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Home › NC › Burnsville › Little Hands Learning Center
55 Oakcrest Road, Burnsville NC 28714 · License #0055004 · Child Care Center
Not published by the state. Owners can add hours via profile claim.
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Ages served
10A NCAC 09 .0304 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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
Generated from this facility's specific inspection record
Data synced from North Carolina's child care licensing agency on Jul 9, 2026 · Report an error
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0514 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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 .0515 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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 .1703 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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 .3222 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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 110-102 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 4/8/2026 Number Present: 16 Completed Date: 4/8/2026 Age: From 0 To 5 Total Minutes: 405 Time In: 10:30 AM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, Center Administrator, during the visit. An electronic signed copy of the visit summary was left on-site and is available to be electronically emailed to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-six (86%) percentage as of 4/7/26. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 5/7/25. The last fire drill was practiced on 3/30/26. The last shelter-in-place drill was practiced on 3/16/26. The last playground inspection was documented on 3/30/26. The last fire inspection was approved on 8/8/26. The last sanitation inspection was conducted on 2/18/26 with five (5) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint testing was completed on 1/24/26 without hazards. Asbestos Inspection Report was completed on 2/5/26, with mitigation pending. The hazard is located in the staff restroom. Administrator has set up a porta john and portable handwashing station for staff to use. Asbestos removal is scheduled for Saturday April 18, 2026. Upon my arrival, I was greeted by the administrator, Miranda Elkins. She accompanied me throughout today’s walkthrough of the facility. The center is low in the number of children in attendance this week due to schools being on spring break. In space #1 children were walking and crawling around the classroom. The teacher was holding and feeding children. We then went outside to monitor the playgrounds. Most of the children from space #4 were playing in the sandbox. They were digging, playing with dinosaurs and communicating with each other and the teachers. One teacher was at a picnic table with some cars with four children and they were singing/playing the game “whole stole the cookie from the cookie jar?” Ms. Elkins stated that starting next week, the infant, toddler’s and two’s playground is scheduled for major renovations due to grant funding. Back inside, the children in spaces #2 and #3 had already eaten lunch and were laying down for nap. The teacher in space #3 and I discussed the placement of the cots to maximize the space. In space #4, the children were fishing their lunch and preparing for rest time. Lunch today consisted of macaroni-n-cheese, hotdogs with ketchup, green beans, peaches and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment GS 110-102 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In space #3, two cots were not place at least 18” apart. 15A NCAC 18A .2821(e) 828 Air conditioning units were accessible or did not have a guard to keep objects from being thrown into the unit. An air conditioning unit/mini split was accessible to children and did not have a guard on it. .0604 (m) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. 10A NCAC 09 .0514(b) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. One child’s file did not have a signed statement of the operational policies upon enrollment. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. One child’s file did not have a signed statement of the parent participation plan upon enrollment. 10A NCAC 09 .0515(a) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. .0604(j) Technical assistance was provided as follows: Item #614 In space #3, two cots were not place at least 18” apart. *We measured it together and talked about 18” is the minimum, but to shoot for 3 feet for a higher score on the ITERS-3. Item #114 One child’s file did not have a signed statement that the parent was given the summary of the law upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1203 One child’s file did not have a signed statement of the operational policies upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1207 One child’s file did not have a signed statement of the parent participation plan upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #1851 One child’s file did not have a signed statement of the no smoking/tobacco policy upon enrollment. *The forms were sent home to be signed and wasn’t sent back. Item #828 An air conditioning unit/mini split was accessible to children and did not have a guard on it. *We discussed the guards that go on these and Ms. Elkins also discussed moving the fence to block off the unit. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Name and position of individual submitting compliance statement • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by April 22, 2026. Email the compliance letter on signed letterhead or it must be sent from the email address registered with the DCDEE (this serves as your signature) to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • We discussed the application for the Star Rated License process step by step. • Ms. Elkins plans to apply for Program Assessment Pathway #1 at the beginning of July. • We discussed that she will call me if she has any questions about anything in the meantime. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .3222 (c) If employment-related changes occur at a facility that result in noncompliance with or failure to meet the standards in the Section for the star rating issued, the operator shall correct the noncompliance within six months. If the operator does not correct the noncompliance within six months, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.g 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 .2201 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: 0625-296L Visit Date: 7/1/2025 Number Present: 27 Completed Date: 7/1/2025 Age: From 0 To 4 Total Minutes: 135 Time In: 01:00 PM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit is to investigate allegations of child care requirements. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator during the visit. An electronic signed copy of the visit summary was left on-site and available to be emailed to you. The facility operates with a four-star license issued on 7/3/19. The Special Services/Restrictions includes; daytime care, enhanced space and enhanced ratios. The complaint was received by the Division of Child Development and Early Education on 6/26/25 and sent to me on 6/27/25. Limited monitoring was conducted during today’s visit. I interviewed the administrator, and four (4) staff as well as viewed video footage of the incident that was reported. Per staff interview, including the staff that was involved in the incident, and reviewing the video footage where two children were running from a teacher. The staff took one child by the wrist and proceeded to chase the second child, the first child fell while they went under a slide and the child was drug to the other side of the slide. Based on the staff stating that she realizes now that she should have let go of the child's hand and she stated that she would never intentionally hurt a child. She was trying to get the current situation under control and it was not in any way a discipline tactic. Based on all these factors, it has been determined that the two children were brought to the administrator to have a time out for running from their teacher while laughing and being disrespectful. The administrator was not made aware of this incident (which occurred on Friday evening) until Monday morning. The following violations were documented during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A child was drug by the wrist for approximately three (3) feet. G.S. 110-91(10) TECHNICAL ASSISTANCE AND CONSULTATION: Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. *A child was drug by the wrist for approximately three (3) feet. Corrective Action Plan: A follow-up visit will be conducted to verify compliance of Item #902 (which is a 6-demerit item). Based on today’s findings, this child care facility received a substantiated complaint regarding discipline. This may warrant an administrative action as identified by Child Care Rule 10A NCAC 09 .2201. Additional monitoring visits may be required. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by July 15, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 29698 Please call me at 828-4334-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
G.S. 110-91 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: 0625-296L Visit Date: 7/1/2025 Number Present: 27 Completed Date: 7/1/2025 Age: From 0 To 4 Total Minutes: 135 Time In: 01:00 PM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit is to investigate allegations of child care requirements. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator during the visit. An electronic signed copy of the visit summary was left on-site and available to be emailed to you. The facility operates with a four-star license issued on 7/3/19. The Special Services/Restrictions includes; daytime care, enhanced space and enhanced ratios. The complaint was received by the Division of Child Development and Early Education on 6/26/25 and sent to me on 6/27/25. Limited monitoring was conducted during today’s visit. I interviewed the administrator, and four (4) staff as well as viewed video footage of the incident that was reported. Per staff interview, including the staff that was involved in the incident, and reviewing the video footage where two children were running from a teacher. The staff took one child by the wrist and proceeded to chase the second child, the first child fell while they went under a slide and the child was drug to the other side of the slide. Based on the staff stating that she realizes now that she should have let go of the child's hand and she stated that she would never intentionally hurt a child. She was trying to get the current situation under control and it was not in any way a discipline tactic. Based on all these factors, it has been determined that the two children were brought to the administrator to have a time out for running from their teacher while laughing and being disrespectful. The administrator was not made aware of this incident (which occurred on Friday evening) until Monday morning. The following violations were documented during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A child was drug by the wrist for approximately three (3) feet. G.S. 110-91(10) TECHNICAL ASSISTANCE AND CONSULTATION: Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. *A child was drug by the wrist for approximately three (3) feet. Corrective Action Plan: A follow-up visit will be conducted to verify compliance of Item #902 (which is a 6-demerit item). Based on today’s findings, this child care facility received a substantiated complaint regarding discipline. This may warrant an administrative action as identified by Child Care Rule 10A NCAC 09 .2201. Additional monitoring visits may be required. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by July 15, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 29698 Please call me at 828-4334-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
