10A NCAC 09 .0902 · Violation

Name of Operation: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: 1024-325L Visit Date: 10/31/2024 Number Present: 40 Completed Date: 10/31/2024 Age: From 0 To 5 Total Minutes: 205 Time In: 10:05 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The compliance history was 92% prior to today’s visit. Supervision, capacity, adequate/approved space and general license requirements were monitored during today’s visit. Upon arrival was greeted by Anne Fisher, Director. I explained the purpose of the visit. I was introduced to Betsy Simerville, Curriculum Coach and Julie Marx, Interim Infant Lead Teacher. I met with Ms. Fisher to discuss the allegation she reported October 24, 2024. Allegation: There is a concern that an infant’s feeding plan was not followed. I interviewed Ms. Fisher. She shared that on October 23, 2024 at 3:10 pm an infant was fed another child’s bottle containing human milk. The infant consumed about 4 ounces of the bottle before the error was discovered. Ms. Fisher was sick and at home the day of the incident however she was notified immediately by Betsy Simerville, Curriculum Coordinator. Ms. Fisher put on a mask and went in to the center to investigate the incident. Ms. Fisher obtained written statements from the two teachers involved. Ms. Fisher contacted the Mecklenburg County Health Department and obtained information and the form to initiate blood testing of the mother providing the human milk. Ms. Fisher emailed Michele Sullivan, Licensing Supervisor to inform her of the situation. Ms. Fisher contacted the complaint intake line at the NC Division of Child Development and Early Education October 24, 2024, to self-report the incident. I asked Ms. Fisher’s to share procedures for documenting and/or reporting incidents to families. She stated that both parents were informed by the teacher responsible for the bottle mix up the day of the incident when they arrived to pick up the children. Ms. Fisher spoke with the parents face to face and showed me the signed incident report dated October 24, 2024. She stated that the families of both children have been cooperative and supportive. I asked Ms. Fisher to share the center policies and procedures for labeling bottles and checking names to faces when feeding infants. All bottles are labeled and dated and placed in a small basket by child in the refrigerator. She described the procedure in place for teachers to document when a bottle is taken out of the refrigerator. A bottle check sheet is posted on the refrigerator which includes the date, the time and the initials of the teacher getting the bottle. Since the incident, both teachers are required to sign the check sheet. During today’s visit I monitored the infant classroom and observed infants sleeping, one being rocked and another on a buggy ride. I observed bottles color coded, labeled and dated and the bottle check sheet document posted on the refrigerator completed and initialed by both teachers. I reviewed the check sheets dated back to October 24, 2024, and found in compliance. The log for October 23, 2024, had not been completed for the afternoon bottle. The bottles containing human milk have been color coded using red rubber bands. I observed the rubber band and asked for the staff to explain the procedures for feeding children their bottles marked by the rubber bands. Both teachers stated that the rubber bands are for visual reminders for them and removed prior to feeding. I explained that rubber bands are considered hazardous for small children. Ms. Fisher stated she would change the rubber bands to silicone labels. I interviewed both teachers present during the incident at 3:10 pm. The interim lead teacher had left for the day at 3 pm. Both teachers present in the room during the incident shared that four toddlers were in feeding chairs eating snack and two non-mobile infants were on a carpet near the feeding chairs. One teacher was on the floor with the infants, and one was helping the toddlers. Both teachers stated they were able to see and hear the children while eating snack. One of the infants began crying and became inconsolable because it was time for his afternoon feeding. The teacher helping the toddlers observed the crying infant and got a bottle from the refrigerator to give to him. She began giving him the bottle while he was on a boppy. He took about 4 ounces, and she sat the bottle down. The other teacher noticed that he was given the incorrect bottle. Both teachers notified the interim lead teacher and the curriculum coordinator to report the incident. I asked the teachers to share about their training and the center procedures for checking bottles prior to and after the incident. They both shared the center has a bottle check sheet required to be initialed each time a bottle is removed from the refrigerator. They shared that the day of the incident it was usually busy. At the time of this incident the teacher failed to document the bottle check sheet and picked up the wrong bottle. The teacher shared that she takes full responsibility and failed to follow the system in place to verify bottles. Both teachers shared that they now verbally communicate with each other when getting a bottle as well as both initial the sheet. During the interview the teachers verified that infant teachers, administrative staff and all substitutes have been trained again in bottle check procedures and that a procedure outline has been developed and posted. I observed signature sheets verifying the training. The teachers have requested support staff from 3 pm – 3:30 pm if needed. Both stated that they do receive the help when requested. Findings: Based on the self-report, the interviews and observations it was determined that the concern that an infant’s feeding plan was not followed specifically that an infant was served a bottle labeled with another child’s name is substantiated. The following violations were cited: Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. An infant was placed on a boppy while eating a bottle. 10A NCAC 09 .0902(b) 1887 Each infant was not served only bottles labeled with their individual name. A child in the infant room was fed another child's bottle. .0902(d) 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 November 14, 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: Lisa Eddins-Smith, Child Care Consultant 8801 Crosstimbers Drive Charlotte. NC 28215 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: We discussed and I encourage you to review the following rules with your staff: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. We discussed changing the rubber bands around the bottles to reduce the risk associated with a teacher forgetting to remove the rubber band creating a safety hazard to young children. I encourage you to review and discuss the following rule with your staff: 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 continued support and training for your infant teachers. Please review trainings offered through Child Care Resources at https://www.childcareresourcesinc.org/training or through NCDCDEE Moodle at https://www.dcdee.moodle.nc.gov/ 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: Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be 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. For official environment rating scale assessments for a NC Star Rated License, the NCRLAP will use the Revised editions until February 1, 2025. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) 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. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle, https://www.dcdee.moodle.nc.gov/ —a video tutorial followed by a few questions. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0604 · Violation

