be fed. A child was observed sitting on the carpet and a second child was observed in a portable crib drinking sippy cups of milk. .1706(k) 903 When medication is administered, authorization for the operator to administer the specific medication according to the parent's or health care professional's instructions was not on file and available. A Fluticasone Propionate HFA inhaler was on file without written permission from the parent. 10A NCAC 09 .1720(c)(1&2) & .1721(a)(4) 927 Operator did not follow the written feeding schedule for each child under 15 months of age. A child 12 months of age did not have a feeding schedule on file. .1706(i) 1401 Prescribed medications were not stored in their original containers in which they are dispensed with the pharmacy label. A Fluticasone Propionate HFA inhaler was not stored in the original container with the pharmacy label. 10A NCAC 09 .1720(c)(1)&(2) 1897 Application did not have an a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child did not have a medical action plan on file for asthma. .1721 (a )(4) 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. On or before 5/31/24, 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Additional Caregiver: An individual who provides care for five hours or more in a week during planned absences of the family child care home operator must be 21 years old. Upon arrival, an 18-year-old was caring for four (4) children, one (1) to three (3) years of age. The caregiver does have a criminal background check on file. We discussed that a true emergency is when you need to rush to the doctors and are unable to care for the children. You stated that you felt that today’s doctor’s appointment was an emergency because the doctor’s office called you this morning for the appointment and you will be out of town next week. You came back to the daycare home after the appointment was complete. We looked at the requirements of an additional caregiver in the child care rules and you printed out a copy of the additional caregiver and substitute file checklist to reference. You stated that you will not have the 18-year-old act as an additional caregiver moving forward. When you have doctor’s appointments, plan for the children to not be in care during that time or have a qualified caregiver that is 21 years or older. Medication: Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. A medical action plan is required for children that need emergency medication, the form needs to be completed by the parent or a health care professional. All medications for children present at the center must have a current, completed medication permission form even if there is a Medical Action Plan. A Fluticasone Propionate HFA inhaler was on file without written permission from the parent and was not stored in the original container with the pharmacy label. You stated the parent had given the inhaler to you this morning and you had not had a chance to get the permission form and medical action plan completed. A child did not have a medical action plan on file for asthma. We reviewed the Division’s website during the visit, and you printed out a medical action for asthma and a permission form and log for the inhaler. Ask the parent for an inhaler with the original box with pharmacy label and the complete the forms that we printed out today. Ensure that you have completed forms and medication with pharmacy labels when you accept medication. Feeding Schedules: Growth and development during infancy require that nourishing, wholesome, and developmentally appropriate food be provided, using safe approaches to feeding. A child was observed sitting on the carpet and a second child was observed in a portable crib drinking sippy cups of milk. We discussed that children must eat and drink while sitting at the table or in a high chair. You stated that this does not occur during a typical day. All children under 15 months of age must have a signed feeding schedule/plan on file. A child 12 months of age did not have a feeding schedule on file. You stated that you were unaware that you needed a feeding schedule for infants as this was your first infant in care. While reviewing the Division’s website, you printed out a copy of a blank feeding schedule and stated that you will have the parent complete it and put it in the child’s file. Use the children's file checklist to ensure that you have all the required documents for infant files. Screen time: Excessive media use has been associated with lags in achievement of knowledge and skills, as well as negative impacts on sleep, weight, and social/emotional health. Screen time, for children three years and older, should be used to stimulate a developmental domain; limited to 30 minutes a day and documented on a cumulative log or the activity plan that is available for review. Children, one (1)-three (3) years of age, were watching cartoons on the television in the childcare space. You stated that today was not a typical day because you went to a doctor’s appointment and do not allow the children to have screen time. We discussed that screen time cannot be used for children under the age of three. Use a CD player or radio as a source of music that does not have a screen. Additional Comments: CPR/First Aid: Reminder that you need to complete a CPR/First Aid course before the end of July 2024. You stated that you will be taking a course in June 2024. EPR Plan: You completed the EPR course on 4/25/24 and have begun writing the EPR plan for your home. It needs to be completed by 8/25/24 and you stated that you will send me a copy when you are completed. 