NC GS 110-90 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: 0625-296L Visit Date: 7/1/2025 Number Present: 27 Completed Date: 7/1/2025 Age: From 0 To 4 Total Minutes: 135 Time In: 01:00 PM Time Out: 03:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s visit is to investigate allegations of child care requirements. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator during the visit. An electronic signed copy of the visit summary was left on-site and available to be emailed to you. The facility operates with a four-star license issued on 7/3/19. The Special Services/Restrictions includes; daytime care, enhanced space and enhanced ratios. The complaint was received by the Division of Child Development and Early Education on 6/26/25 and sent to me on 6/27/25. Limited monitoring was conducted during today’s visit. I interviewed the administrator, and four (4) staff as well as viewed video footage of the incident that was reported. Per staff interview, including the staff that was involved in the incident, and reviewing the video footage where two children were running from a teacher. The staff took one child by the wrist and proceeded to chase the second child, the first child fell while they went under a slide and the child was drug to the other side of the slide. Based on the staff stating that she realizes now that she should have let go of the child's hand and she stated that she would never intentionally hurt a child. She was trying to get the current situation under control and it was not in any way a discipline tactic. Based on all these factors, it has been determined that the two children were brought to the administrator to have a time out for running from their teacher while laughing and being disrespectful. The administrator was not made aware of this incident (which occurred on Friday evening) until Monday morning. The following violations were documented during today’s visit: Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A child was drug by the wrist for approximately three (3) feet. G.S. 110-91(10) TECHNICAL ASSISTANCE AND CONSULTATION: Item #902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. *A child was drug by the wrist for approximately three (3) feet. Corrective Action Plan: A follow-up visit will be conducted to verify compliance of Item #902 (which is a 6-demerit item). Based on today’s findings, this child care facility received a substantiated complaint regarding discipline. This may warrant an administrative action as identified by Child Care Rule 10A NCAC 09 .2201. Additional monitoring visits may be required. Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by July 15, 2025. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 29698 Please call me at 828-4334-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0304 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 5/7/2025 Number Present: 28 Completed Date: 5/7/2025 Age: From 0 To 4 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An electronic signed copy of the visit summary was left on-site with to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty (80%) percentage as of 5/2/25. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 6/13/24. The last fire drill was practiced on 4/30/25. The last lock down drill was practiced on 3/31/25. The last playground inspection was documented on 4/24/25. The last fire inspection was approved on 8/12/24. The last sanitation inspection was conducted on 12/2/24 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint and asbestos testing has not yet been completed. Ms. Elkins stated that she has enrolled and started this process. Upon my arrival, I greeted Ms. Elkins and explained the reason for today’s visit. Groups #1, #2 and #3 were all outside playing on the playground. Group #4 was playing in centers. I observed children in space #1 playing outside, floor play and feeding. In space #2 I observed children playing outside. They were riding on trikes/cars, and two children were getting pushed in a side-by-side push car. This was a popular item since it was new, so the teacher was having the children take turns. In space #3, children had arrived inside and were eating lunch at the table. The mats were down and ready for them to transition to rest time. In space #4, I observed center play, taking turns going to the bathroom and washing hands, transitioning outside as well as rest time. Lunch today consisted of turkey and cheese sandwiches, cooked carrots, mandarin oranges and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. .0605(j) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Four (4) children had sunscreen that the permission form was over 12 months old. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1898 Staff did not complete the health and safety training within one year of employment Four (4) children had sunscreen that the permission form was over 12 months old. .1102(a) Technical assistance was provided as follows: *There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. Equipment, more than 18 inches high, must be installed over protective surfacing. *A parent may give a caregiver standing authorization for up to 12 months to apply over-the- counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. Four (4) children had sunscreen that the permission form was over 12 months old. *One staff did not complete the health and safety training within one year of employment. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/21/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PB Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • During today’s visit, I gave you two copies of the NC Foundations for Early Learning and Development. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 5/7/2025 Number Present: 28 Completed Date: 5/7/2025 Age: From 0 To 4 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An electronic signed copy of the visit summary was left on-site with to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty (80%) percentage as of 5/2/25. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 6/13/24. The last fire drill was practiced on 4/30/25. The last lock down drill was practiced on 3/31/25. The last playground inspection was documented on 4/24/25. The last fire inspection was approved on 8/12/24. The last sanitation inspection was conducted on 12/2/24 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint and asbestos testing has not yet been completed. Ms. Elkins stated that she has enrolled and started this process. Upon my arrival, I greeted Ms. Elkins and explained the reason for today’s visit. Groups #1, #2 and #3 were all outside playing on the playground. Group #4 was playing in centers. I observed children in space #1 playing outside, floor play and feeding. In space #2 I observed children playing outside. They were riding on trikes/cars, and two children were getting pushed in a side-by-side push car. This was a popular item since it was new, so the teacher was having the children take turns. In space #3, children had arrived inside and were eating lunch at the table. The mats were down and ready for them to transition to rest time. In space #4, I observed center play, taking turns going to the bathroom and washing hands, transitioning outside as well as rest time. Lunch today consisted of turkey and cheese sandwiches, cooked carrots, mandarin oranges and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. .0605(j) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Four (4) children had sunscreen that the permission form was over 12 months old. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1898 Staff did not complete the health and safety training within one year of employment Four (4) children had sunscreen that the permission form was over 12 months old. .1102(a) Technical assistance was provided as follows: *There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. Equipment, more than 18 inches high, must be installed over protective surfacing. *A parent may give a caregiver standing authorization for up to 12 months to apply over-the- counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. Four (4) children had sunscreen that the permission form was over 12 months old. *One staff did not complete the health and safety training within one year of employment. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/21/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PB Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • During today’s visit, I gave you two copies of the NC Foundations for Early Learning and Development. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1703 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 5/7/2025 Number Present: 28 Completed Date: 5/7/2025 Age: From 0 To 4 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An electronic signed copy of the visit summary was left on-site with to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty (80%) percentage as of 5/2/25. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 6/13/24. The last fire drill was practiced on 4/30/25. The last lock down drill was practiced on 3/31/25. The last playground inspection was documented on 4/24/25. The last fire inspection was approved on 8/12/24. The last sanitation inspection was conducted on 12/2/24 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint and asbestos testing has not yet been completed. Ms. Elkins stated that she has enrolled and started this process. Upon my arrival, I greeted Ms. Elkins and explained the reason for today’s visit. Groups #1, #2 and #3 were all outside playing on the playground. Group #4 was playing in centers. I observed children in space #1 playing outside, floor play and feeding. In space #2 I observed children playing outside. They were riding on trikes/cars, and two children were getting pushed in a side-by-side push car. This was a popular item since it was new, so the teacher was having the children take turns. In space #3, children had arrived inside and were eating lunch at the table. The mats were down and ready for them to transition to rest time. In space #4, I observed center play, taking turns going to the bathroom and washing hands, transitioning outside as well as rest time. Lunch today consisted of turkey and cheese sandwiches, cooked carrots, mandarin oranges and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. .0605(j) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Four (4) children had sunscreen that the permission form was over 12 months old. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1898 Staff did not complete the health and safety training within one year of employment Four (4) children had sunscreen that the permission form was over 12 months old. .1102(a) Technical assistance was provided as follows: *There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. Equipment, more than 18 inches high, must be installed over protective surfacing. *A parent may give a caregiver standing authorization for up to 12 months to apply over-the- counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. Four (4) children had sunscreen that the permission form was over 12 months old. *One staff did not complete the health and safety training within one year of employment. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/21/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PB Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • During today’s visit, I gave you two copies of the NC Foundations for Early Learning and Development. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .2830 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 5/7/2025 Number Present: 28 Completed Date: 5/7/2025 Age: From 0 To 4 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An electronic signed copy of the visit summary was left on-site with to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty (80%) percentage as of 5/2/25. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 6/13/24. The last fire drill was practiced on 4/30/25. The last lock down drill was practiced on 3/31/25. The last playground inspection was documented on 4/24/25. The last fire inspection was approved on 8/12/24. The last sanitation inspection was conducted on 12/2/24 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint and asbestos testing has not yet been completed. Ms. Elkins stated that she has enrolled and started this process. Upon my arrival, I greeted Ms. Elkins and explained the reason for today’s visit. Groups #1, #2 and #3 were all outside playing on the playground. Group #4 was playing in centers. I observed children in space #1 playing outside, floor play and feeding. In space #2 I observed children playing outside. They were riding on trikes/cars, and two children were getting pushed in a side-by-side push car. This was a popular item since it was new, so the teacher was having the children take turns. In space #3, children had arrived inside and were eating lunch at the table. The mats were down and ready for them to transition to rest time. In space #4, I observed center play, taking turns going to the bathroom and washing hands, transitioning outside as well as rest time. Lunch today consisted of turkey and cheese sandwiches, cooked carrots, mandarin oranges and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. .0605(j) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Four (4) children had sunscreen that the permission form was over 12 months old. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1898 Staff did not complete the health and safety training within one year of employment Four (4) children had sunscreen that the permission form was over 12 months old. .1102(a) Technical assistance was provided as follows: *There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. Equipment, more than 18 inches high, must be installed over protective surfacing. *A parent may give a caregiver standing authorization for up to 12 months to apply over-the- counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. Four (4) children had sunscreen that the permission form was over 12 months old. *One staff did not complete the health and safety training within one year of employment. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/21/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PB Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • During today’s visit, I gave you two copies of the NC Foundations for Early Learning and Development. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-90 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 5/7/2025 Number Present: 28 Completed Date: 5/7/2025 Age: From 0 To 4 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An electronic signed copy of the visit summary was left on-site with to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty (80%) percentage as of 5/2/25. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 6/13/24. The last fire drill was practiced on 4/30/25. The last lock down drill was practiced on 3/31/25. The last playground inspection was documented on 4/24/25. The last fire inspection was approved on 8/12/24. The last sanitation inspection was conducted on 12/2/24 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint and asbestos testing has not yet been completed. Ms. Elkins stated that she has enrolled and started this process. Upon my arrival, I greeted Ms. Elkins and explained the reason for today’s visit. Groups #1, #2 and #3 were all outside playing on the playground. Group #4 was playing in centers. I observed children in space #1 playing outside, floor play and feeding. In space #2 I observed children playing outside. They were riding on trikes/cars, and two children were getting pushed in a side-by-side push car. This was a popular item since it was new, so the teacher was having the children take turns. In space #3, children had arrived inside and were eating lunch at the table. The mats were down and ready for them to transition to rest time. In space #4, I observed center play, taking turns going to the bathroom and washing hands, transitioning outside as well as rest time. Lunch today consisted of turkey and cheese sandwiches, cooked carrots, mandarin oranges and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. .0605(j) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Four (4) children had sunscreen that the permission form was over 12 months old. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1898 Staff did not complete the health and safety training within one year of employment Four (4) children had sunscreen that the permission form was over 12 months old. .1102(a) Technical assistance was provided as follows: *There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. Equipment, more than 18 inches high, must be installed over protective surfacing. *A parent may give a caregiver standing authorization for up to 12 months to apply over-the- counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. Four (4) children had sunscreen that the permission form was over 12 months old. *One staff did not complete the health and safety training within one year of employment. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/21/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PB Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • During today’s visit, I gave you two copies of the NC Foundations for Early Learning and Development. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
NC GS 110-90 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 5/7/2025 Number Present: 28 Completed Date: 5/7/2025 Age: From 0 To 4 Total Minutes: 285 Time In: 10:00 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An electronic signed copy of the visit summary was left on-site with to you. Today, the administrator accompanied me throughout the visit. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty (80%) percentage as of 5/2/25. This facility is owned and operated by Yancey County Department of Social Services. Permit type – Four Star License, issued on July 3, 2019. Special Services/Restrictions – Daytime care only, meets enhanced ratio and enhanced space. The last annual compliance visit was conducted on 6/13/24. The last fire drill was practiced on 4/30/25. The last lock down drill was practiced on 3/31/25. The last playground inspection was documented on 4/24/25. The last fire inspection was approved on 8/12/24. The last sanitation inspection was conducted on 12/2/24 with eight (8) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Lead water testing was completed on 12/18/24 without hazards. Lead paint and asbestos testing has not yet been completed. Ms. Elkins stated that she has enrolled and started this process. Upon my arrival, I greeted Ms. Elkins and explained the reason for today’s visit. Groups #1, #2 and #3 were all outside playing on the playground. Group #4 was playing in centers. I observed children in space #1 playing outside, floor play and feeding. In space #2 I observed children playing outside. They were riding on trikes/cars, and two children were getting pushed in a side-by-side push car. This was a popular item since it was new, so the teacher was having the children take turns. In space #3, children had arrived inside and were eating lunch at the table. The mats were down and ready for them to transition to rest time. In space #4, I observed center play, taking turns going to the bathroom and washing hands, transitioning outside as well as rest time. Lunch today consisted of turkey and cheese sandwiches, cooked carrots, mandarin oranges and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 716 All stationary equipment, more than 18 inches high, was not installed over protective surfacing. There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. .0605(j) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Four (4) children had sunscreen that the permission form was over 12 months old. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1898 Staff did not complete the health and safety training within one year of employment Four (4) children had sunscreen that the permission form was over 12 months old. .1102(a) Technical assistance was provided as follows: *There were two Little Tykes type slides and a cube climber that were all above 18 inches high with no surfacing underneath. Equipment, more than 18 inches high, must be installed over protective surfacing. *A parent may give a caregiver standing authorization for up to 12 months to apply over-the- counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. Four (4) children had sunscreen that the permission form was over 12 months old. *One staff did not complete the health and safety training within one year of employment. Achieving Compliance: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Signed statement of compliance I must receive your compliance statement by 5/21/25. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PB Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • During today’s visit, I gave you two copies of the NC Foundations for Early Learning and Development. Lead Paint and Asbestos Testing: In April 2023, North Carolina enacted final rules 10A NCAC 41C .1001-1007 requiring all public schools and child care facilities to: Test for lead in drinking/cooking water (.1005 and .2816), Identify lead-based paint hazards (.1004), Identify asbestos hazards (.1003), Mitigate or restrict access to any identified hazards. Testing is required to be completed by May 31, 2025. New and terminated staff notification requirement: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828-434-0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0604 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 1/30/2025 Number Present: 23 Completed Date: 1/30/2025 Age: From 0 To 4 Total Minutes: 240 Time In: 10:45 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Nicole Gortney, lead teacher in charge. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Nicole Cortney, teacher that opened the door for me. I explained the reason for my visit. I also explained that I had received a message from the administrator this morning stating that she had a family emergency and would not be at work today. She knows it has been over six (6) months since my las visit and she has been expecting me. The children in space #4 was outside so I went out to observe them first and monitor the outdoor environment. Children were climbing, sliding and playing on three (3) plastic see-saws that seemed to be very popular. They came inside, put their coats away, went t the bathroom and washed hands for lunch. In space #1 there were four (4) infants in care. Two (2) were trying to fall asleep in their cribs and the other two was sitting in the floor with the teacher playing and interacting with her. The two (2) in the cribs gave up and the teacher got them out and placed one in a bouncy seat and held the other one. In space #3 children had finished lunch and routines and was all laying down for rest time. The substitute teacher was rubbing the backs of the children who needed help to drift off to sleep. In space #2, the children were napping. There was only two (2) children in this classroom today so it was quiet and peaceful. Lunch today consisted of tacos over tortilla chips with cheese (salsa was optional), corn, pineapple chunks and milk. There were three (3) new teachers at this facility today. These three (3) files were monitored today. There are twenty-eight (28) children enrolled and twenty-three (23) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/13/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Five-star license, effective 10/23/20. Permit Restrictions- Daytime care only, certified developmental day, meets enhanced space, meets reduced ratios. The last fire drill was practiced on 12/31/24. An emergency drill was conducted on 12/31/24. The last fire inspection was 8/12/24. The last sanitation inspection was completed on 12/2/24 with eight (8) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1 there was a power strip that had outlets that were uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, the sleep logs were not maintained in a consistent manner. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The depth of mulch at the climber measured three (3) inches deep instead of six (6) inches deep. .0605(k)(1-4) 1881 Over-the-counter medication was given which exceeded the amount and frequency of the dosage on the manufacturer's label. in space #2 with child 1 year of age, there were three (3) containers of Tylenol to be given as needed. The box states to see a physician for children under 2 years of age. .0803(4)(c ) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: • In space #1 there was a power strip that had outlets that were uncovered. • In space #1, the sleep logs were not maintained in a consistent manner. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. The teacher moved them to the administrators’ office. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. Either the item should be locked, or the office should be locked. • The depth of mulch at the climber did not measure six (6) inches deep. • In space #2, there was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. Also, Tylenol states to see a physician for children under 2 years of age (which these are). Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by February 13, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0304 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 1/30/2025 Number Present: 23 Completed Date: 1/30/2025 Age: From 0 To 4 Total Minutes: 240 Time In: 10:45 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Nicole Gortney, lead teacher in charge. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Nicole Cortney, teacher that opened the door for me. I explained the reason for my visit. I also explained that I had received a message from the administrator this morning stating that she had a family emergency and would not be at work today. She knows it has been over six (6) months since my las visit and she has been expecting me. The children in space #4 was outside so I went out to observe them first and monitor the outdoor environment. Children were climbing, sliding and playing on three (3) plastic see-saws that seemed to be very popular. They came inside, put their coats away, went t the bathroom and washed hands for lunch. In space #1 there were four (4) infants in care. Two (2) were trying to fall asleep in their cribs and the other two was sitting in the floor with the teacher playing and interacting with her. The two (2) in the cribs gave up and the teacher got them out and placed one in a bouncy seat and held the other one. In space #3 children had finished lunch and routines and was all laying down for rest time. The substitute teacher was rubbing the backs of the children who needed help to drift off to sleep. In space #2, the children were napping. There was only two (2) children in this classroom today so it was quiet and peaceful. Lunch today consisted of tacos over tortilla chips with cheese (salsa was optional), corn, pineapple chunks and milk. There were three (3) new teachers at this facility today. These three (3) files were monitored today. There are twenty-eight (28) children enrolled and twenty-three (23) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/13/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Five-star license, effective 10/23/20. Permit Restrictions- Daytime care only, certified developmental day, meets enhanced space, meets reduced ratios. The last fire drill was practiced on 12/31/24. An emergency drill was conducted on 12/31/24. The last fire inspection was 8/12/24. The last sanitation inspection was completed on 12/2/24 with eight (8) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1 there was a power strip that had outlets that were uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, the sleep logs were not maintained in a consistent manner. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The depth of mulch at the climber measured three (3) inches deep instead of six (6) inches deep. .0605(k)(1-4) 1881 Over-the-counter medication was given which exceeded the amount and frequency of the dosage on the manufacturer's label. in space #2 with child 1 year of age, there were three (3) containers of Tylenol to be given as needed. The box states to see a physician for children under 2 years of age. .0803(4)(c ) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: • In space #1 there was a power strip that had outlets that were uncovered. • In space #1, the sleep logs were not maintained in a consistent manner. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. The teacher moved them to the administrators’ office. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. Either the item should be locked, or the office should be locked. • The depth of mulch at the climber did not measure six (6) inches deep. • In space #2, there was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. Also, Tylenol states to see a physician for children under 2 years of age (which these are). Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by February 13, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 1/30/2025 Number Present: 23 Completed Date: 1/30/2025 Age: From 0 To 4 Total Minutes: 240 Time In: 10:45 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Nicole Gortney, lead teacher in charge. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Nicole Cortney, teacher that opened the door for me. I explained the reason for my visit. I also explained that I had received a message from the administrator this morning stating that she had a family emergency and would not be at work today. She knows it has been over six (6) months since my las visit and she has been expecting me. The children in space #4 was outside so I went out to observe them first and monitor the outdoor environment. Children were climbing, sliding and playing on three (3) plastic see-saws that seemed to be very popular. They came inside, put their coats away, went t the bathroom and washed hands for lunch. In space #1 there were four (4) infants in care. Two (2) were trying to fall asleep in their cribs and the other two was sitting in the floor with the teacher playing and interacting with her. The two (2) in the cribs gave up and the teacher got them out and placed one in a bouncy seat and held the other one. In space #3 children had finished lunch and routines and was all laying down for rest time. The substitute teacher was rubbing the backs of the children who needed help to drift off to sleep. In space #2, the children were napping. There was only two (2) children in this classroom today so it was quiet and peaceful. Lunch today consisted of tacos over tortilla chips with cheese (salsa was optional), corn, pineapple chunks and milk. There were three (3) new teachers at this facility today. These three (3) files were monitored today. There are twenty-eight (28) children enrolled and twenty-three (23) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/13/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Five-star license, effective 10/23/20. Permit Restrictions- Daytime care only, certified developmental day, meets enhanced space, meets reduced ratios. The last fire drill was practiced on 12/31/24. An emergency drill was conducted on 12/31/24. The last fire inspection was 8/12/24. The last sanitation inspection was completed on 12/2/24 with eight (8) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1 there was a power strip that had outlets that were uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, the sleep logs were not maintained in a consistent manner. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The depth of mulch at the climber measured three (3) inches deep instead of six (6) inches deep. .0605(k)(1-4) 1881 Over-the-counter medication was given which exceeded the amount and frequency of the dosage on the manufacturer's label. in space #2 with child 1 year of age, there were three (3) containers of Tylenol to be given as needed. The box states to see a physician for children under 2 years of age. .0803(4)(c ) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: • In space #1 there was a power strip that had outlets that were uncovered. • In space #1, the sleep logs were not maintained in a consistent manner. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. The teacher moved them to the administrators’ office. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. Either the item should be locked, or the office should be locked. • The depth of mulch at the climber did not measure six (6) inches deep. • In space #2, there was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. Also, Tylenol states to see a physician for children under 2 years of age (which these are). Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by February 13, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1703 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 1/30/2025 Number Present: 23 Completed Date: 1/30/2025 Age: From 0 To 4 Total Minutes: 240 Time In: 10:45 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Nicole Gortney, lead teacher in charge. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Nicole Cortney, teacher that opened the door for me. I explained the reason for my visit. I also explained that I had received a message from the administrator this morning stating that she had a family emergency and would not be at work today. She knows it has been over six (6) months since my las visit and she has been expecting me. The children in space #4 was outside so I went out to observe them first and monitor the outdoor environment. Children were climbing, sliding and playing on three (3) plastic see-saws that seemed to be very popular. They came inside, put their coats away, went t the bathroom and washed hands for lunch. In space #1 there were four (4) infants in care. Two (2) were trying to fall asleep in their cribs and the other two was sitting in the floor with the teacher playing and interacting with her. The two (2) in the cribs gave up and the teacher got them out and placed one in a bouncy seat and held the other one. In space #3 children had finished lunch and routines and was all laying down for rest time. The substitute teacher was rubbing the backs of the children who needed help to drift off to sleep. In space #2, the children were napping. There was only two (2) children in this classroom today so it was quiet and peaceful. Lunch today consisted of tacos over tortilla chips with cheese (salsa was optional), corn, pineapple chunks and milk. There were three (3) new teachers at this facility today. These three (3) files were monitored today. There are twenty-eight (28) children enrolled and twenty-three (23) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/13/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Five-star license, effective 10/23/20. Permit Restrictions- Daytime care only, certified developmental day, meets enhanced space, meets reduced ratios. The last fire drill was practiced on 12/31/24. An emergency drill was conducted on 12/31/24. The last fire inspection was 8/12/24. The last sanitation inspection was completed on 12/2/24 with eight (8) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1 there was a power strip that had outlets that were uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, the sleep logs were not maintained in a consistent manner. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The depth of mulch at the climber measured three (3) inches deep instead of six (6) inches deep. .0605(k)(1-4) 1881 Over-the-counter medication was given which exceeded the amount and frequency of the dosage on the manufacturer's label. in space #2 with child 1 year of age, there were three (3) containers of Tylenol to be given as needed. The box states to see a physician for children under 2 years of age. .0803(4)(c ) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: • In space #1 there was a power strip that had outlets that were uncovered. • In space #1, the sleep logs were not maintained in a consistent manner. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. The teacher moved them to the administrators’ office. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. Either the item should be locked, or the office should be locked. • The depth of mulch at the climber did not measure six (6) inches deep. • In space #2, there was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. Also, Tylenol states to see a physician for children under 2 years of age (which these are). Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by February 13, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .2830 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 1/30/2025 Number Present: 23 Completed Date: 1/30/2025 Age: From 0 To 4 Total Minutes: 240 Time In: 10:45 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Nicole Gortney, lead teacher in charge. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Nicole Cortney, teacher that opened the door for me. I explained the reason for my visit. I also explained that I had received a message from the administrator this morning stating that she had a family emergency and would not be at work today. She knows it has been over six (6) months since my las visit and she has been expecting me. The children in space #4 was outside so I went out to observe them first and monitor the outdoor environment. Children were climbing, sliding and playing on three (3) plastic see-saws that seemed to be very popular. They came inside, put their coats away, went t the bathroom and washed hands for lunch. In space #1 there were four (4) infants in care. Two (2) were trying to fall asleep in their cribs and the other two was sitting in the floor with the teacher playing and interacting with her. The two (2) in the cribs gave up and the teacher got them out and placed one in a bouncy seat and held the other one. In space #3 children had finished lunch and routines and was all laying down for rest time. The substitute teacher was rubbing the backs of the children who needed help to drift off to sleep. In space #2, the children were napping. There was only two (2) children in this classroom today so it was quiet and peaceful. Lunch today consisted of tacos over tortilla chips with cheese (salsa was optional), corn, pineapple chunks and milk. There were three (3) new teachers at this facility today. These three (3) files were monitored today. There are twenty-eight (28) children enrolled and twenty-three (23) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/13/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Five-star license, effective 10/23/20. Permit Restrictions- Daytime care only, certified developmental day, meets enhanced space, meets reduced ratios. The last fire drill was practiced on 12/31/24. An emergency drill was conducted on 12/31/24. The last fire inspection was 8/12/24. The last sanitation inspection was completed on 12/2/24 with eight (8) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1 there was a power strip that had outlets that were uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, the sleep logs were not maintained in a consistent manner. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The depth of mulch at the climber measured three (3) inches deep instead of six (6) inches deep. .0605(k)(1-4) 1881 Over-the-counter medication was given which exceeded the amount and frequency of the dosage on the manufacturer's label. in space #2 with child 1 year of age, there were three (3) containers of Tylenol to be given as needed. The box states to see a physician for children under 2 years of age. .0803(4)(c ) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: • In space #1 there was a power strip that had outlets that were uncovered. • In space #1, the sleep logs were not maintained in a consistent manner. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. The teacher moved them to the administrators’ office. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. Either the item should be locked, or the office should be locked. • The depth of mulch at the climber did not measure six (6) inches deep. • In space #2, there was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. Also, Tylenol states to see a physician for children under 2 years of age (which these are). Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by February 13, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-90 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 1/30/2025 Number Present: 23 Completed Date: 1/30/2025 Age: From 0 To 4 Total Minutes: 240 Time In: 10:45 AM Time Out: 02:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. The visit summary was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Nicole Gortney, lead teacher in charge. The computerized generated report of today’s visit was completed and left on site. It is also available electronically upon request. Upon my arrival I greeted Nicole Cortney, teacher that opened the door for me. I explained the reason for my visit. I also explained that I had received a message from the administrator this morning stating that she had a family emergency and would not be at work today. She knows it has been over six (6) months since my las visit and she has been expecting me. The children in space #4 was outside so I went out to observe them first and monitor the outdoor environment. Children were climbing, sliding and playing on three (3) plastic see-saws that seemed to be very popular. They came inside, put their coats away, went t the bathroom and washed hands for lunch. In space #1 there were four (4) infants in care. Two (2) were trying to fall asleep in their cribs and the other two was sitting in the floor with the teacher playing and interacting with her. The two (2) in the cribs gave up and the teacher got them out and placed one in a bouncy seat and held the other one. In space #3 children had finished lunch and routines and was all laying down for rest time. The substitute teacher was rubbing the backs of the children who needed help to drift off to sleep. In space #2, the children were napping. There was only two (2) children in this classroom today so it was quiet and peaceful. Lunch today consisted of tacos over tortilla chips with cheese (salsa was optional), corn, pineapple chunks and milk. There were three (3) new teachers at this facility today. These three (3) files were monitored today. There are twenty-eight (28) children enrolled and twenty-three (23) present today. No children’s files were monitored during today’s routine unannounced visit. The last annual compliance visit was 6/13/24. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Five-star license, effective 10/23/20. Permit Restrictions- Daytime care only, certified developmental day, meets enhanced space, meets reduced ratios. The last fire drill was practiced on 12/31/24. An emergency drill was conducted on 12/31/24. The last fire inspection was 8/12/24. The last sanitation inspection was completed on 12/2/24 with eight (8) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In space #1 there was a power strip that had outlets that were uncovered. 10A NCAC 09 .0604(c) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, the sleep logs were not maintained in a consistent manner. .0606(g) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The depth of mulch at the climber measured three (3) inches deep instead of six (6) inches deep. .0605(k)(1-4) 1881 Over-the-counter medication was given which exceeded the amount and frequency of the dosage on the manufacturer's label. in space #2 with child 1 year of age, there were three (3) containers of Tylenol to be given as needed. The box states to see a physician for children under 2 years of age. .0803(4)(c ) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Technical assistance: • In space #1 there was a power strip that had outlets that were uncovered. • In space #1, the sleep logs were not maintained in a consistent manner. • In space #4, there were lotions a deodorant and a container of petroleum jelly, that had a “keep out of reach of children” warning on them, in the teacher’s desk drawers. The teacher moved them to the administrators’ office. • In the open/unlocked office, there was canned air that is under pressure which is considered to be an aerosol and must be locked. Either the item should be locked, or the office should be locked. • The depth of mulch at the climber did not measure six (6) inches deep. • In space #2, there was three (3) children with Tylenol, one (1) teething gel and one (1) bottle of gas drops that all were to be given “as needed” for teething and gas, which is not allowed. Also, Tylenol states to see a physician for children under 2 years of age (which these are). Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by February 13, 2025. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email kaitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Lead and asbestos testing deadlines have been extended till May 2025 with remediation funding available. • New Environment Rating Scales have arrived! Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be used for DCDEE assessments. Go to https://ncrlap.org/ for resources and training opportunities. • Please be reminded that when the ground is frozen, children should not be on the climbers due to the surfacing being compromised. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0803 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi 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 .0302 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0304 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0601 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi 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 .0606 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0801 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0803 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1703 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .2830 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi 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: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi 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: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 6/13/2024 Number Present: 26 Completed Date: 6/13/2024 Age: From 0 To 5 Total Minutes: 360 Time In: 10:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit. A computerized generated report of today’s visit was completed, reviewed with you, and signed by me, Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. An signed copy of the visit summary was left on-site and is available electronically upon request. Today, Ms. Elkins accompanied me during part of my walk-through of the facility and was available to answer and ask questions along the way. The indoor and outdoor areas were monitored today, including (but not limited to) supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. An annual compliance monitoring checklist for child care centers was used to note the requirements monitored and is attached to the computerized generated visit summary for your records. The center’s compliance history was reviewed with the operator. The program’s compliance history was eighty-three (83%) percentage as of 06/13/24. The facility is owned and operated by Yancey County Department of Social Services. Permit type – Four (4) star, issued on 7/3/19. Special Services/Restrictions – Daytime care only, meets enhanced ratios and enhanced space. The last annual compliance visit was conducted on 7/5/23. The last fire drill was practiced on 5/30/24. The last shelter-in-place drill was practiced on 3/21/24. The last playground inspection was documented on 5/30/24. The last fire inspection was approved on 8/28/23. The last sanitation inspection was conducted on 5/30/24 with seven (7) demerits for a superior classification. The Emergency Medical Care plan was posted and current. The approved curriculum for four-year-old children is Creative Curriculum. Upon my arrival, some children were outside playing on the playground, while others were inside playing with a variety of materials. In space #1, the teacher was sitting with a child that was playing on the floor and one that was in an infant swing. In space #2, children were settling down for rest time. Teachers were rubbing backs and holding children while rocking them. In space #3, children were on their cots for rest time. The teacher was patting a child on their back to help settle them. In spaces #4A & 4B, I observed children outside on the playground riding trikes and playing on the climber. I also observed these two groups of children while they were eating lunch. In space 4A the teacher read them a book and gave them seconds of food. In space #4B the children were having conversations with each other while they ate. All teacher interactions were positive and nurturing, Lunch today consisted of turkey and cheese sandwich (on whole wheat bread), carrots, apples and milk. I used the Child Care Center Item Number Listing (DCDEE-0357) as a basic monitoring tool to assess compliance with all applicable child care requirements pertinent to this facility. For specific rule references, refer to Chapter 110 General Statues Child Care Facilities, Chapter nine (9) Child Care Rule (10A NCAC 09) and Section 2800 Sanitation of Child Care Center (15A NCAC 18A) for additional information. Updated copies of these rules can be located on our website at https://ncchildcare.ncdhhs.gov/ The program does not provide transportation. The following violations were documented during today’s visit: Violation Number Comment Rule 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. 15A NCAC 18A .2803(a) 721 All equipment and furnishings were not in good repair. Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. G.S. 110-91(6); .0601(b) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #1, diaper ointment and spray did not have a permission slip. 10A NCAC 09 .0803(1)(a & b) 843 A drug or medicine was administered after its expiration date. In space #2, a diaper cream was expired. 10A NCAC 09 .0803(1)(d) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In space #1, sleep charts have not been maintained for the past three days due to running out of forms. .0606(g) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child did not have a record of immunizations. 10A NCAC 09 .0302(d)(2) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. An epi pen did not have parent or health care professional’s signature on the medical action plan. .0801(b) Technical assistance was provided as follows: Item #1323 10A NCAC 09 .0302 APPLICATION FOR A LICENSE FOR A CHILD CARE CENTER (d) During the pre-licensing visit the applicant shall have the following available for review pursuant to 10A NCAC 09 .0304(g): (2) children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care. Note: One child did not have a record of immunizations. Item #887 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (g) Documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. Note: In space #1, sleep charts have not been maintained for the past three days due to running out of forms. Item #609 15A NCAC 18A .2803 HANDWASHING (a) Child care center employees shall wash their hands as follows when at work in a child care center: (1) upon reporting for work at the child care center: (2) before and after handling or preparing food; (3) before bottle feeding a child; (4) before providing food service; (5) before handling clean utensils; (6) after toileting or handling of body fluids, including but not limited to saliva, nasal secretions, vomitus, feces, urine, blood, secretions from sores, and pustulant discharge; (7) after diaper changing; (8) after handling soiled items that are not clean; (9) after being outdoors; (10) after handling animals or animal cages; and (11) after removing disposable gloves. Note: Teacher who came in to give a break in Space #1, wiped a child’s noes and wiped up spit-up, but did not wash her hands. Items #842 and 843 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (1) No prescription or over-the-counter medication and no topical, non-medical ointment, repellent, lotion, cream, fluoridated toothpaste, or powder shall be administered to any child: (a) without written authorization from the child's parent; (b) without written instructions from the child's parent, physician or other health professional; (d) after its expiration date; Note: In space #1, diaper ointment and spray did not have a permission slip. In space #2, a diaper cream was expired. Item #1835 10A NCAC 09 .0801 APPLICATION FOR ENROLLMENT (b) For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan shall be attached to the application. The medical action plan shall be completed by the child's parent or a health care professional and may include the following: (1) a list of the child's diagnosis or diagnoses including dietary, environmental, and activity considerations that are applicable; (2) contact information for the child's health care professional(s); (3) medications to be administered on a scheduled basis; and (4) medications to be administered on an emergency basis with symptoms, and instructions. Note: An epi pen did not have parent or health care professional’s signature on the medical action plan. Item #721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, that include instructions from the manufacturer, those manufacturer's instructions shall be kept on file at the center, unless they are available electronically for review. Note: Blinds in spaces 4A & 4B are broken and need to be replaced. Administrator has some ready to be installed but more will need to be ordered and installed. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by June 27, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@ dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive it by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt is within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Consultation is provided as follows: • You are in cohort #2, which means your prep year will begin July 1, 2024 to June 30, 2025 and your assessment year is July 1, 2025 to June 30, 2026. • We discussed the Clean Water for Carolina Kids lead water test. Ms. Elkins stated that she is in the process of getting this sent in. • We discussed the ratio sheets today and how the center goal is below the enhanced standards. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify a DCDEE representative may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 (c) If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any monitoring visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathi If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0604 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0304 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0508 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0601 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0604 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0701 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0803 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1101 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1703 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .2830 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-90 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
G.S. 110-91 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
GS 110-91 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: Visit Date: 3/4/2024 Number Present: 25 Completed Date: 3/4/2024 Age: From 0 To 5 Total Minutes: 315 Time In: 10:45 AM Time Out: 04:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this routine unannounced visit was to conduct limited compliance monitoring and offer consultation to the program. Today, Miranda Elkins, administrator, accompanied me today during the visit walk through. The indoor and outdoor areas were monitored today, including (but not limited to), supervision, staff/child ratios, permit restrictions, discipline, nutrition and routine caregiving activities. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by, Miranda Elkins, administrator. The computerized generated report of today’s visit was completed off site and electronically emailed to Ms. Elkins. Upon my arrival I greeted the administrator and explained the reason for my visit. Some children were outside on the playground and the younger children were still inside. I proceeded to the playground first to monitor the outdoor environment. Children were engaged in playing in the sandbox, climbing, sliding as well as pretend play. One teacher had a small group of children engaged in an activity with plastic fish and fishing poles. She stated that they had read the Dr. Seuss book “One Fish, Two Fish, Red Fish, Blue Fish. Inside children were preparing for lunch and then transitioning to rest time. Lunch today consisted of turkey and cheese sandwich, carrots, watermelon and milk. The administrator was the only new staff at this facility since the annual compliance visit. I monitored her file during this visit. This facility is owned and operated by Yancey County Department of Social Services. The following items were monitored today: Supervision Staff Child Ratios CPR First Aid Special Training Criminal Record Checks Completed Emergency Medical Care Plan Administration of Medication Storage of Hazardous Substances Storage of Medication Adequate/Approved Space General Safety Discipline Program Records License Posted- Four (4) star license issued July 3, 2019. Permit Restrictions- Daytime care only, meets enhanced ratios and space. The last fire drill was practiced on 2/28/24. An emergency drill was conducted on 12/21/23. The last fire inspection was 8/28/23. The last sanitation inspection was completed on 7/20/23 with eleven (11) demerits for a superior rating. The Emergency Medical Care Plan is posted and current. The incident log is in use and maintained. The following violations were documented during today’s visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. All activity plans were not current. GS 110-91(12); .0508(a) 429 The activity plan was not designed to stimulate emotional and social, health and physical, approaches to play and learning, language development and communication, and cognitive development for each group of children in care. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. .0508(b)(1-5) 721 All equipment and furnishings were not in good repair. Space #2 had a broken electrical outlet cover. G.S. 110-91(6); .0601(b) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in Space #2 did not have protective covers. 10A NCAC 09 .0604(c) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. Plastic bags were stored below five (5) feet in spaces #1 and #2. .0604(q) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. New staff (ME) hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid training within 90 days of employment. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. New staff (ME), hired on 9/18/23, did not complete CPR training within 90 days of employment. .1102(d) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. A child in space #1 had gas drops but did not have a permission form filled out. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. New staff (ME), hired on 9/18/23, did not complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. .1102(g) 9995 A violation was found for which there is no item number. 2820(c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. 15 NCAC 18A .2820(c) Technical assistance: Item #1045 10A NCAC 09 .1101 NEW STAFF ORIENTATION REQUIREMENTS (a) Each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. Note: New staff (ME), hired on 9/18/23, did not have documentation of the second half of the orientation which accounts for at least ten (10) hours. Item # 1033 10A NCAC 09 .0701 HEALTH STANDARDS FOR CHILD CARE PROVIDERS, SUBSTITUTE PROVIDERS, VOLUNTEERS, AND UNCOMPENSATED PROVIDERS (a) Health and emergency information shall be obtained for staff members as specified in the chart below: Tuberculin (TB) Test or Screening The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. Note: New staff (ME), hired on 9/18/23, completed the TB test/screening on 9/20/23, which was two (2) days after her date of hire. Items #1048, 1049 and 1897 10A NCAC 09 .1102 HEALTH AND SAFETY TRAINING REQUIREMENTS (c) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in First Aid appropriate to the ages of children in care. The training shall be completed by June 30, 2018, or for new staff hired on or after September 1, 2017, training must be completed within 90 days of employment. Distance learning shall not be permitted for First Aid training. At all times when children are in care at least one staff member present must have successfully completed First Aid training, as evidenced by a certificate or card from an approved training organization. First Aid training shall be renewed on or before expiration of the certification. "Successfully completed" is defined as demonstrating competency, as evaluated by the instructor. Verification of each required staff member's member's file in the center. The Division shall post a list of approved training organizations on its website. (d) All staff who provide direct care or accompany children when they are off premises shall successfully complete certification in a cardiopulmonary resuscitation (CPR) course appropriate to the ages of children in care. At all times when children are in care one staff member present must have successfully completed CPR training. The training shall be completed by June 30, 2018 or for new staff hired on or after September 1, 2017 training must be completed within 90 days of employment. Distance learning shall not be permitted for CPR training. CPR training shall be renewed on or before the expiration of the certification. Verification of each staff member's completion of this course from an approved training organization shall be maintained in the staff member's file in the center. The Division shall post a list of approved training organizations on its website. (g) The child care administrator and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. This training shall count toward requirements set forth in Rule .1103 of this Section. Recognizing and Responding to Suspicions of Child Maltreatment training is available at https://www.preventchildabusenc.org/services/trainings-and-professional-development/rrcourse. A certificate of each staff member's completion of this course shall be maintained in the staff member's file in the center. Note: New staff (ME), hired on 9/18/23, did not complete Pediatric First Aid, CPR and Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Item #.9995 15A NCAC 18A .2820 STORAGE (c) Non-aerosol sanitizing solutions, approved disinfectants, detergent solutions, hand antiseptics, and hand lotions shall be kept inaccessible to children when not in use, but are not required to be in locked storage. These solutions shall be labeled as sanitizing, disinfecting, or detergent solutions. Hand soap other than that which is in bulk containers is not required to be kept inaccessible to children or in locked storage. Bulk soaps shall be kept inaccessible to children. Note: A mailbox on the playground that was located lower than five (5) feet had hand sanitizer in it. Item #812 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (c) When not in use, electrical outlets and power strips located in space used by children shall have safety outlets or be covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. Note: An outlet in Space #2 did not have protective covers. Item # 721 10A NCAC 09 .0601 SAFE ENVIRONMENT (b) All equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. For equipment and furnishings purchased after September 1, 2017, the manufacturer's instructions shall be kept on file or electronically accessible, if available. Note: Space #2 had a broken electrical outlet plate cover. Item # 1882 10A NCAC 09 .0803 ADMINISTERING MEDICATION IN CHILD CARE CENTERS The following provisions apply to the administration of medication in child care centers: (7) A parent may give a caregiver standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. The authorization shall be in writing and shall contain: (a) the child's name; (b) the names of the authorized ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (c) the criteria for the administration of the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders; (d) the manner in which the ointments, repellents, lotions, creams, fluoridated toothpaste, and powders shall be applied; (e) the signature of the parent; (f) the date the authorization was signed by the parent; and (g) the length of time the authorization is valid, if less than 12 months. Note: A child in space #1 had gas drops but did not have a permission form filled out. Items #428 and 429 10A NCAC 09 .0508 ACTIVITY SCHEDULES AND PLANS (a) All centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. (b) For each group of children in care, the activity plan shall include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: (1) emotional and social development; (2) health and physical development; (3) approaches to play and learning; (4) language development and communication; and (5) cognitive development. Note: All activity plans were not current. Activity plans did not include goals from North Carolina Foundations for Early Learning and Development to link to domains. Item 858 10A NCAC 09 .0604 SAFETY REQUIREMENTS FOR CHILD CARE CENTERS (q) Plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. However, styrofoam plates and larger pieces of foam rubber may be used for supervised art activities and styrofoam plates may be used for food service. Jump ropes and rubber bands shall not be accessible to children under five years of age without adult supervision. Balloons shall be prohibited for children of all ages. Note: Plastic bags were stored below five (5) feet in spaces #1 and #2. Corrective Action Plan: All violations are required to be corrected immediately. However, if at any time you are unable to correct all violations within the specified time frame, please send a written statement regarding those violations that were corrected and include a specific plan for correction of the remaining violations. Please be aware that any written information submitted by you regarding correction of violations documented during today’s visit would be considered as legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined that information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license may be issued. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: •Facility name •Facility ID# •Date of visit •Violation item number •Statement of compliance I must receive your compliance statement by March 18, 2024. Email the compliance letter on signed letterhead or on the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828.434.0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Falsification of any information may result in a revocation of your license. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) ©. Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. If you have any questions or concerns regarding the Stabilization Grant, please contact Kaitlyn Marshall, Child Care Consultant, at 828.713.8192 or email aitlyn.marshall@dhhs.nc.gov. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Child Care Rule 10A NCAC 09 .0304(a) states “Each operator shall schedule and obtain a fire inspection within 12 months of the center’s previous fire inspection. The operator shall notify the local fire inspector when it is time for the center’s annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division.” As child care providers, you are a vital part in the prevention and intervention of child maltreatment! You may see potential indicators of maltreatment in the children under your care. Some children may even be more likely to disclose maltreatment to a child care provider than to a family member. It is required that all providers are aware of maltreatment indicators and to report any suspicions of maltreatment. Follow child care rules related to child maltreatment training: 10A NCAC 09 .1102(g) and 10A NCAC 09 .1703(a)(5) states the child care administrator, operator, and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. Child Care Rule 10A NCAC 09 .2830 MAINTAINING THE STAR RATING (a)A representative of the Division may make announced or unannounced visits to facilities to assess on-going compliance with the requirements of a star rating after it has been issued. It is the center operator’s responsibility to make sure each staff person has registered for a WORKS account, submit an official transcript (if applicable) and apply for a position for evaluation. This should be completed immediately upon hiring or at the latest, by the end of the six-week orientation process. Failure to maintain the same education point level may result in a violation of the above rule reference and may result in a reduction of stars. Child Care Rule 10A NCAC 09 .2830 © If employment-related changes occur at a facility that result in the operator not complying with the standards in the Section for the star rating issued, the operator shall correct the noncompliance within 120 days. If the operator does not correct the noncompliance within 120 days, the operator shall notify the Division. Consultation: • Today we discussed the rubber mulch and how it needs to be raked and fluffed like other mulch. Ms. Elkins is going to do more research on the rubber mulch vs. wood mulch. • We discussed the NC- FELD training for the lead teachers so they will know how to link their plans to the goals. • We discussed the timeline for first aid and CPR. Ms. Elkins scheduled the training with the local CCR&R during my visit. • We discussed the gate that leads from the building to the playground needs to be extended so that children can’t go under the gate. The gate that leads to the ball field needs an at least 1-inch intention. • We discussed the tall shelves in the preschool room could cause supervision issues. • We discussed the space needed between cots. • We discussed the need to be specific on the diaper cream forms as to how much to apply (dime size amount). • We discussed that space #4 can put locks on the cabinets if she wishes to have things inside such as lotions. • We discussed the potential for expanding the playground in the future and adding a swing and in-ground slide. We discussed what all would need to occur for that to take place. • We discussed some sharp edges on the fence next to the ball field. I suggested adding some type of covering over that. • We discussed that the Summary of the Law has been updated and she will print and post the new one. It is your responsibility to understand the health and safety requirements in child care rule .1102. If the program is out of compliance in accordance with health and safety requirements, Child Care Development Block Grant (CCDBG), it may affect subsidy funding. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. Please continue to visit DCDEE’s website to get the latest COVID-19 information for child care at https://ncchildcare.ncdhhs.gov/. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .1803 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: 0124-225L Visit Date: 1/30/2024 Number Present: 26 Completed Date: 1/30/2024 Age: From 0 To 5 Total Minutes: 120 Time In: 01:00 PM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced complaint visit was to investigate a self-report that was received by the Division of Child Development and Early Education (DCDEE) on 1/22/24 and sent to Georgia Lee Marshall, Child Care Consultant, on 1/22/24. There was a concern regarding discipline. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. Upon my arrival I signed in and met with Miranda Elkins, administrator, and explained the purpose of today’s visit. Ms. Elkins and I discussed the allegation and what steps have been taken internally. I viewed the video recording of the incident and read the written warning for inappropriate behavior toward a child. The teacher self-reported the incident to the administrator and was commended by the administrator for her honesty. Ms. Elkins accompanied me in a walk through of the facility to meet each teacher and see each classroom. In space #3, where the incident occurred, I spoke to the teacher about the situation and what occurred. As a result, the discipline policy was reviewed again with this teacher as well as a training on Staff/Child Interactions and Behavior Management, was assigned. This complaint allegation was substantiated. Little Hands Learning Center operates with a four (4) star license issued July 03, 2019. Restrictions include; Daytime care only, meeting enhanced ratios and enhanced space. The following violation was documented during today’s visit: Violation Number Comment Rule 872 Appropriate discipline practices were not followed. On January 19, 2024, a two-year-old child in space #3 was pulled down to sit and smacked on the hand by a staff member. .1803 Technical Assistance given: Item #872 10A NCAC 09 .1803 PROHIBITED DISCIPLINE IN CHILD CARE CENTERS (a) No child shall be subjected to any form of corporal punishment by the owner, operator, director, or staff of any child care center. For purposes of this Rule, "staff" shall mean any regular or substitute caregiver, any volunteer, and any auxiliary personnel, including cooks, secretaries, janitors, maids, or vehicle drivers. The following shall apply at all child care centers: (1) no child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) no child shall be placed in a locked room, closet, or box or be left alone in a room separated from staff; (3) no discipline shall be delegated to another child; (4) no food shall be withheld as punishment or given as a means of reward; (5) no child shall be disciplined for toileting accidents; (6) no child shall be disciplined for not sleeping during rest period; (7) no child shall be disciplined by assigning chores that require contact with or use of hazardous materials, such as cleaning bathrooms, floors, or emptying diaper pails; (8) physical activity, such as running laps and doing push-ups, shall not be withheld as punishment or required as punishment; (9) no child shall be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) no child shall be restrained as a form of discipline unless the child’s safety or the safety of others is at risk. For purposes of this Rule, “restraining” shall mean that a caregiver physically holds a child in a manner that restricts the child’s movement, for a minimum amount of time necessary to ensure a safe environment. Notwithstanding any other provision of this Rule, no child shall be restrained through the use of heavy objects, including a caregiver’s body, or any device such as straps, blankets, car seats, or cribs. Note: A child was pulled down to sit and smacked on the hand. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 13, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
NC GS 110-90 · Violation
Name of Operation: LITTLE HANDS LEARNING CENTER Facility ID: 0055004 Consultant: GEORGIA MARSHALL Operation Type: Center Case Number: 0124-225L Visit Date: 1/30/2024 Number Present: 26 Completed Date: 1/30/2024 Age: From 0 To 5 Total Minutes: 120 Time In: 01:00 PM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced complaint visit was to investigate a self-report that was received by the Division of Child Development and Early Education (DCDEE) on 1/22/24 and sent to Georgia Lee Marshall, Child Care Consultant, on 1/22/24. There was a concern regarding discipline. A computerized generated report of today’s visit was completed, reviewed with you, and signed by Georgia Lee Marshall, Child Care Consultant and also signed by Miranda Elkins, administrator, during the visit. Upon my arrival I signed in and met with Miranda Elkins, administrator, and explained the purpose of today’s visit. Ms. Elkins and I discussed the allegation and what steps have been taken internally. I viewed the video recording of the incident and read the written warning for inappropriate behavior toward a child. The teacher self-reported the incident to the administrator and was commended by the administrator for her honesty. Ms. Elkins accompanied me in a walk through of the facility to meet each teacher and see each classroom. In space #3, where the incident occurred, I spoke to the teacher about the situation and what occurred. As a result, the discipline policy was reviewed again with this teacher as well as a training on Staff/Child Interactions and Behavior Management, was assigned. This complaint allegation was substantiated. Little Hands Learning Center operates with a four (4) star license issued July 03, 2019. Restrictions include; Daytime care only, meeting enhanced ratios and enhanced space. The following violation was documented during today’s visit: Violation Number Comment Rule 872 Appropriate discipline practices were not followed. On January 19, 2024, a two-year-old child in space #3 was pulled down to sit and smacked on the hand by a staff member. .1803 Technical Assistance given: Item #872 10A NCAC 09 .1803 PROHIBITED DISCIPLINE IN CHILD CARE CENTERS (a) No child shall be subjected to any form of corporal punishment by the owner, operator, director, or staff of any child care center. For purposes of this Rule, "staff" shall mean any regular or substitute caregiver, any volunteer, and any auxiliary personnel, including cooks, secretaries, janitors, maids, or vehicle drivers. The following shall apply at all child care centers: (1) no child shall be handled roughly in any way, including shaking, pushing, shoving, pinching, slapping, biting, kicking, or spanking; (2) no child shall be placed in a locked room, closet, or box or be left alone in a room separated from staff; (3) no discipline shall be delegated to another child; (4) no food shall be withheld as punishment or given as a means of reward; (5) no child shall be disciplined for toileting accidents; (6) no child shall be disciplined for not sleeping during rest period; (7) no child shall be disciplined by assigning chores that require contact with or use of hazardous materials, such as cleaning bathrooms, floors, or emptying diaper pails; (8) physical activity, such as running laps and doing push-ups, shall not be withheld as punishment or required as punishment; (9) no child shall be yelled at, shamed, humiliated, frightened, threatened, or bullied; and (10) no child shall be restrained as a form of discipline unless the child’s safety or the safety of others is at risk. For purposes of this Rule, “restraining” shall mean that a caregiver physically holds a child in a manner that restricts the child’s movement, for a minimum amount of time necessary to ensure a safe environment. Notwithstanding any other provision of this Rule, no child shall be restrained through the use of heavy objects, including a caregiver’s body, or any device such as straps, blankets, car seats, or cribs. Note: A child was pulled down to sit and smacked on the hand. Corrective Action Plan: Child Care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the following: • Facility name • Facility ID# • Date of visit • Violation item number • Statement of compliance I must receive your compliance statement by February 13, 2024. Email the compliance letter on signed letterhead or in the email identifying your facility name, ID#, name and position to: lee.marshall@dhhs.nc.gov or you can mail to: Department of Health and Human Services Division of Child Development and Early Education Attn: Georgia Lee Marshall PO Box 253 Zionville, NC 28698 Please call me at 828-434-0236, or email lee.marshall@dhhs.nc.gov, if you need assistance. Please note: if mailing the letter of compliance, I must receive by the due date listed above. You will need to mail a compliance statement three to five days prior to the due date to ensure receipt within the designated timeline. Failure to correct the violations and send the written statement by the due date listed above may result in an unannounced follow-up visit being conducted. Based on Child Care Rule 10A NCAC 09 Section .2200, the Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. If you elect to change and/or alter any previously approved spaces used by children as indicated on the approved indoor and outdoor floor plan, you will need to contact me within thirty (30) days prior to the change. Failure to notify me, may result in a violation of child care requirements. Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/.It is your responsibility to understand the rules and laws that are applicable your program. All rules/laws cannot be verbally reviewed during any licensing visit. Please ask questions if you are having difficulty and would like additional technical assistance. I welcome your questions and want to be a resource for you. We appreciate all you are doing to serve the children and families of NC. If you have questions, please contact me at lee.marshall@dhhs.nc.gov or 828.434.0236, or Bonnie Mathis, Licensing Supervisor, at bonnie.mathis@dhhs.nc.gov. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
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