Name of Operation: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: 1024-325L Visit Date: 10/31/2024 Number Present: 40 Completed Date: 10/31/2024 Age: From 0 To 5 Total Minutes: 205 Time In: 10:05 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The compliance history was 92% prior to today’s visit. Supervision, capacity, adequate/approved space and general license requirements were monitored during today’s visit. Upon arrival was greeted by Anne Fisher, Director. I explained the purpose of the visit. I was introduced to Betsy Simerville, Curriculum Coach and Julie Marx, Interim Infant Lead Teacher. I met with Ms. Fisher to discuss the allegation she reported October 24, 2024. Allegation: There is a concern that an infant’s feeding plan was not followed. I interviewed Ms. Fisher. She shared that on October 23, 2024 at 3:10 pm an infant was fed another child’s bottle containing human milk. The infant consumed about 4 ounces of the bottle before the error was discovered. Ms. Fisher was sick and at home the day of the incident however she was notified immediately by Betsy Simerville, Curriculum Coordinator. Ms. Fisher put on a mask and went in to the center to investigate the incident. Ms. Fisher obtained written statements from the two teachers involved. Ms. Fisher contacted the Mecklenburg County Health Department and obtained information and the form to initiate blood testing of the mother providing the human milk. Ms. Fisher emailed Michele Sullivan, Licensing Supervisor to inform her of the situation. Ms. Fisher contacted the complaint intake line at the NC Division of Child Development and Early Education October 24, 2024, to self-report the incident. I asked Ms. Fisher’s to share procedures for documenting and/or reporting incidents to families. She stated that both parents were informed by the teacher responsible for the bottle mix up the day of the incident when they arrived to pick up the children. Ms. Fisher spoke with the parents face to face and showed me the signed incident report dated October 24, 2024. She stated that the families of both children have been cooperative and supportive. I asked Ms. Fisher to share the center policies and procedures for labeling bottles and checking names to faces when feeding infants. All bottles are labeled and dated and placed in a small basket by child in the refrigerator. She described the procedure in place for teachers to document when a bottle is taken out of the refrigerator. A bottle check sheet is posted on the refrigerator which includes the date, the time and the initials of the teacher getting the bottle. Since the incident, both teachers are required to sign the check sheet. During today’s visit I monitored the infant classroom and observed infants sleeping, one being rocked and another on a buggy ride. I observed bottles color coded, labeled and dated and the bottle check sheet document posted on the refrigerator completed and initialed by both teachers. I reviewed the check sheets dated back to October 24, 2024, and found in compliance. The log for October 23, 2024, had not been completed for the afternoon bottle. The bottles containing human milk have been color coded using red rubber bands. I observed the rubber band and asked for the staff to explain the procedures for feeding children their bottles marked by the rubber bands. Both teachers stated that the rubber bands are for visual reminders for them and removed prior to feeding. I explained that rubber bands are considered hazardous for small children. Ms. Fisher stated she would change the rubber bands to silicone labels. I interviewed both teachers present during the incident at 3:10 pm. The interim lead teacher had left for the day at 3 pm. Both teachers present in the room during the incident shared that four toddlers were in feeding chairs eating snack and two non-mobile infants were on a carpet near the feeding chairs. One teacher was on the floor with the infants, and one was helping the toddlers. Both teachers stated they were able to see and hear the children while eating snack. One of the infants began crying and became inconsolable because it was time for his afternoon feeding. The teacher helping the toddlers observed the crying infant and got a bottle from the refrigerator to give to him. She began giving him the bottle while he was on a boppy. He took about 4 ounces, and she sat the bottle down. The other teacher noticed that he was given the incorrect bottle. Both teachers notified the interim lead teacher and the curriculum coordinator to report the incident. I asked the teachers to share about their training and the center procedures for checking bottles prior to and after the incident. They both shared the center has a bottle check sheet required to be initialed each time a bottle is removed from the refrigerator. They shared that the day of the incident it was usually busy. At the time of this incident the teacher failed to document the bottle check sheet and picked up the wrong bottle. The teacher shared that she takes full responsibility and failed to follow the system in place to verify bottles. Both teachers shared that they now verbally communicate with each other when getting a bottle as well as both initial the sheet. During the interview the teachers verified that infant teachers, administrative staff and all substitutes have been trained again in bottle check procedures and that a procedure outline has been developed and posted. I observed signature sheets verifying the training. The teachers have requested support staff from 3 pm – 3:30 pm if needed. Both stated that they do receive the help when requested. Findings: Based on the self-report, the interviews and observations it was determined that the concern that an infant’s feeding plan was not followed specifically that an infant was served a bottle labeled with another child’s name is substantiated. The following violations were cited: Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. An infant was placed on a boppy while eating a bottle. 10A NCAC 09 .0902(b) 1887 Each infant was not served only bottles labeled with their individual name. A child in the infant room was fed another child's bottle. .0902(d) 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 November 14, 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: Lisa Eddins-Smith, Child Care Consultant 8801 Crosstimbers Drive Charlotte. NC 28215 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: We discussed and I encourage you to review the following rules with your staff: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. We discussed changing the rubber bands around the bottles to reduce the risk associated with a teacher forgetting to remove the rubber band creating a safety hazard to young children. I encourage you to review and discuss the following rule with your staff: 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 continued support and training for your infant teachers. Please review trainings offered through Child Care Resources at https://www.childcareresourcesinc.org/training or through NCDCDEE Moodle at https://www.dcdee.moodle.nc.gov/ 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: Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be 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. For official environment rating scale assessments for a NC Star Rated License, the NCRLAP will use the Revised editions until February 1, 2025. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) 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. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle, https://www.dcdee.moodle.nc.gov/ —a video tutorial followed by a few questions. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. 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 .0902 · Violation