5 Steps to Taking Care of Yourself: Hectic schedules can drain your energy and keep you so busy that you often forget to take care of yourself both physically and emotionally. Take a moment to stop and think about what you need to do to enable you to perform at your best. So what does self-care look like, and what can you do? 1. Tell yourself that you do matter, and because you matter, it is important to spend time and energy on helping yourself feel better. 2. Be extra nice to yourself. Do things you enjoy that help you relax and unwind. 3. Be patient with yourself. Accept that you will make mistakes and know that you can’t please everyone. Know that things will get better, even if it takes a while. 4. Invest in yourself! Follow your dreams! Say no to situations or people that you know could trigger you in a negative way. Self-care means that you protect yourself so you can build a stronger future self. Pamlico Partnership for Children is also able to provide you with resources and information, training opportunities, technical assistance on childcare issues. Their phone number is (252) 745-7850 or check out their website at www.pamlicopartnership.org. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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 09.1701 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 5/17/2024 Number Present: 4 Completed Date: 5/17/2024 Age: From 1 To 3 Total Minutes: 280 Time In: 08:50 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age. The last annual compliance visit was conducted 6/2/23. The center's compliance history was reviewed with the operator. The program’s compliance history was eighty six percent as of 5/7/24. The NC Secretary of State website was reviewed on 5/7/24 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. We reviewed your facility contact information listed on the Division of Child Development and Early Education (DCDEE) website and all information is current. Contact me if you need to make any changes to your contact information, e.g., phone numbers, mailing address. All indoor and outdoor spaces were monitored. Upon arrival, the children were engaged in free play in activity centers. T. Jones, Operator arrived during the visit. Before lunch, the children completed personal care routines before the operator read them a story about parts of the body. The outdoor space was observed to have a portable house, riding toys, wagon, balls, and hula hoops for the children to engage in gross motor activities. Lunch was observed and consisted of pepperoni pizza, salad, pineapples, and milk. The following violation(s) were documented. Violation Number Comment Rule 417 Individual providing care during unplanned absences of the operator, such as medical emergencies, was not at least 21 years of age. Upon arrival, an 18-year-old was caring for four (4) children, one (1) to three (3) years of age. 10A NCAC 09.1701(e) 543 Screen time was not prohibited for children under the age of three. The operator did not offer alternative activities for children under the age of three years. Children, one (1)-three (3) years of age, were watching cartoons on the television in the childcare space. .1718(c) 606 Each child was not held or placed in an appropriate feeding chair or other age appropriate seating apparatus to be fed. A child was observed sitting on the carpet and a second child was observed in a portable crib drinking sippy cups of milk. .1706(k) 903 When medication is administered, authorization for the operator to administer the specific medication according to the parent's or health care professional's instructions was not on file and available. A Fluticasone Propionate HFA inhaler was on file without written permission from the parent. 10A NCAC 09 .1720(c)(1&2) & .1721(a)(4) 927 Operator did not follow the written feeding schedule for each child under 15 months of age. A child 12 months of age did not have a feeding schedule on file. .1706(i) 1401 Prescribed medications were not stored in their original containers in which they are dispensed with the pharmacy label. A Fluticasone Propionate HFA inhaler was not stored in the original container with the pharmacy label. 10A NCAC 09 .1720(c)(1)&(2) 1897 Application did not have an a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child did not have a medical action plan on file for asthma. .1721 (a )(4) 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. On or before 5/31/24, 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Additional Caregiver: An individual who provides care for five hours or more in a week during planned absences of the family child care home operator must be 21 years old. Upon arrival, an 18-year-old was caring for four (4) children, one (1) to three (3) years of age. The caregiver does have a criminal background check on file. We discussed that a true emergency is when you need to rush to the doctors and are unable to care for the children. You stated that you felt that today’s doctor’s appointment was an emergency because the doctor’s office called you this morning for the appointment and you will be out of town next week. You came back to the daycare home after the appointment was complete. We looked at the requirements of an additional caregiver in the child care rules and you printed out a copy of the additional caregiver and substitute file checklist to reference. You stated that you will not have the 18-year-old act as an additional caregiver moving forward. When you have doctor’s appointments, plan for the children to not be in care during that time or have a qualified