10A NCAC 09 .0604 · Violation

Name of Operation: LITTLE TOTS Facility ID: 60003718 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 10 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 125 Time In: 09:40 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Your program currently operates a Three Star Rated License with an effective date of August 1, 2019. The program’s 18-month compliance history before today’s visit was 92%. The NC Secretary of State website was reviewed on February 11, 2025, and Little Tots Preschool LLC was listed as current- active. The license was posted, and the restrictions were in compliance. The following items were monitored during today’s visit, supervision, staff/child ratio, First Aid/CPR, special training, ITS/SIDS training, CBC letters, emergency medical care plan, administering of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate/approved space, program records, license posted, permit restrictions. Upon my arrival, I was greeted by Patricia Ordonez-Prado, Operator/Lead Teacher. I introduced myself and stated the reason for the visit. Ms. Ordonez-Prado assisted me with the visit. A walk-through of the approved areas was conducted. I observed two groups of children. The infants and toddlers were playing on the floor and engaged in activities with a teacher. The age children were playing in learning centers. I observed the preschool children transition to lunch and a teacher directed art activity explained to the children in both Spanish and English. I observed infants and toddlers eating lunch. I observed supervision and staff/child ratios to be in compliance. The caregivers were nurturing and meeting the developmental needs for each of the children. In Space 2, I observed a basket containing diaper creams, hand sanitizer and bleach water stored on top of a bookshelf which measured lower than five (5) feet. There have been no changes in the staff. Files were reviewed to confirm staff were current with current CBC Qualifying Letters, ITS-SIDS training, First Aid and CPR certification. All staff files were in compliance. Program records were reviewed. The last fire inspection was conducted on December 13, 2024. The sanitation inspection was conducted on October 22, 2024, with four demerits and a Superior rating. The last fire drill was conducted on February 4, 2025, and the drill log was found in compliance. A shelter in place drill was conducted on January 7, 2025. The playground inspections and incident log were reviewed and found in compliance. The following violation was observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 2, a basket containing Aquaphor, hand sanitizer and bleach water was observed stored on top of a bookshelf less than five (5) feet high. .2820(b) Compliance Statement: Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before February 25, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Email the information to: Lisa Eddins-Smith, Child Care Consultant Lisa.Eddins-Smith@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. 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 or an administrative action may be recommended. 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. Technical Assistance: Storage of Hazardous Materials: We discussed 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT as follows: 7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked area when not in use. Locked areas shall include those that are unlocked with a combination, electronic, or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed in this Paragraph that is labeled "keep out of reach of children" without any other warnings shall be kept inaccessible to children when not in use but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor; Toxic Plants: We discussed checking all plants in the facility to make sure there is no toxic plant accessible to children. A Toxic Plants List can be accessed at https://eh.mecknc.gov/lodging. Tobacco Statement: We discussed that signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. The operator shall notify the parent of each child enrolled in the center, in writing, of the smoking and tobacco restriction (10A NCAC 09 .0604 (i) and (j) SAFETY REQUIREMENTS FOR CHILD CARE CENTERS ). Reminders: Continue to review emails from the Division of Child Development and Early Education (DCDEE) and from your assigned child care consultant. DCDEE Website: I encourage you to utilize the DCDEE website, https://ncchildcare.ncdhhs.gov/, on a regular basis. All the laws, rules and regulations, item number listing, sanitation requirements, and provider documents can be found on the website. Additionally, there are many resources such as DCDEE Moodle where you can complete health and safety trainings free of charge. The What’s New tab provides current information that is sent out through blast emails. Get Ready for the 3’s / QRIS: On February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—is being used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website, https://www.ncrlap.org/ for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. Understanding the New QRIS If you missed the information sessions on the QRIS Modernization, you can now watch recordings of the webinars for parents and providers, including one with live Spanish translation. Visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization for videos, new resources and updates. ABCMS (Criminal Background System): North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. I left three Verification of Required Information Forms for you to complete for each staff member. I will review these at your annual compliance visit. Thank you for your time today. If you have questions or concerns regarding today’s visit, please contact me at Lisa.Eddins-Smith@dhhs.nc.gov or 980-748-6270. 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 .1719 · Violation