Name of Operation: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: 1024-325L Visit Date: 10/31/2024 Number Present: 40 Completed Date: 10/31/2024 Age: From 0 To 5 Total Minutes: 205 Time In: 10:05 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The compliance history was 92% prior to today’s visit. Supervision, capacity, adequate/approved space and general license requirements were monitored during today’s visit. Upon arrival was greeted by Anne Fisher, Director. I explained the purpose of the visit. I was introduced to Betsy Simerville, Curriculum Coach and Julie Marx, Interim Infant Lead Teacher. I met with Ms. Fisher to discuss the allegation she reported October 24, 2024. Allegation: There is a concern that an infant’s feeding plan was not followed. I interviewed Ms. Fisher. She shared that on October 23, 2024 at 3:10 pm an infant was fed another child’s bottle containing human milk. The infant consumed about 4 ounces of the bottle before the error was discovered. Ms. Fisher was sick and at home the day of the incident however she was notified immediately by Betsy Simerville, Curriculum Coordinator. Ms. Fisher put on a mask and went in to the center to investigate the incident. Ms. Fisher obtained written statements from the two teachers involved. Ms. Fisher contacted the Mecklenburg County Health Department and obtained information and the form to initiate blood testing of the mother providing the human milk. Ms. Fisher emailed Michele Sullivan, Licensing Supervisor to inform her of the situation. Ms. Fisher contacted the complaint intake line at the NC Division of Child Development and Early Education October 24, 2024, to self-report the incident. I asked Ms. Fisher’s to share procedures for documenting and/or reporting incidents to families. She stated that both parents were informed by the teacher responsible for the bottle mix up the day of the incident when they arrived to pick up the children. Ms. Fisher spoke with the parents face to face and showed me the signed incident report dated October 24, 2024. She stated that the families of both children have been cooperative and supportive. I asked Ms. Fisher to share the center policies and procedures for labeling bottles and checking names to faces when feeding infants. All bottles are labeled and dated and placed in a small basket by child in the refrigerator. She described the procedure in place for teachers to document when a bottle is taken out of the refrigerator. A bottle check sheet is posted on the refrigerator which includes the date, the time and the initials of the teacher getting the bottle. Since the incident, both teachers are required to sign the check sheet. During today’s visit I monitored the infant classroom and observed infants sleeping, one being rocked and another on a buggy ride. I observed bottles color coded, labeled and dated and the bottle check sheet document posted on the refrigerator completed and initialed by both teachers. I reviewed the check sheets dated back to October 24, 2024, and found in compliance. The log for October 23, 2024, had not been completed for the afternoon bottle. The bottles containing human milk have been color coded using red rubber bands. I observed the rubber band and asked for the staff to explain the procedures for feeding children their bottles marked by the rubber bands. Both teachers stated that the rubber bands are for visual reminders for them and removed prior to feeding. I explained that rubber bands are considered hazardous for small children. Ms. Fisher stated she would change the rubber bands to silicone labels. I interviewed both teachers present during the incident at 3:10 pm. The interim lead teacher had left for the day at 3 pm. Both teachers present in the room during the incident shared that four toddlers were in feeding chairs eating snack and two non-mobile infants were on a carpet near the feeding chairs. One teacher was on the floor with the infants, and one was helping the toddlers. Both teachers stated they were able to see and hear the children while eating snack. One of the infants began crying and became inconsolable because it was time for his afternoon feeding. The teacher helping the toddlers observed the crying infant and got a bottle from the refrigerator to give to him. She began giving him the bottle while he was on a boppy. He took about 4 ounces, and she sat the bottle down. The other teacher noticed that he was given the incorrect bottle. Both teachers notified the interim lead teacher and the curriculum coordinator to report the incident. I asked the teachers to share about their training and the center procedures for checking bottles prior to and after the incident. They both shared the center has a bottle check sheet required to be initialed each time a bottle is removed from the refrigerator. They shared that the day of the incident it was usually busy. At the time of this incident the teacher failed to document the bottle check sheet and picked up the wrong bottle. The teacher shared that she takes full responsibility and failed to follow the system in place to verify bottles. Both teachers shared that they now verbally communicate with each other when getting a bottle as well as both initial the sheet. During the interview the teachers verified that infant teachers, administrative staff and all substitutes have been trained again in bottle check procedures and that a procedure outline has been developed and posted. I observed signature sheets verifying the training. The teachers have requested support staff from 3 pm – 3:30 pm if needed. Both stated that they do receive the help when requested. Findings: Based on the self-report, the interviews and observations it was determined that the concern that an infant’s feeding plan was not followed specifically that an infant was served a bottle labeled with another child’s name is substantiated. The following violations were cited: Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. An infant was placed on a boppy while eating a bottle. 10A NCAC 09 .0902(b) 1887 Each infant was not served only bottles labeled with their individual name. A child in the infant room was fed another child's bottle. .0902(d) 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 November 14, 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: Lisa Eddins-Smith, Child Care Consultant 8801 Crosstimbers Drive Charlotte. NC 28215 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: We discussed and I encourage you to review the following rules with your staff: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. We discussed changing the rubber bands around the bottles to reduce the risk associated with a teacher forgetting to remove the rubber band creating a safety hazard to young children. I encourage you to review and discuss the following rule with your staff: 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 continued support and training for your infant teachers. Please review trainings offered through Child Care Resources at https://www.childcareresourcesinc.org/training or through NCDCDEE Moodle at https://www.dcdee.moodle.nc.gov/ 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: Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be 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. For official environment rating scale assessments for a NC Star Rated License, the NCRLAP will use the Revised editions until February 1, 2025. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) 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. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle, https://www.dcdee.moodle.nc.gov/ —a video tutorial followed by a few questions. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. 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: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: LISA EDDINS-SMITH Operation Type: Center Case Number: 1024-325L Visit Date: 10/31/2024 Number Present: 40 Completed Date: 10/31/2024 Age: From 0 To 5 Total Minutes: 205 Time In: 10:05 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. The compliance history was 92% prior to today’s visit. Supervision, capacity, adequate/approved space and general license requirements were monitored during today’s visit. Upon arrival was greeted by Anne Fisher, Director. I explained the purpose of the visit. I was introduced to Betsy Simerville, Curriculum Coach and Julie Marx, Interim Infant Lead Teacher. I met with Ms. Fisher to discuss the allegation she reported October 24, 2024. Allegation: There is a concern that an infant’s feeding plan was not followed. I interviewed Ms. Fisher. She shared that on October 23, 2024 at 3:10 pm an infant was fed another child’s bottle containing human milk. The infant consumed about 4 ounces of the bottle before the error was discovered. Ms. Fisher was sick and at home the day of the incident however she was notified immediately by Betsy Simerville, Curriculum Coordinator. Ms. Fisher put on a mask and went in to the center to investigate the incident. Ms. Fisher obtained written statements from the two teachers involved. Ms. Fisher contacted the Mecklenburg County Health Department and obtained information and the form to initiate blood testing of the mother providing the human milk. Ms. Fisher emailed Michele Sullivan, Licensing Supervisor to inform her of the situation. Ms. Fisher contacted the complaint intake line at the NC Division of Child Development and Early Education October 24, 2024, to self-report the incident. I asked Ms. Fisher’s to share procedures for documenting and/or reporting incidents to families. She stated that both parents were informed by the teacher responsible for the bottle mix up the day of the incident when they arrived to pick up the children. Ms. Fisher spoke with the parents face to face and showed me the signed incident report dated October 24, 2024. She stated that the families of both children have been cooperative and supportive. I asked Ms. Fisher to share the center policies and procedures for labeling bottles and checking names to faces when feeding infants. All bottles are labeled and dated and placed in a small basket by child in the refrigerator. She described the procedure in place for teachers to document when a bottle is taken out of the refrigerator. A bottle check sheet is posted on the refrigerator which includes the date, the time and the initials of the teacher getting the bottle. Since the incident, both teachers are required to sign the check sheet. During today’s visit I monitored the infant classroom and observed infants sleeping, one being rocked and another on a buggy ride. I observed bottles color coded, labeled and dated and the bottle check sheet document posted on the refrigerator completed and initialed by both teachers. I reviewed the check sheets dated back to October 24, 2024, and found in compliance. The log for October 23, 2024, had not been completed for the afternoon bottle. The bottles containing human milk have been color coded using red rubber bands. I observed the rubber band and asked for the staff to explain the procedures for feeding children their bottles marked by the rubber bands. Both teachers stated that the rubber bands are for visual reminders for them and removed prior to feeding. I explained that rubber bands are considered hazardous for small children. Ms. Fisher stated she would change the rubber bands to silicone labels. I interviewed both teachers present during the incident at 3:10 pm. The interim lead teacher had left for the day at 3 pm. Both teachers present in the room during the incident shared that four toddlers were in feeding chairs eating snack and two non-mobile infants were on a carpet near the feeding chairs. One teacher was on the floor with the infants, and one was helping the toddlers. Both teachers stated they were able to see and hear the children while eating snack. One of the infants began crying and became inconsolable because it was time for his afternoon feeding. The teacher helping the toddlers observed the crying infant and got a bottle from the refrigerator to give to him. She began giving him the bottle while he was on a boppy. He took about 4 ounces, and she sat the bottle down. The other teacher noticed that he was given the incorrect bottle. Both teachers notified the interim lead teacher and the curriculum coordinator to report the incident. I asked the teachers to share about their training and the center procedures for checking bottles prior to and after the incident. They both shared the center has a bottle check sheet required to be initialed each time a bottle is removed from the refrigerator. They shared that the day of the incident it was usually busy. At the time of this incident the teacher failed to document the bottle check sheet and picked up the wrong bottle. The teacher shared that she takes full responsibility and failed to follow the system in place to verify bottles. Both teachers shared that they now verbally communicate with each other when getting a bottle as well as both initial the sheet. During the interview the teachers verified that infant teachers, administrative staff and all substitutes have been trained again in bottle check procedures and that a procedure outline has been developed and posted. I observed signature sheets verifying the training. The teachers have requested support staff from 3 pm – 3:30 pm if needed. Both stated that they do receive the help when requested. Findings: Based on the self-report, the interviews and observations it was determined that the concern that an infant’s feeding plan was not followed specifically that an infant was served a bottle labeled with another child’s name is substantiated. The following violations were cited: Violation Number Comment Rule 532 All children were not held or placed in feeding chairs or other appropriate apparatus to be fed. An infant was placed on a boppy while eating a bottle. 