caregiver that is 21 years or older. Medication: Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. A medical action plan is required for children that need emergency medication, the form needs to be completed by the parent or a health care professional. All medications for children present at the center must have a current, completed medication permission form even if there is a Medical Action Plan. A Fluticasone Propionate HFA inhaler was on file without written permission from the parent and was not stored in the original container with the pharmacy label. You stated the parent had given the inhaler to you this morning and you had not had a chance to get the permission form and medical action plan completed. A child did not have a medical action plan on file for asthma. We reviewed the Division’s website during the visit, and you printed out a medical action for asthma and a permission form and log for the inhaler. Ask the parent for an inhaler with the original box with pharmacy label and the complete the forms that we printed out today. Ensure that you have completed forms and medication with pharmacy labels when you accept medication. Feeding Schedules: Growth and development during infancy require that nourishing, wholesome, and developmentally appropriate food be provided, using safe approaches to feeding. A child was observed sitting on the carpet and a second child was observed in a portable crib drinking sippy cups of milk. We discussed that children must eat and drink while sitting at the table or in a high chair. You stated that this does not occur during a typical day. All children under 15 months of age must have a signed feeding schedule/plan on file. A child 12 months of age did not have a feeding schedule on file. You stated that you were unaware that you needed a feeding schedule for infants as this was your first infant in care. While reviewing the Division’s website, you printed out a copy of a blank feeding schedule and stated that you will have the parent complete it and put it in the child’s file. Use the children's file checklist to ensure that you have all the required documents for infant files. Screen time: Excessive media use has been associated with lags in achievement of knowledge and skills, as well as negative impacts on sleep, weight, and social/emotional health. Screen time, for children three years and older, should be used to stimulate a developmental domain; limited to 30 minutes a day and documented on a cumulative log or the activity plan that is available for review. Children, one (1)-three (3) years of age, were watching cartoons on the television in the childcare space. You stated that today was not a typical day because you went to a doctor’s appointment and do not allow the children to have screen time. We discussed that screen time cannot be used for children under the age of three. Use a CD player or radio as a source of music that does not have a screen. Additional Comments: CPR/First Aid: Reminder that you need to complete a CPR/First Aid course before the end of July 2024. You stated that you will be taking a course in June 2024. EPR Plan: You completed the EPR course on 4/25/24 and have begun writing the EPR plan for your home. It needs to be completed by 8/25/24 and you stated that you will send me a copy when you are completed. 5 Steps to Taking Care of Yourself: Hectic schedules can drain your energy and keep you so busy that you often forget to take care of yourself both physically and emotionally. Take a moment to stop and think about what you need to do to enable you to perform at your best. So what does self-care look like, and what can you do? 1. Tell yourself that you do matter, and because you matter, it is important to spend time and energy on helping yourself feel better. 2. Be extra nice to yourself. Do things you enjoy that help you relax and unwind. 3. Be patient with yourself. Accept that you will make mistakes and know that you can’t please everyone. Know that things will get better, even if it takes a while. 4. Invest in yourself! Follow your dreams! Say no to situations or people that you know could trigger you in a negative way. Self-care means that you protect yourself so you can build a stronger future self. Pamlico Partnership for Children is also able to provide you with resources and information, training opportunities, technical assistance on childcare issues. Their phone number is (252) 745-7850 or check out their website at www.pamlicopartnership.org. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: BRITTANY JONES Operation Type: Family CC Home Case Number: Visit Date: 5/17/2024 Number Present: 4 Completed Date: 5/17/2024 Age: From 1 To 3 Total Minutes: 280 Time In: 08:50 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. T. Jones, Operator, assisted me with today’s visit. Your program currently operates with a four-star license, issued 12/3/23, earning 7 points in the education component, 2 points in the program standards component and 1 quality point for infant capacity restricted to no more than two children under one year of age. The last annual compliance visit was conducted 6/2/23. The center's compliance history was reviewed with the operator. The program’s compliance history was eighty six percent as of 5/7/24. The NC Secretary of State website was reviewed on 5/7/24 and this facility is not currently owned or operated by a corporation. Please contact me prior to any changes regarding ownership of this facility. We reviewed your facility contact information listed on the Division of Child Development and Early Education (DCDEE) website and all information is current. Contact me if you need to make any changes to your contact information, e.g., phone numbers, mailing address. All indoor and outdoor spaces were monitored. Upon arrival, the children were engaged in free play in activity centers. T. Jones, Operator arrived during the visit. Before lunch, the children completed personal care routines before the operator read them a story about parts of the body. The outdoor space was observed to have a portable house, riding toys, wagon, balls, and hula hoops for the children to engage in gross motor activities. Lunch was observed and consisted of pepperoni pizza, salad, pineapples, and milk. The following violation(s) were documented. Violation Number Comment Rule 417 Individual providing care during unplanned absences of the operator, such as medical emergencies, was not at least 21 years of age. Upon arrival, an 18-year-old was caring for four (4) children, one (1) to three (3) years of age. 10A NCAC 09.1701(e) 543 Screen time was not prohibited for children under the age of three. The operator did not offer alternative activities for children under the age of three years. Children, one (1)-three (3) years of age, were watching cartoons on the television in the childcare space. .1718(c) 606 Each child was not held or placed in an appropriate feeding chair or other age appropriate seating apparatus to be fed. A child was observed sitting on the carpet and a second child was observed in a portable crib drinking sippy cups of milk. .1706(k) 903 When medication is administered, authorization for the operator to administer the specific medication according to the parent's or health care professional's instructions was not on file and available. A Fluticasone Propionate HFA inhaler was on file without written permission from the parent. 10A NCAC 09 .1720(c)(1&2) & .1721(a)(4) 927 Operator did not follow the written feeding schedule for each child under 15 months of age. A child 12 months of age did not have a feeding schedule on file. .1706(i) 1401 Prescribed medications were not stored in their original containers in which they are dispensed with the pharmacy label. A Fluticasone Propionate HFA inhaler was not stored in the original container with the pharmacy label. 10A NCAC 09 .1720(c)(1)&(2) 1897 Application did not have an a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child did not have a medical action plan on file for asthma. .1721 (a )(4) 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. On or before 5/31/24, 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. Mail or email the information to: Brittany Jones, Child Care Consultant PO Box 3272 New Bern, NC 28564 Brittany.j.jones@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance with Documented Violations: Additional Caregiver: An individual who provides care for five hours or more in a week during planned absences of the family child care home operator must be 21 years old. Upon arrival, an 18-year-old was caring for four (4) children, one (1) to three (3) years of age. The caregiver does have a criminal background check on file. We discussed that a true emergency is when you need to rush to the doctors and are unable to care for the children. You stated that you felt that today’s doctor’s appointment was an emergency because the doctor’s office called you this morning for the appointment and you will be out of town next week. You came back to the daycare home after the appointment was complete. We looked at the requirements of an additional caregiver in the child care rules and you printed out a copy of the additional caregiver and substitute file checklist to reference. You stated that you will not have the 18-year-old act as an additional caregiver moving forward. When you have doctor’s appointments, plan for the children to not be in care during that time or have a qualified caregiver that is 21 years or older. Medication: Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. A medical action plan is required for children that need emergency medication, the form needs to be completed by the parent or a health care professional. All medications for children present at the center must have a current, completed medication permission form even if there is a Medical Action Plan. A Fluticasone Propionate HFA inhaler was on file without written permission from the parent and was not stored in the original container with the pharmacy label. You stated the parent had given the inhaler to you this morning and you had not had a chance to get the permission form and medical action plan completed. A child did not have a medical action plan on file for asthma. We reviewed the Division’s website during the visit, and you printed out a medical action for asthma and a permission form and log for the inhaler. Ask the parent for an inhaler with the original box with pharmacy label and the complete the forms that we printed out today. Ensure that you have completed forms and medication with pharmacy labels when you accept medication. Feeding Schedules: Growth and development during infancy require that nourishing, wholesome, and developmentally appropriate food be provided, using safe approaches to feeding. A child was observed sitting on the carpet and a second child was observed in a portable crib drinking sippy cups of milk. We discussed that children must eat and drink while sitting at the table or in a high chair. You stated that this does not occur during a typical day. All children under 15 months of age must have a signed feeding schedule/plan on file. A child 12 months of age