Name of Operation: LITTLE TOTS Facility ID: 60003718 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 10 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 125 Time In: 09:40 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Your program currently operates a Three Star Rated License with an effective date of August 1, 2019. The program’s 18-month compliance history before today’s visit was 92%. The NC Secretary of State website was reviewed on February 11, 2025, and Little Tots Preschool LLC was listed as current- active. The license was posted, and the restrictions were in compliance. The following items were monitored during today’s visit, supervision, staff/child ratio, First Aid/CPR, special training, ITS/SIDS training, CBC letters, emergency medical care plan, administering of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate/approved space, program records, license posted, permit restrictions. Upon my arrival, I was greeted by Patricia Ordonez-Prado, Operator/Lead Teacher. I introduced myself and stated the reason for the visit. Ms. Ordonez-Prado assisted me with the visit. A walk-through of the approved areas was conducted. I observed two groups of children. The infants and toddlers were playing on the floor and engaged in activities with a teacher. The age children were playing in learning centers. I observed the preschool children transition to lunch and a teacher directed art activity explained to the children in both Spanish and English. I observed infants and toddlers eating lunch. I observed supervision and staff/child ratios to be in compliance. The caregivers were nurturing and meeting the developmental needs for each of the children. In Space 2, I observed a basket containing diaper creams, hand sanitizer and bleach water stored on top of a bookshelf which measured lower than five (5) feet. There have been no changes in the staff. Files were reviewed to confirm staff were current with current CBC Qualifying Letters, ITS-SIDS training, First Aid and CPR certification. All staff files were in compliance. Program records were reviewed. The last fire inspection was conducted on December 13, 2024. The sanitation inspection was conducted on October 22, 2024, with four demerits and a Superior rating. The last fire drill was conducted on February 4, 2025, and the drill log was found in compliance. A shelter in place drill was conducted on January 7, 2025. The playground inspections and incident log were reviewed and found in compliance. The following violation was observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 2, a basket containing Aquaphor, hand sanitizer and bleach water was observed stored on top of a bookshelf less than five (5) feet high. .2820(b) Compliance Statement: Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before February 25, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Email the information to: Lisa Eddins-Smith, Child Care Consultant Lisa.Eddins-Smith@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. 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 or an administrative action may be recommended. 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. Technical Assistance: Storage of Hazardous Materials: We discussed 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT as follows: 7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked area when not in use. Locked areas shall include those that are unlocked with a combination, electronic, or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed in this Paragraph that is labeled "keep out of reach of children" without any other warnings shall be kept inaccessible to children when not in use but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor; Toxic Plants: We discussed checking all plants in the facility to make sure there is no toxic plant accessible to children. A Toxic Plants List can be accessed at https://eh.mecknc.gov/lodging. Tobacco Statement: We discussed that signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. The operator shall notify the parent of each child enrolled in the center, in writing, of the smoking and tobacco restriction (10A NCAC 09 .0604 (i) and (j) SAFETY REQUIREMENTS FOR CHILD CARE CENTERS ). Reminders: Continue to review emails from the Division of Child Development and Early Education (DCDEE) and from your assigned child care consultant. DCDEE Website: I encourage you to utilize the DCDEE website, https://ncchildcare.ncdhhs.gov/, on a regular basis. All the laws, rules and regulations, item number listing, sanitation requirements, and provider documents can be found on the website. Additionally, there are many resources such as DCDEE Moodle where you can complete health and safety trainings free of charge. The What’s New tab provides current information that is sent out through blast emails. Get Ready for the 3’s / QRIS: On February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—is being used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website, https://www.ncrlap.org/ for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. Understanding the New QRIS If you missed the information sessions on the QRIS Modernization, you can now watch recordings of the webinars for parents and providers, including one with live Spanish translation. Visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization for videos, new resources and updates. ABCMS (Criminal Background System): North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. I left three Verification of Required Information Forms for you to complete for each staff member. I will review these at your annual compliance visit. Thank you for your time today. If you have questions or concerns regarding today’s visit, please contact me at Lisa.Eddins-Smith@dhhs.nc.gov or 980-748-6270. 