10A NCAC 09 .0902(b) 1887 Each infant was not served only bottles labeled with their individual name. A child in the infant room was fed another child's bottle. .0902(d) 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 November 14, 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: Lisa Eddins-Smith, Child Care Consultant 8801 Crosstimbers Drive Charlotte. NC 28215 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: We discussed and I encourage you to review the following rules with your staff: 10A NCAC 09 .0902 REQUIREMENTS FOR INFANTS (a) The parent or health care provider of each child under 15 months of age shall provide the center an individual written feeding plan for the child. This plan shall be followed at the center. This plan shall include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan shall be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant shall include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. (b) Each infant shall be held for bottle feeding until able to hold his or her own bottle. Bottles shall not be propped. Each child shall be held or placed in feeding chairs or other age-appropriate seating apparatus to be fed. The feeding chair or other seating apparatus shall be disassembled for cleaning purposes. (c) Infants shall not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. (d) Each infant shall be served only bottles labeled with their individual name. We discussed changing the rubber bands around the bottles to reduce the risk associated with a teacher forgetting to remove the rubber band creating a safety hazard to young children. I encourage you to review and discuss the following rule with your staff: 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 continued support and training for your infant teachers. Please review trainings offered through Child Care Resources at https://www.childcareresourcesinc.org/training or through NCDCDEE Moodle at https://www.dcdee.moodle.nc.gov/ 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: Starting on February 1, 2025, the ECERS-3, ITERS-3, and FCCERS-3—also known as the "3s"—will be 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. For official environment rating scale assessments for a NC Star Rated License, the NCRLAP will use the Revised editions until February 1, 2025. Until February 1, 2025, NCRLAP will use the Revised editions for official environment rating scale assessments for a NC Star Rated License (for new licensees or upon request.) 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. To get started, complete the ABCMS Child Care Provider Portal Training in Moodle, https://www.dcdee.moodle.nc.gov/ —a video tutorial followed by a few questions. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you. 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: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: ANDREA ANDERSON Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 52 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 09:30 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 unannounced visit was to monitor compliance of applicable child care requirements during the annual compliance visit. A checklist was used to monitor the program. The 18 month compliance history, prior to today’s visit is 96%. I met with Anne Fisher, Administrator. You accompanied me on the walkthrough of the facility. I monitored the indoor and outdoor environment. The facility does not offer transportation. Each classroom had a current activity plan, daily schedule, allergy information, menu, first aid poster, and EMC plan posted, all meeting compliance. The infant room had the ITS/SIDS policy posted and feeding schedules posted. All material and equipment in each classroom were found to be clean, in good repair and developmentally appropriate for the age range served. Nurturing tones were used as staff spoke with children. Supervision and staff/child ratios were observed meeting compliance. I observed infants having tummy time with staff encouraging play; one infant was observed resting. Attendance and visual safe sleep checks are stored electronically and were reviewed today, they were found to be current and meeting compliance. The group of toddlers were in free choice activities with teachers engaging them in play. The preschool groups were observed during free choice center play and outdoors. Program records were monitored and found meeting compliance. The last fire inspection was conducted on 10/17/23. The last sanitation inspection was conducted on 4/2/24. The emergency drill log, playground inspections, incident log, and EPR plan were reviewed and found meeting compliance. Information required to be posted were observed posted in the center. Medications were stored properly. Medical action plans and permission to administer were reviewed. In Space 4, one medical action plan is not signed by the physician, the parent completed the permission and medical action plan requesting Benadryl be given. The child is 4 years old and the instructions on the medication itself states 2-5 years do not used unless directed by a doctor, so you need a doctor to provide permission to administer. Space 3 had one sunscreen on site expired 4/24. I reviewed a sample of children's records and found them meeting compliance. Staff files were reviewed and all full time and part time staff files are current. The substitute that has been subbing since 2020 has not had an annual review or staff/development plan nor have you reviewed the EPR and EMC plan with her annually. The following violations were cited during today's visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The chain link fencing measures 3'6" behind the hill slide, on the preschool playground. GS 110-91(6); .0605((i) 843 A drug or medicine was administered after its expiration date. One sunscreen was observed in Space 3; the sunscreen expired 4/24. 10A NCAC 09 .0803(1)(d) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. You have not reviewed the EMC plan with the substitute annual, she has been subbing since 2020. 10A NCAC 09 .0802(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The substitute that has been employed since 2020, has not had an annual review or had a staff development plan. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. You have not reviewed the EPR plan with the substitute, she has been subbing since 2020. .0607(f) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One Benadryl on site, for a child with a medical condition requiring the medication when needed, does not have written permission from his physician. The child is 4 years old and the Benadryl instructions states 2-5 years do not use unless directed by a doctor. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Compliance Statement Childcare providers are expected to maintain compliance with all applicable child care requirements at all times. All violations cited today shall be corrected immediately. Anne Fisher, administrator, will email a compliance letter explaining how each violation cited today has been corrected. The compliance letter must be received by 9-18-24. I will be retiring next week, so you will send the compliance statement to my supervisor, Michele Sullivan, her email is Michele.sullivan@dhhs.nc.gov Failure to correct the violations and/or submit the compliance letter to me by the date listed above may result in an unannounced follow-up visit being conducted to ensure corrections were made. Technical Assistance was provided on the following: Fencing: We discussed the chain linked fencing, we measured it in two places, both below 4'. We discussed when getting the fencing pulled up to four feet, the top will need to be flush with the rail, so it doesn't cause a protrusion. If the pull the fencing up and the base comes up, make sure it is tied down and you will check it regularly to ensure it doesn't unravel and leave sharp edges. Medications: I encourage you all check medications monthly to ensure they do not expire. You keep a master list of emergency medications, I encourage you keep a master list of all medications, when the permission to administer, medical action plans (if applicable, and the medication itself expire. Substitutes- we reviewed the substitute checklist that is on the DCDEE website, you have one with the sub's file, but the bottom portion is not completed, I encourage you to reference them at least annually to ensure everything is maintained. I will be in touch next week to provide contact information. Until then you may continue to contact me with questions. My last day will be 9-13-24. 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 .0514 · Violation