did not have a feeding schedule on file. You stated that you were unaware that you needed a feeding schedule for infants as this was your first infant in care. While reviewing the Division’s website, you printed out a copy of a blank feeding schedule and stated that you will have the parent complete it and put it in the child’s file. Use the children's file checklist to ensure that you have all the required documents for infant files. Screen time: Excessive media use has been associated with lags in achievement of knowledge and skills, as well as negative impacts on sleep, weight, and social/emotional health. Screen time, for children three years and older, should be used to stimulate a developmental domain; limited to 30 minutes a day and documented on a cumulative log or the activity plan that is available for review. Children, one (1)-three (3) years of age, were watching cartoons on the television in the childcare space. You stated that today was not a typical day because you went to a doctor’s appointment and do not allow the children to have screen time. We discussed that screen time cannot be used for children under the age of three. Use a CD player or radio as a source of music that does not have a screen. Additional Comments: CPR/First Aid: Reminder that you need to complete a CPR/First Aid course before the end of July 2024. You stated that you will be taking a course in June 2024. EPR Plan: You completed the EPR course on 4/25/24 and have begun writing the EPR plan for your home. It needs to be completed by 8/25/24 and you stated that you will send me a copy when you are completed. 5 Steps to Taking Care of Yourself: Hectic schedules can drain your energy and keep you so busy that you often forget to take care of yourself both physically and emotionally. Take a moment to stop and think about what you need to do to enable you to perform at your best. So what does self-care look like, and what can you do? 1. Tell yourself that you do matter, and because you matter, it is important to spend time and energy on helping yourself feel better. 2. Be extra nice to yourself. Do things you enjoy that help you relax and unwind. 3. Be patient with yourself. Accept that you will make mistakes and know that you can’t please everyone. Know that things will get better, even if it takes a while. 4. Invest in yourself! Follow your dreams! Say no to situations or people that you know could trigger you in a negative way. Self-care means that you protect yourself so you can build a stronger future self. Pamlico Partnership for Children is also able to provide you with resources and information, training opportunities, technical assistance on childcare issues. Their phone number is (252) 745-7850 or check out their website at www.pamlicopartnership.org. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me at Brittany Jones, Child Care Consultant, (252) 947-1036, Brittany.j.jones@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor, (252) 373-4199, Jennifer.Linhardt@dhhs.nc.gov if you have questions. 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: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: ANGELA HERNANDEZ Operation Type: Family CC Home Case Number: Visit Date: 7/27/2023 Number Present: 3 Completed Date: 7/27/2023 Age: From 1 To 4 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with all applicable child care requirements during the first temporary time period visit. This facility was issued a temporary license on June 2, 2023 – December 2, 2023 caring for no more than 8 children on first shift. During this visit, the operator was home and provided care for three children. Two of the children were the operator’s grandchildren. The operator read stories to the group, used flash cards to discuss the alphabet, and encouraged problem solving by doing puzzles. Program records, the operator and household member records, and children’s records were monitored for compliance. The children washed their hands and were positioned at the child sized table in the kitchen. Lunch was served and consisted of chicken nuggets, French fries, peaches, and milk. The youngest child ate while positioned in a high chair. The operator sat in a chair next to the children as they ate lunch. The oldest children rested on linen covered cots and the one year old was in a pack and play. 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. On or before, August 10, 2023 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 considered 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 may be completed. Mail or email the information to: Angela Hernandez PO Box 2409 Winterville, NC 28590 Angela.Hernandez@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Violation Number Comment Rule 543 Screen time was not prohibited for children under the age of three. The operator did not offer alternative activities for children under the age of three years. Children ages 1 - 2 years of age had access to a show called "Gracie's Corner" for about 30 minutes daily. .1718(c) 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. The operator's prescription and over the counter medications were stored in an unlocked cabinet in the kitchen. .1719(a)(5) 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Three out of three bedrooms that were unlocked contained hazardous products such as health and beauty supplies and aerosol spray cans of Lysol and shaving cream. An unlocked cabinet below five feet in the kitchen contained hand sanitizer and canine worm liquid. .1719 (a)(7) 714 Monthly check for hazards on the outdoor play area was not completed using a form supplied by the Division. An inspection of the outdoor play area was not completed for the month of June 2023. 