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 TOTS Facility ID: 60003718 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 10 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 125 Time In: 09:40 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Your program currently operates a Three Star Rated License with an effective date of August 1, 2019. The program’s 18-month compliance history before today’s visit was 92%. The NC Secretary of State website was reviewed on February 11, 2025, and Little Tots Preschool LLC was listed as current- active. The license was posted, and the restrictions were in compliance. The following items were monitored during today’s visit, supervision, staff/child ratio, First Aid/CPR, special training, ITS/SIDS training, CBC letters, emergency medical care plan, administering of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate/approved space, program records, license posted, permit restrictions. Upon my arrival, I was greeted by Patricia Ordonez-Prado, Operator/Lead Teacher. I introduced myself and stated the reason for the visit. Ms. Ordonez-Prado assisted me with the visit. A walk-through of the approved areas was conducted. I observed two groups of children. The infants and toddlers were playing on the floor and engaged in activities with a teacher. The age children were playing in learning centers. I observed the preschool children transition to lunch and a teacher directed art activity explained to the children in both Spanish and English. I observed infants and toddlers eating lunch. I observed supervision and staff/child ratios to be in compliance. The caregivers were nurturing and meeting the developmental needs for each of the children. In Space 2, I observed a basket containing diaper creams, hand sanitizer and bleach water stored on top of a bookshelf which measured lower than five (5) feet. There have been no changes in the staff. Files were reviewed to confirm staff were current with current CBC Qualifying Letters, ITS-SIDS training, First Aid and CPR certification. All staff files were in compliance. Program records were reviewed. The last fire inspection was conducted on December 13, 2024. The sanitation inspection was conducted on October 22, 2024, with four demerits and a Superior rating. The last fire drill was conducted on February 4, 2025, and the drill log was found in compliance. A shelter in place drill was conducted on January 7, 2025. The playground inspections and incident log were reviewed and found in compliance. The following violation was observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 2, a basket containing Aquaphor, hand sanitizer and bleach water was observed stored on top of a bookshelf less than five (5) feet high. .2820(b) Compliance Statement: Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before February 25, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Email the information to: Lisa Eddins-Smith, Child Care Consultant Lisa.Eddins-Smith@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. 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 or an administrative action may be recommended. 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. Technical Assistance: Storage of Hazardous Materials: We discussed 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT as follows: 7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked area when not in use. Locked areas shall include those that are unlocked with a combination, electronic, or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed in this Paragraph that is labeled "keep out of reach of children" without any other warnings shall be kept inaccessible to children when not in use but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor; Toxic Plants: We discussed checking all plants in the facility to make sure there is no toxic plant accessible to children. A Toxic Plants List can be accessed at https://eh.mecknc.gov/lodging. Tobacco Statement: We discussed that signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. The operator shall notify the parent of each child enrolled in the center, in writing, of the smoking and tobacco restriction (10A NCAC 09 .0604 (i) and (j) SAFETY REQUIREMENTS FOR CHILD CARE CENTERS ). Reminders: Continue to review emails from the Division of Child Development and Early Education (DCDEE) and from your assigned child care consultant. DCDEE Website: I encourage you to utilize the DCDEE website, https://ncchildcare.ncdhhs.gov/, on a regular basis. All the laws, rules and regulations, item number listing, sanitation requirements, and provider documents can be found on the website. Additionally, there are many resources such as DCDEE Moodle where you can complete health and safety trainings free of charge. The What’s New tab provides current information that is sent out through blast emails. Get Ready for the 3’s / QRIS: On February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—is being used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website, https://www.ncrlap.org/ for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. Understanding the New QRIS If you missed the information sessions on the QRIS Modernization, you can now watch recordings of the webinars for parents and providers, including one with live Spanish translation. Visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization for videos, new resources and updates. ABCMS (Criminal Background System): North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. I left three Verification of Required Information Forms for you to complete for each staff member. I will review these at your annual compliance visit. Thank you for your time today. If you have questions or concerns regarding today’s visit, please contact me at Lisa.Eddins-Smith@dhhs.nc.gov or 980-748-6270. 