Name of Operation: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: ANDREA ANDERSON Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 52 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 09:30 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 unannounced visit was to monitor compliance of applicable child care requirements during the annual compliance visit. A checklist was used to monitor the program. The 18 month compliance history, prior to today’s visit is 96%. I met with Anne Fisher, Administrator. You accompanied me on the walkthrough of the facility. I monitored the indoor and outdoor environment. The facility does not offer transportation. Each classroom had a current activity plan, daily schedule, allergy information, menu, first aid poster, and EMC plan posted, all meeting compliance. The infant room had the ITS/SIDS policy posted and feeding schedules posted. All material and equipment in each classroom were found to be clean, in good repair and developmentally appropriate for the age range served. Nurturing tones were used as staff spoke with children. Supervision and staff/child ratios were observed meeting compliance. I observed infants having tummy time with staff encouraging play; one infant was observed resting. Attendance and visual safe sleep checks are stored electronically and were reviewed today, they were found to be current and meeting compliance. The group of toddlers were in free choice activities with teachers engaging them in play. The preschool groups were observed during free choice center play and outdoors. Program records were monitored and found meeting compliance. The last fire inspection was conducted on 10/17/23. The last sanitation inspection was conducted on 4/2/24. The emergency drill log, playground inspections, incident log, and EPR plan were reviewed and found meeting compliance. Information required to be posted were observed posted in the center. Medications were stored properly. Medical action plans and permission to administer were reviewed. In Space 4, one medical action plan is not signed by the physician, the parent completed the permission and medical action plan requesting Benadryl be given. The child is 4 years old and the instructions on the medication itself states 2-5 years do not used unless directed by a doctor, so you need a doctor to provide permission to administer. Space 3 had one sunscreen on site expired 4/24. I reviewed a sample of children's records and found them meeting compliance. Staff files were reviewed and all full time and part time staff files are current. The substitute that has been subbing since 2020 has not had an annual review or staff/development plan nor have you reviewed the EPR and EMC plan with her annually. The following violations were cited during today's visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The chain link fencing measures 3'6" behind the hill slide, on the preschool playground. GS 110-91(6); .0605((i) 843 A drug or medicine was administered after its expiration date. One sunscreen was observed in Space 3; the sunscreen expired 4/24. 10A NCAC 09 .0803(1)(d) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. You have not reviewed the EMC plan with the substitute annual, she has been subbing since 2020. 10A NCAC 09 .0802(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The substitute that has been employed since 2020, has not had an annual review or had a staff development plan. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. You have not reviewed the EPR plan with the substitute, she has been subbing since 2020. .0607(f) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One Benadryl on site, for a child with a medical condition requiring the medication when needed, does not have written permission from his physician. The child is 4 years old and the Benadryl instructions states 2-5 years do not use unless directed by a doctor. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Compliance Statement Childcare providers are expected to maintain compliance with all applicable child care requirements at all times. All violations cited today shall be corrected immediately. Anne Fisher, administrator, will email a compliance letter explaining how each violation cited today has been corrected. The compliance letter must be received by 9-18-24. I will be retiring next week, so you will send the compliance statement to my supervisor, Michele Sullivan, her email is Michele.sullivan@dhhs.nc.gov Failure to correct the violations and/or submit the compliance letter to me by the date listed above may result in an unannounced follow-up visit being conducted to ensure corrections were made. Technical Assistance was provided on the following: Fencing: We discussed the chain linked fencing, we measured it in two places, both below 4'. We discussed when getting the fencing pulled up to four feet, the top will need to be flush with the rail, so it doesn't cause a protrusion. If the pull the fencing up and the base comes up, make sure it is tied down and you will check it regularly to ensure it doesn't unravel and leave sharp edges. Medications: I encourage you all check medications monthly to ensure they do not expire. You keep a master list of emergency medications, I encourage you keep a master list of all medications, when the permission to administer, medical action plans (if applicable, and the medication itself expire. Substitutes- we reviewed the substitute checklist that is on the DCDEE website, you have one with the sub's file, but the bottom portion is not completed, I encourage you to reference them at least annually to ensure everything is maintained. I will be in touch next week to provide contact information. Until then you may continue to contact me with questions. My last day will be 9-13-24. 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 .0802 · Violation