10A NCAC .1721(e)(5)(A-F) 929 Developmentally appropriate activities for the ages of children in care, were not provided as planned on the written schedule and activity plan. A current activity plan was not available for review. G.S.110-91(12) & .1718(a)(6) 1853 The operator did not conduct a monthly fire drill. A fire drill was not conducted for the month of June 2023. .1719(a)(15) & .1721( e)(2) 1897 Application did not have an a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child enrolled on 7/14/23, identified as having allergies and Albuterol did not have a medical action plan on file. .1721 (a )(4) Technical Assistance on Documented Violations: Medication: Medicines can have toxic effects if too much is taken or if unintentionally ingested by children. Each year, approximately 50,000 children younger than 6 years are brought to emergency departments after unintentionally taking medicine when a caregiver was not watching. Most (75%) of these exposures involve 1- or 2-year-old children. Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container. A locked cabinet in the kitchen has been designated as locked storage for the operators personal medications. At arrival, the cabinet was unlocked however when prompted the operator locked the cabinet. Storage of Hazardous Items- Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. Aerosol spray cans may be potential hazardous if not stored properly. Some of the main dangers surrounding aerosols are linked to the fact that they are in a pressurized container. While the pressure serves its purpose well and substances can be released easily when required, if adverse circumstances occur, aerosol cans can potentially burst, burn or explode. Therefore aerosol spray cans must be stored in locked storage at all times. Prior to licensure the operator made the decision to install locks on the three bedrooms to ensure that hazardous products were inaccessible to the children however the bedrooms were not locked today. We discussed strategies for ensuring that the cabinets and bedrooms are locked prior to the children arriving in the morning. You may want to create a daily morning reminder on your phone to alert you to lock the doors and cabinets. Fire Drills: Fire drills are required to be conducted at least monthly to ensure that all staff and children, are aware of what actions to take in the event of a life-threatening emergency. It is important that you use the smoke detectors as the source of notification. It is most beneficial for staff and children to become familiar with the sound of the smoke detectors that will go off should a real fire occur. Medical Action Plans - Growing up healthy is every child's right and every parent's dream for their children. Significant advances in improving the overall health and development of children with chronic illnesses have been made. Having a medical action plan in place when caring for children with health issues is vital in ensuring their health and safety. These health issues could include allergies, asthma, or other chronic conditions that require specialized health services. The maintenance of these plans and the ability to implement such plans for the treatment of reactions are essential. It is important to remember medical action plan must be attached to the child’s application for enrollment, completed by the child's parent or a health care professional and must be updated on an annual basis. Screen Time: Studies have shown that this increase in screen time is decreasing children's cognitive ability in some areas and is related to weight gain. With these studies, in addition to studies that conversely show that actively engaging children in a variety of activities promotes a child's development in all areas, there was a need to create rules to limit the amount of time a child watches TV, works on the computer and the like. screen time should be limited to 2 ½ hours per week per child. For children under 3 years old, screen time is prohibited. Screen time includes television, videos, video games, and computers. Screen time must be offered only as a free choice activity; used to meet a developmental goal; and again limited to no more than 2 ½ hours a week for children three years and older. Reminder: Your annual health questionnaire was completed on 8/15/22 therefore is required to be updated no later than 8/15/23. The form may be downloaded from the DCDEE website under provide documents. Comments: Child Care Centers with a Temporary License in good standing may be eligible for participation in the NC Child Care Subsidy System during their first 6 months of operation. Only programs with a 3 Star or higher license are eligible to continue to participate in the Subsidy System after the first 6 months of operation. You should begin making plans now to obtain at least a 3 Star License by the expiration of your Temporary License if you intend to participate in the NC Subsidized Child Care System. We discussed the rated license process. You were reminded a compliance history score of seventy five percent or above must be maintained in order to receive a rated license. An Application for Assessment for a Two Component Star Rated License and the request form for the Environment Rating Scales (ERS) was provided to you today. Education: You are currently qualified as a FCCH provider with an AAS in ECE + 30 years of experience. Therefore, you are eligible for 7 points in this component. Program: The operator plans to complete