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 TOTS Facility ID: 60003718 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: Visit Date: 2/11/2025 Number Present: 10 Completed Date: 2/11/2025 Age: From 0 To 5 Total Minutes: 125 Time In: 09:40 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. Your program currently operates a Three Star Rated License with an effective date of August 1, 2019. The program’s 18-month compliance history before today’s visit was 92%. The NC Secretary of State website was reviewed on February 11, 2025, and Little Tots Preschool LLC was listed as current- active. The license was posted, and the restrictions were in compliance. The following items were monitored during today’s visit, supervision, staff/child ratio, First Aid/CPR, special training, ITS/SIDS training, CBC letters, emergency medical care plan, administering of medication, storage of hazardous products, storage of medication, general safety, discipline, adequate/approved space, program records, license posted, permit restrictions. Upon my arrival, I was greeted by Patricia Ordonez-Prado, Operator/Lead Teacher. I introduced myself and stated the reason for the visit. Ms. Ordonez-Prado assisted me with the visit. A walk-through of the approved areas was conducted. I observed two groups of children. The infants and toddlers were playing on the floor and engaged in activities with a teacher. The age children were playing in learning centers. I observed the preschool children transition to lunch and a teacher directed art activity explained to the children in both Spanish and English. I observed infants and toddlers eating lunch. I observed supervision and staff/child ratios to be in compliance. The caregivers were nurturing and meeting the developmental needs for each of the children. In Space 2, I observed a basket containing diaper creams, hand sanitizer and bleach water stored on top of a bookshelf which measured lower than five (5) feet. There have been no changes in the staff. Files were reviewed to confirm staff were current with current CBC Qualifying Letters, ITS-SIDS training, First Aid and CPR certification. All staff files were in compliance. Program records were reviewed. The last fire inspection was conducted on December 13, 2024. The sanitation inspection was conducted on October 22, 2024, with four demerits and a Superior rating. The last fire drill was conducted on February 4, 2025, and the drill log was found in compliance. A shelter in place drill was conducted on January 7, 2025. The playground inspections and incident log were reviewed and found in compliance. The following violation was observed today: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space 2, a basket containing Aquaphor, hand sanitizer and bleach water was observed stored on top of a bookshelf less than five (5) feet high. .2820(b) Compliance Statement: Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before February 25, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Email the information to: Lisa Eddins-Smith, Child Care Consultant Lisa.Eddins-Smith@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. 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 or an administrative action may be recommended. 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. Technical Assistance: Storage of Hazardous Materials: We discussed 10A NCAC 09 .1719 REQUIREMENTS FOR A SAFE INDOOR/OUTDOOR ENVIRONMENT as follows: 7) keep all corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product that is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled shall be kept in its original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked area when not in use. Locked areas shall include those that are unlocked with a combination, electronic, or magnetic device, key, or equivalent locking device. These unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any product not listed in this Paragraph that is labeled "keep out of reach of children" without any other warnings shall be kept inaccessible to children when not in use but is not required to be kept in locked storage. The product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor; Toxic Plants: We discussed checking all plants in the facility to make sure there is no toxic plant accessible to children. A Toxic Plants List can be accessed at https://eh.mecknc.gov/lodging. Tobacco Statement: We discussed that signage regarding the smoking and tobacco restriction shall be posted at each entrance to the center and in vehicles used to transport children. The operator shall notify the parent of each child enrolled in the center, in writing, of the smoking and tobacco restriction (10A NCAC 09 .0604 (i) and (j) SAFETY REQUIREMENTS FOR CHILD CARE CENTERS ). Reminders: Continue to review emails from the Division of Child Development and Early Education (DCDEE) and from your assigned child care consultant. DCDEE Website: I encourage you to utilize the DCDEE website, https://ncchildcare.ncdhhs.gov/, on a regular basis. All the laws, rules and regulations, item number listing, sanitation requirements, and provider documents can be found on the website. Additionally, there are many resources such as DCDEE Moodle where you can complete health and safety trainings free of charge. The What’s New tab provides current information that is sent out through blast emails. Get Ready for the 3’s / QRIS: On February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—is being used for DCDEE environment rating scale assessments. The DCDEE and the North Carolina Rated License Assessment Project (NCRLAP) are collaboratively working on preparations for the transition to the third editions. These third editions come with a spiral binding at the top, replacing the current revised editions. Visit the NCRLAP’s website, https://www.ncrlap.org/ for more information about updated resources, credit hour trainings, and outreach assessment opportunities to help you become familiar with these tools. Understanding the New QRIS If you missed the information sessions on the QRIS Modernization, you can now watch recordings of the webinars for parents and providers, including one with live Spanish translation. Visit https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization for videos, new resources and updates. ABCMS (Criminal Background System): North Carolina child care administrators can now view and edit their facility’s staff roster in ABCMS, the DCDEE’s criminal background check system. Provider Access to ABCMS allows administrators to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. I left three Verification of Required Information Forms for you to complete for each staff member. I will review these at your annual compliance visit. Thank you for your time today. If you have questions or concerns regarding today’s visit, please contact me at Lisa.Eddins-Smith@dhhs.nc.gov or 980-748-6270. 