Name of Operation: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: ANDREA ANDERSON Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 52 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 09:30 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 unannounced visit was to monitor compliance of applicable child care requirements during the annual compliance visit. A checklist was used to monitor the program. The 18 month compliance history, prior to today’s visit is 96%. I met with Anne Fisher, Administrator. You accompanied me on the walkthrough of the facility. I monitored the indoor and outdoor environment. The facility does not offer transportation. Each classroom had a current activity plan, daily schedule, allergy information, menu, first aid poster, and EMC plan posted, all meeting compliance. The infant room had the ITS/SIDS policy posted and feeding schedules posted. All material and equipment in each classroom were found to be clean, in good repair and developmentally appropriate for the age range served. Nurturing tones were used as staff spoke with children. Supervision and staff/child ratios were observed meeting compliance. I observed infants having tummy time with staff encouraging play; one infant was observed resting. Attendance and visual safe sleep checks are stored electronically and were reviewed today, they were found to be current and meeting compliance. The group of toddlers were in free choice activities with teachers engaging them in play. The preschool groups were observed during free choice center play and outdoors. Program records were monitored and found meeting compliance. The last fire inspection was conducted on 10/17/23. The last sanitation inspection was conducted on 4/2/24. The emergency drill log, playground inspections, incident log, and EPR plan were reviewed and found meeting compliance. Information required to be posted were observed posted in the center. Medications were stored properly. Medical action plans and permission to administer were reviewed. In Space 4, one medical action plan is not signed by the physician, the parent completed the permission and medical action plan requesting Benadryl be given. The child is 4 years old and the instructions on the medication itself states 2-5 years do not used unless directed by a doctor, so you need a doctor to provide permission to administer. Space 3 had one sunscreen on site expired 4/24. I reviewed a sample of children's records and found them meeting compliance. Staff files were reviewed and all full time and part time staff files are current. The substitute that has been subbing since 2020 has not had an annual review or staff/development plan nor have you reviewed the EPR and EMC plan with her annually. The following violations were cited during today's visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The chain link fencing measures 3'6" behind the hill slide, on the preschool playground. GS 110-91(6); .0605((i) 843 A drug or medicine was administered after its expiration date. One sunscreen was observed in Space 3; the sunscreen expired 4/24. 10A NCAC 09 .0803(1)(d) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. You have not reviewed the EMC plan with the substitute annual, she has been subbing since 2020. 10A NCAC 09 .0802(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The substitute that has been employed since 2020, has not had an annual review or had a staff development plan. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. You have not reviewed the EPR plan with the substitute, she has been subbing since 2020. .0607(f) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One Benadryl on site, for a child with a medical condition requiring the medication when needed, does not have written permission from his physician. The child is 4 years old and the Benadryl instructions states 2-5 years do not use unless directed by a doctor. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Compliance Statement Childcare providers are expected to maintain compliance with all applicable child care requirements at all times. All violations cited today shall be corrected immediately. Anne Fisher, administrator, will email a compliance letter explaining how each violation cited today has been corrected. The compliance letter must be received by 9-18-24. I will be retiring next week, so you will send the compliance statement to my supervisor, Michele Sullivan, her email is Michele.sullivan@dhhs.nc.gov Failure to correct the violations and/or submit the compliance letter to me by the date listed above may result in an unannounced follow-up visit being conducted to ensure corrections were made. Technical Assistance was provided on the following: Fencing: We discussed the chain linked fencing, we measured it in two places, both below 4'. We discussed when getting the fencing pulled up to four feet, the top will need to be flush with the rail, so it doesn't cause a protrusion. If the pull the fencing up and the base comes up, make sure it is tied down and you will check it regularly to ensure it doesn't unravel and leave sharp edges. Medications: I encourage you all check medications monthly to ensure they do not expire. You keep a master list of emergency medications, I encourage you keep a master list of all medications, when the permission to administer, medical action plans (if applicable, and the medication itself expire. Substitutes- we reviewed the substitute checklist that is on the DCDEE website, you have one with the sub's file, but the bottom portion is not completed, I encourage you to reference them at least annually to ensure everything is maintained. I will be in touch next week to provide contact information. Until then you may continue to contact me with questions. My last day will be 9-13-24. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: ANDREA ANDERSON Operation Type: Center Case Number: Visit Date: 9/4/2024 Number Present: 52 Completed Date: 9/4/2024 Age: From 0 To 4 Total Minutes: 210 Time In: 09:30 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 unannounced visit was to monitor compliance of applicable child care requirements during the annual compliance visit. A checklist was used to monitor the program. The 18 month compliance history, prior to today’s visit is 96%. I met with Anne Fisher, Administrator. You accompanied me on the walkthrough of the facility. I monitored the indoor and outdoor environment. The facility does not offer transportation. Each classroom had a current activity plan, daily schedule, allergy information, menu, first aid poster, and EMC plan posted, all meeting compliance. The infant room had the ITS/SIDS policy posted and feeding schedules posted. All material and equipment in each classroom were found to be clean, in good repair and developmentally appropriate for the age range served. Nurturing tones were used as staff spoke with children. Supervision and staff/child ratios were observed meeting compliance. I observed infants having tummy time with staff encouraging play; one infant was observed resting. Attendance and visual safe sleep checks are stored electronically and were reviewed today, they were found to be current and meeting compliance. The group of toddlers were in free choice activities with teachers engaging them in play. The preschool groups were observed during free choice center play and outdoors. Program records were monitored and found meeting compliance. The last fire inspection was conducted on 10/17/23. The last sanitation inspection was conducted on 4/2/24. The emergency drill log, playground inspections, incident log, and EPR plan were reviewed and found meeting compliance. Information required to be posted were observed posted in the center. Medications were stored properly. Medical action plans and permission to administer were reviewed. In Space 4, one medical action plan is not signed by the physician, the parent completed the permission and medical action plan requesting Benadryl be given. The child is 4 years old and the instructions on the medication itself states 2-5 years do not used unless directed by a doctor, so you need a doctor to provide permission to administer. Space 3 had one sunscreen on site expired 4/24. I reviewed a sample of children's records and found them meeting compliance. Staff files were reviewed and all full time and part time staff files are current. The substitute that has been subbing since 2020 has not had an annual review or staff/development plan nor have you reviewed the EPR and EMC plan with her annually. The following violations were cited during today's visit: Violation Number Comment Rule 824 Outdoor play area was not enclosed by fence with a minimum height of 4 feet. The top of the fence, less than six feet, was not free from protrusions. The chain link fencing measures 3'6" behind the hill slide, on the preschool playground. GS 110-91(6); .0605((i) 843 A drug or medicine was administered after its expiration date. One sunscreen was observed in Space 3; the sunscreen expired 4/24. 