the three month study process however has declined to have the ERS during the temporary time period. Three Month Study: Self study documentation was resent to you via email during today’s visit. To earn at least 2 points in Program Standards, the self study is required for programs choosing to earn higher points towards a star rating. The self study will need to be documented over the course of 3 months (August, September, and October) to earn credit. Updates: NITTO - The Birth-to-Three Quality Initiative and DCDEE are offering a New Infant Toddler Teacher Orientation (NITTO). * Free online format, with 14 credit hours upon completion * Comprehensive training completed in 7 weeks * Practical knowledge that you can apply in a birth-to-three classroom Understand your value as a birth-to-three teacher and ways to care for yourself while caring for our youngest. Find the course at dcdee.moodle.nc.gov. Individuals will need to have an NCID to access the Moodle site. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Angela Hernandez, Lead Child Care Consultant at 252-373-9505 or angela.hernandez@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor at 252-373-4199 or jennifer.linhardt@dhhs.nc.gov if you have questions. 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.

NC GS 110-90 · Violation

Name of Operation: TENDER LOVING JEWELS HOME DAYCARE Facility ID: 69000096 Consultant: ANGELA HERNANDEZ Operation Type: Family CC Home Case Number: Visit Date: 7/27/2023 Number Present: 3 Completed Date: 7/27/2023 Age: From 1 To 4 Total Minutes: 195 Time In: 10:00 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced The purpose of today's visit was to monitor your program for compliance with all applicable child care requirements during the first temporary time period visit. This facility was issued a temporary license on June 2, 2023 – December 2, 2023 caring for no more than 8 children on first shift. During this visit, the operator was home and provided care for three children. Two of the children were the operator’s grandchildren. The operator read stories to the group, used flash cards to discuss the alphabet, and encouraged problem solving by doing puzzles. Program records, the operator and household member records, and children’s records were monitored for compliance. The children washed their hands and were positioned at the child sized table in the kitchen. Lunch was served and consisted of chicken nuggets, French fries, peaches, and milk. The youngest child ate while positioned in a high chair. The operator sat in a chair next to the children as they ate lunch. The oldest children rested on linen covered cots and the one year old was in a pack and play. 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. On or before, August 10, 2023 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 considered 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 may be completed. Mail or email the information to: Angela Hernandez PO Box 2409 Winterville, NC 28590 Angela.Hernandez@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Violation Number Comment Rule 543 Screen time was not prohibited for children under the age of three. The operator did not offer alternative activities for children under the age of three years. Children ages 1 - 2 years of age had access to a show called "Gracie's Corner" for about 30 minutes daily. .1718(c) 705 All medicines, including refrigerated and unrefrigerated, were not kept in locked storage. The operator's prescription and over the counter medications were stored in an unlocked cabinet in the kitchen. .1719(a)(5) 706 Corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, and products under pressure in an aerosol dispenser and any substance that may be hazardous to a child if ingested, inhaled, or handled were not kept in locked storage when children were in care. Three out of three bedrooms that were unlocked contained hazardous products such as health and beauty supplies and aerosol spray cans of Lysol and shaving cream. An unlocked cabinet below five feet in the kitchen contained hand sanitizer and canine worm liquid. .1719 (a)(7) 714 Monthly check for hazards on the outdoor play area was not completed using a form supplied by the Division. An inspection of the outdoor play area was not completed for the month of June 2023. 10A NCAC .1721(e)(5)(A-F) 929 Developmentally appropriate activities for the ages of children in care, were not provided as planned on the written schedule and activity plan. A current activity plan was not available for review. G.S.110-91(12) & .1718(a)(6) 1853 The operator did not conduct a monthly fire drill. A fire drill was not conducted for the month of June 2023. .1719(a)(15) & .1721( e)(2) 1897 Application did not have an a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. A child enrolled on 7/14/23, identified as having allergies and Albuterol did not have a medical action plan on file. .1721 (a )(4) Technical Assistance on Documented Violations: Medication: Medicines can have toxic effects if too much is taken or if unintentionally ingested by children. Each year, approximately 50,000 children younger than 6 years are brought to emergency departments after unintentionally taking medicine when a caregiver was not watching. Most (75%) of these exposures involve 1- or 2-year-old children. Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container. A locked cabinet in the kitchen has been designated as locked storage for the operators personal medications. At arrival, the cabinet was unlocked however when prompted the operator locked the cabinet. Storage of Hazardous Items- Intentional planning of the environment ensures a safe environment has been created which prevents and reduces injuries to young children. Aerosol spray cans may be potential hazardous if not stored properly. Some of the main dangers surrounding aerosols are linked to the fact that they are in a pressurized container. While the pressure serves its purpose well and substances can be released easily when required, if adverse circumstances occur, aerosol cans can potentially burst, burn or explode. Therefore aerosol spray cans must be stored in locked storage at all times. Prior to licensure the operator made the decision to install locks on the three bedrooms to ensure that hazardous products were inaccessible to the children however the bedrooms were not locked today. We discussed strategies for ensuring that the cabinets and bedrooms are locked prior to the children arriving in the morning. You may want to create a daily morning reminder on your phone to alert you to lock the doors and cabinets. Fire Drills: Fire drills are required to be conducted at least monthly to ensure that all staff and children, are aware of what actions to take in the event of a life-threatening emergency. It is important that you use the smoke detectors as the source of notification. It is most beneficial for staff and children to become familiar with the sound of the smoke detectors that will go off should a real fire occur. Medical Action Plans - Growing up healthy is every child's right and every parent's dream for their children. Significant advances in improving the overall health and development of children with chronic illnesses have been made. Having a medical action plan in place when caring for children with health issues is vital in ensuring their health and safety. These health issues could include allergies, asthma, or other chronic conditions that require specialized health services. The maintenance of these plans and the ability to implement such plans for the treatment of reactions are essential. It is important to remember medical action plan must be attached to the child’s application for enrollment, completed by the child's parent or a health care professional and must be updated on an annual basis. Screen Time: Studies have shown that this increase in screen time is decreasing children's cognitive ability in some areas and is related to weight gain. With these studies, in addition to studies that conversely show that actively engaging children in a variety of activities promotes a child's development in all areas, there was a need to create rules to limit the amount of time a child watches TV, works on the computer and the like. screen time should be limited to 2 ½ hours per week per child. For children under 3 years old, screen time is prohibited. Screen time includes television, videos, video games, and computers. Screen time must be offered only as a free choice activity; used to meet a developmental goal; and again limited to no more than 2 ½ hours a week for children three years and older. Reminder: Your annual health questionnaire was completed on 8/15/22 therefore is required to be updated no later than 8/15/23. The form may be downloaded from the DCDEE website under provide documents. Comments: Child Care Centers with a Temporary License in good standing may be eligible for participation in the NC Child Care Subsidy System during their first 6 months of operation. Only programs with a 3 Star or higher license are eligible to continue to participate in the Subsidy System after the first 6 months of operation. You should begin making plans now to obtain at least a 3 Star License by the expiration of your Temporary License if you intend to participate in the NC Subsidized Child Care System. We discussed the rated license process. You were reminded a compliance history score of seventy five percent or above must be maintained in order to receive a rated license. An Application for Assessment for a Two Component Star Rated License and the request form for the Environment Rating Scales (ERS) was provided to you today. Education: You are currently qualified as a FCCH provider with an AAS in ECE + 30 years of experience. Therefore, you are eligible for 7 points in this component. Program: The operator plans to complete the three month study process however has declined to have the ERS during the temporary time period. Three Month Study: Self study documentation was resent to you via email during today’s visit. To earn at least 2 points in Program Standards, the self study is required for programs choosing to earn higher points towards a star rating. The self study will need to be documented over the course of 3 months (August, September, and October) to earn credit. Updates: NITTO - The Birth-to-Three Quality Initiative and DCDEE are offering a New Infant Toddler Teacher Orientation (NITTO). * Free online format, with 14 credit hours upon completion * Comprehensive training completed in 7 weeks * Practical knowledge that you can apply in a birth-to-three classroom Understand your value as a birth-to-three teacher and ways to care for yourself while caring for our youngest. Find the course at dcdee.moodle.nc.gov. Individuals will need to have an NCID to access the Moodle site. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. Contact me, Angela Hernandez, Lead Child Care Consultant at 252-373-9505 or angela.hernandez@dhhs.nc.gov or Jennifer Linhardt, Licensing Supervisor at 252-373-4199 or jennifer.linhardt@dhhs.nc.gov if you have questions. 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