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 TOTS Facility ID: 60003718 Consultant: KAYE DUNLAP Operation Type: Center Case Number: Visit Date: 5/17/2024 Number Present: 6 Completed Date: 5/17/2024 Age: From 0 To 4 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. P. Ordonez, Owner/Lead Teacher assisted me with the visit. The facility currently operates with a three-star license, issued April 1, 2019 earning 4 points in the education component, 2 points in the program standards component meeting enhanced ratios and 1 quality point since the program has earned 4 points in education and has a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher and group leader positions over the last 12 months. The last annual compliance visit was conducted May 22, 2023. A sanitation inspection was completed March 21, 2024 with a “Superior” classification. The last fire inspection was conducted on December 13, 2023. The last fire drill was conducted on May 1, 2024 and a shelter-in-place and lockdown drill on April 2, 2024. Outdoor inspections were monitored today and are occurring monthly as required. The NC Secretary of State website was reviewed on May 16, 2024, and Little Tots Preschool, LLC was listed as current- active. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in personal care routines, free play of indoor activity areas and transitions. There is one infant enrolled. The infant was observed participating in rest time and tummy time with a Lead Teacher. Both Lead Teachers were observed interacting and meeting the developmental needs for each of the children. One child’s file was monitored. Verification of required information for Operator and Additional Caregivers was completed today for both caregivers. The following violations were documented. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Although, non-prescription diaper creams and ointments are not required to be in locked storage, they are required to be stored at least five feet above the floor. There were nine containers of diaper creams and ointments stored on an open shelf less than five feet above the floor. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. One child had permission for Aquaphor Healing Ointment however, there were no instructions on how and when to administer the Aquaphor. 10A NCAC 09 .0803(4)(6-9) 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 in a drawer in the restroom making them accessible to the children. Plastic bags were also stored on an open shelf in another restroom. .0604(q) 860 Balloons were accessible to children. There were eleven latex balloons hanging on the window in the sunroom. .0604(q) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The safe sleep policy was not posted in the area where infants sleep. .0606(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There were seven containers of diaper creams and ointments that had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number.(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. There were two containers of disinfectant wipes that were being stored on an open shelf of the changing table. This is a violation of 15A NCAC 18A .2820(c). 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 violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 31, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Kaye Dunlap, Child Care Consultant PO Box 627 Matthews, NC 28106 Kaye.Dunlap@dhhs.nc.gov The following technical assistance was provided: -The safe sleep policy must be posted in the space where infants are sleeping. During the visit, the Lead Teacher placed the safe sleep policy in the space where the infant was resting. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. -We discussed storage of plastic bags and use of balloons. It was explained that the plastics bags were required to be out of reach of children under three. Balloons cannot be used with children of any age. The Lead Teacher stated that the balloons were present due to a child’s birthday today. I suggested replacing the balloons with a banner, streamers, etc. instead of balloons. -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. -We discussed storage of disinfectants and diaper creams. Disinfectant wipes and non-prescription diaper creams must be stored at least five feet above the floor. The Lead Teacher moved the disinfectant wipes and diaper creams/ointments to a shelf that was at least five feet from the floor. 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include 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 shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (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. d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. -We also discussed administering over-the-counter medications, specifically being aware of expiration dates and ensuring parents complete the permission form to administer over-the-counter medication correctly. 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; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (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. Thank you for your time today. If you have questions or concerns, please contact me 704-594-0152 or email at kaye.dunlap@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 .0606 · Violation

Name of Operation: LITTLE TOTS Facility ID: 60003718 Consultant: KAYE DUNLAP Operation Type: Center Case Number: Visit Date: 5/17/2024 Number Present: 6 Completed Date: 5/17/2024 Age: From 0 To 4 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. P. Ordonez, Owner/Lead Teacher assisted me with the visit. The facility currently operates with a three-star license, issued April 1, 2019 earning 4 points in the education component, 2 points in the program standards component meeting enhanced ratios and 1 quality point since the program has earned 4 points in education and has a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher and group leader positions over the last 12 months. The last annual compliance visit was conducted May 22, 2023. A sanitation inspection was completed March 21, 2024 with a “Superior” classification. The last fire inspection was conducted on December 13, 2023. The last fire drill was conducted on May 1, 2024 and a shelter-in-place and lockdown drill on April 2, 2024. Outdoor inspections were monitored today and are occurring monthly as required. The NC Secretary of State website was reviewed on May 16, 2024, and Little Tots Preschool, LLC was listed as current- active. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in personal care routines, free play of indoor activity areas and transitions. There is one infant enrolled. The infant was observed participating in rest time and tummy time with a Lead Teacher. Both Lead Teachers were observed interacting and meeting the developmental needs for each of the children. One child’s file was monitored. Verification of required information for Operator and Additional Caregivers was completed today for both caregivers. The following violations were documented. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Although, non-prescription diaper creams and ointments are not required to be in locked storage, they are required to be stored at least five feet above the floor. There were nine containers of diaper creams and ointments stored on an open shelf less than five feet above the floor. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. One child had permission for Aquaphor Healing Ointment however, there were no instructions on how and when to administer the Aquaphor. 10A NCAC 09 .0803(4)(6-9) 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 in a drawer in the restroom making them accessible to the children. Plastic bags were also stored on an open shelf in another restroom. .0604(q) 860 Balloons were accessible to children. There were eleven latex balloons hanging on the window in the sunroom. .0604(q) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The safe sleep policy was not posted in the area where infants sleep. .0606(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There were seven containers of diaper creams and ointments that had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number.(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. There were two containers of disinfectant wipes that were being stored on an open shelf of the changing table. This is a violation of 15A NCAC 18A .2820(c). 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 violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 31, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Kaye Dunlap, Child Care Consultant PO Box 627 Matthews, NC 28106 Kaye.Dunlap@dhhs.nc.gov The following technical assistance was provided: -The safe sleep policy must be posted in the space where infants are sleeping. During the visit, the Lead Teacher placed the safe sleep policy in the space where the infant was resting. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. -We discussed storage of plastic bags and use of balloons. It was explained that the plastics bags were required to be out of reach of children under three. Balloons cannot be used with children of any age. The Lead Teacher stated that the balloons were present due to a child’s birthday today. I suggested replacing the balloons with a banner, streamers, etc. instead of balloons. -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. -We discussed storage of disinfectants and diaper creams. Disinfectant wipes and non-prescription diaper creams must be stored at least five feet above the floor. The Lead Teacher moved the disinfectant wipes and diaper creams/ointments to a shelf that was at least five feet from the floor. 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include 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 shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (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. d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. -We also discussed administering over-the-counter medications, specifically being aware of expiration dates and ensuring parents complete the permission form to administer over-the-counter medication correctly. 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; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (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. Thank you for your time today. If you have questions or concerns, please contact me 704-594-0152 or email at kaye.dunlap@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 TOTS Facility ID: 60003718 Consultant: KAYE DUNLAP Operation Type: Center Case Number: Visit Date: 5/17/2024 Number Present: 6 Completed Date: 5/17/2024 Age: From 0 To 4 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. P. Ordonez, Owner/Lead Teacher assisted me with the visit. The facility currently operates with a three-star license, issued April 1, 2019 earning 4 points in the education component, 2 points in the program standards component meeting enhanced ratios and 1 quality point since the program has earned 4 points in education and has a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher and group leader positions over the last 12 months. The last annual compliance visit was conducted May 22, 2023. A sanitation inspection was completed March 21, 2024 with a “Superior” classification. The last fire inspection was conducted on December 13, 2023. The last fire drill was conducted on May 1, 2024 and a shelter-in-place and lockdown drill on April 2, 2024. Outdoor inspections were monitored today and are occurring monthly as required. The NC Secretary of State website was reviewed on May 16, 2024, and Little Tots Preschool, LLC was listed as current- active. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in personal care routines, free play of indoor activity areas and transitions. There is one infant enrolled. The infant was observed participating in rest time and tummy time with a Lead Teacher. Both Lead Teachers were observed interacting and meeting the developmental needs for each of the children. One child’s file was monitored. Verification of required information for Operator and Additional Caregivers was completed today for both caregivers. The following violations were documented. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Although, non-prescription diaper creams and ointments are not required to be in locked storage, they are required to be stored at least five feet above the floor. There were nine containers of diaper creams and ointments stored on an open shelf less than five feet above the floor. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. One child had permission for Aquaphor Healing Ointment however, there were no instructions on how and when to administer the Aquaphor. 10A NCAC 09 .0803(4)(6-9) 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 in a drawer in the restroom making them accessible to the children. Plastic bags were also stored on an open shelf in another restroom. .0604(q) 860 Balloons were accessible to children. There were eleven latex balloons hanging on the window in the sunroom. .0604(q) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The safe sleep policy was not posted in the area where infants sleep. .0606(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There were seven containers of diaper creams and ointments that had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number.(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. There were two containers of disinfectant wipes that were being stored on an open shelf of the changing table. This is a violation of 15A NCAC 18A .2820(c). 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 violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 31, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Kaye Dunlap, Child Care Consultant PO Box 627 Matthews, NC 28106 Kaye.Dunlap@dhhs.nc.gov The following technical assistance was provided: -The safe sleep policy must be posted in the space where infants are sleeping. During the visit, the Lead Teacher placed the safe sleep policy in the space where the infant was resting. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. -We discussed storage of plastic bags and use of balloons. It was explained that the plastics bags were required to be out of reach of children under three. Balloons cannot be used with children of any age. The Lead Teacher stated that the balloons were present due to a child’s birthday today. I suggested replacing the balloons with a banner, streamers, etc. instead of balloons. -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. -We discussed storage of disinfectants and diaper creams. Disinfectant wipes and non-prescription diaper creams must be stored at least five feet above the floor. The Lead Teacher moved the disinfectant wipes and diaper creams/ointments to a shelf that was at least five feet from the floor. 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include 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 shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (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. d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. -We also discussed administering over-the-counter medications, specifically being aware of expiration dates and ensuring parents complete the permission form to administer over-the-counter medication correctly. 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; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (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. Thank you for your time today. If you have questions or concerns, please contact me 704-594-0152 or email at kaye.dunlap@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 TOTS Facility ID: 60003718 Consultant: KAYE DUNLAP Operation Type: Center Case Number: Visit Date: 5/17/2024 Number Present: 6 Completed Date: 5/17/2024 Age: From 0 To 4 Total Minutes: 195 Time In: 09:45 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for an annual compliance visit. P. Ordonez, Owner/Lead Teacher assisted me with the visit. The facility currently operates with a three-star license, issued April 1, 2019 earning 4 points in the education component, 2 points in the program standards component meeting enhanced ratios and 1 quality point since the program has earned 4 points in education and has a combined turnover rate of 20 percent or less for the administrator, program coordinator, lead teacher, teacher and group leader positions over the last 12 months. The last annual compliance visit was conducted May 22, 2023. A sanitation inspection was completed March 21, 2024 with a “Superior” classification. The last fire inspection was conducted on December 13, 2023. The last fire drill was conducted on May 1, 2024 and a shelter-in-place and lockdown drill on April 2, 2024. Outdoor inspections were monitored today and are occurring monthly as required. The NC Secretary of State website was reviewed on May 16, 2024, and Little Tots Preschool, LLC was listed as current- active. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in personal care routines, free play of indoor activity areas and transitions. There is one infant enrolled. The infant was observed participating in rest time and tummy time with a Lead Teacher. Both Lead Teachers were observed interacting and meeting the developmental needs for each of the children. One child’s file was monitored. Verification of required information for Operator and Additional Caregivers was completed today for both caregivers. The following violations were documented. Violation Number Comment Rule 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. Although, non-prescription diaper creams and ointments are not required to be in locked storage, they are required to be stored at least five feet above the floor. There were nine containers of diaper creams and ointments stored on an open shelf less than five feet above the floor. 15A NCAC 18A .2820(d) 847 Parent's medication authorization did not include required information. One child had permission for Aquaphor Healing Ointment however, there were no instructions on how and when to administer the Aquaphor. 10A NCAC 09 .0803(4)(6-9) 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 in a drawer in the restroom making them accessible to the children. Plastic bags were also stored on an open shelf in another restroom. .0604(q) 860 Balloons were accessible to children. There were eleven latex balloons hanging on the window in the sunroom. .0604(q) 892 The center's safe sleep policy was not posted in a prominent place in the infant room where parents and caregivers were able to view daily. The safe sleep policy was not posted in the area where infants sleep. .0606(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. There were seven containers of diaper creams and ointments that had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 9995 A violation was found for which there is no item number.(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. There were two containers of disinfectant wipes that were being stored on an open shelf of the changing table. This is a violation of 15A NCAC 18A .2820(c). 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 violations documented may impact the compliance history score. The violations documented must be corrected immediately. On or before May 31, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Kaye Dunlap, Child Care Consultant PO Box 627 Matthews, NC 28106 Kaye.Dunlap@dhhs.nc.gov The following technical assistance was provided: -The safe sleep policy must be posted in the space where infants are sleeping. During the visit, the Lead Teacher placed the safe sleep policy in the space where the infant was resting. 10A NCAC 09 .0606 SAFE SLEEP PRACTICES (b) The center shall post a copy of its safe sleep policy about infant safe sleep practices in a prominent place in the infant room where parents and caregivers are able to view daily. -We discussed storage of plastic bags and use of balloons. It was explained that the plastics bags were required to be out of reach of children under three. Balloons cannot be used with children of any age. The Lead Teacher stated that the balloons were present due to a child’s birthday today. I suggested replacing the balloons with a banner, streamers, etc. instead of balloons. -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. -We discussed storage of disinfectants and diaper creams. Disinfectant wipes and non-prescription diaper creams must be stored at least five feet above the floor. The Lead Teacher moved the disinfectant wipes and diaper creams/ointments to a shelf that was at least five feet from the floor. 15A NCAC 18A .2820 STORAGE (b) Toxic substances, which include 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 shall be kept in the original container or in another labeled container, used according to the manufacturer's instructions, and stored in a locked storage room or cabinet when not in use. Locked storage rooms and cabinets shall include those which are unlocked with a combination lock, electronic or magnetic device, keypad, key, or equivalent locking device. Keys and electronic or magnetic unlocking devices shall be kept out of the reach of a child and shall not be stored in the lock. Toxic substances shall be stored below or separate from medications and food. Any other product that is labeled "keep out of reach of children" and does not have any other warnings on the label shall be kept inaccessible to children when not in use, but is not required to be kept in locked storage. For the purpose of Paragraphs (b), (c), and (d) of this Rule, a product shall be considered inaccessible to children when stored on a shelf or in an unlocked cabinet that is mounted a minimum vertical distance of five feet above the finished floor. (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. d) Medications including prescription and non-prescription items shall be stored in a locked cabinet or other locked container and shall not be stored above food. Designated emergency medications shall be kept inaccessible to children, but are not required to be in locked storage. Non-prescription diaper creams and sunscreen shall be kept inaccessible to children when not in use, but are not required to be in locked storage. -We also discussed administering over-the-counter medications, specifically being aware of expiration dates and ensuring parents complete the permission form to administer over-the-counter medication correctly. 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; (c) in any manner not authorized by the child's parent, physician or other health professional; (d) after its expiration date; (e) for non-medical reasons, such as to induce sleep; or (f) with a known allergy to the medication. (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. Thank you for your time today. If you have questions or concerns, please contact me 704-594-0152 or email at kaye.dunlap@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