10A NCAC 09 .0803(1)(d) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. You have not reviewed the EMC plan with the substitute annual, she has been subbing since 2020. 10A NCAC 09 .0802(a) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. The substitute that has been employed since 2020, has not had an annual review or had a staff development plan. 10A NCAC 09 .0514(f) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. You have not reviewed the EPR plan with the substitute, she has been subbing since 2020. .0607(f) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. One Benadryl on site, for a child with a medical condition requiring the medication when needed, does not have written permission from his physician. The child is 4 years old and the Benadryl instructions states 2-5 years do not use unless directed by a doctor. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) Compliance Statement Childcare providers are expected to maintain compliance with all applicable child care requirements at all times. All violations cited today shall be corrected immediately. Anne Fisher, administrator, will email a compliance letter explaining how each violation cited today has been corrected. The compliance letter must be received by 9-18-24. I will be retiring next week, so you will send the compliance statement to my supervisor, Michele Sullivan, her email is Michele.sullivan@dhhs.nc.gov Failure to correct the violations and/or submit the compliance letter to me by the date listed above may result in an unannounced follow-up visit being conducted to ensure corrections were made. Technical Assistance was provided on the following: Fencing: We discussed the chain linked fencing, we measured it in two places, both below 4'. We discussed when getting the fencing pulled up to four feet, the top will need to be flush with the rail, so it doesn't cause a protrusion. If the pull the fencing up and the base comes up, make sure it is tied down and you will check it regularly to ensure it doesn't unravel and leave sharp edges. Medications: I encourage you all check medications monthly to ensure they do not expire. You keep a master list of emergency medications, I encourage you keep a master list of all medications, when the permission to administer, medical action plans (if applicable, and the medication itself expire. Substitutes- we reviewed the substitute checklist that is on the DCDEE website, you have one with the sub's file, but the bottom portion is not completed, I encourage you to reference them at least annually to ensure everything is maintained. I will be in touch next week to provide contact information. Until then you may continue to contact me with questions. My last day will be 9-13-24. 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: THE NEST AT CHARLOTTE LATIN SCHOOL Facility ID: 60003199 Consultant: ANDREA ANDERSON Operation Type: Center Case Number: Visit Date: 9/20/2023 Number Present: 50 Completed Date: 9/20/2023 Age: From 0 To 4 Total Minutes: 220 Time In: 09:35 AM Time Out: 01:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor compliance of applicable child care requirements during the annual compliance visit. A checklist was used to monitor the program. I met with Anne Fisher, Administrator, during today's visit. you accompanied me on the walkthrough of the facility. I monitored the indoor and outdoor environment. You informed me that facility does not offer transportation. Each classroom had a current activity plan, daily schedule, allergy information, menu, firs aid poster, and EMC plan posted and found meeting compliance. The infant room had the ITS?SIDS policy posted and feeding schedules posted. One feeding schedule did not indicate the child's current eating habits, this was corrected during the visit. All material and equipment in each classroom were found to be clean, in good repair and developmentally appropriate for the age range served. Nurturing tones were used as staff spoke with children. Supervision and staff/child ratios were observed meeting compliance. I observed infants having tummy time with staff encouraging play; one infant was observed being held while being bottle fed. Attendance and visual safe sleep checks are stored electronically and available for my review today. The group of toddlers were on a nature walk and the preschool groups were observed during free choice center play and a teacher directed activity. Program records were monitored and found meeting compliance. The last fire inspection was conducted on 11/4/22. The last sanitation inspection was conducted on 1/10/23. The emergency drill log, playground inspections, incident log, and EPR plan were reviewed and found meeting compliance. Medications were observed stored properly. Medical action plans and permission to administer were current. Space 2 had one petroleum jelly that expired 5/23 and Space 4 had one sunscreen that expired 6/23. I reviewed a sample of children's records and found them meeting compliance. Two existing staff and four new staff files were reviewed. Existing staff files were found meeting compliance. The four new staff were hired 7/31/23 and did not sign the shaken baby syndrome abusive head trauma policy stating they reviewed and discussed until 8/22/23 and had been caring form the children prior to review and signing. The following violations were cited durign today's visit: Violation Number Comment Rule 542 The written feeding plan was not modified as the child's needs changed. One feeding schedule was not current. 10 NCAC 09 .0902(a) 843 A drug or medicine was administered after its expiration date. Space 2 - 1 petroleum jelly expired 5/23. Space 4 - 1 sunscreen expired 6/23. 10A NCAC 09 .0803(1)(d) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. 4 new staff that were hired 7/31/23 did not review or sign the policy until 8/22/23. .0608(d)(1-4) Because all violations were corrected during the visit you are not required to submit a compliance statement. Technical Assistance was provided on the following: Staff Orientation - Is site specific. The health and safety trainings are not orientation. You need to discuss each topic area of the orientation document in regards to how your center complies, policies and procedures. On-going training - does not begin until the 1st anniversary date. The first year of employment staff must complete health and safety trainings and do not count as training hours that year. When completing within the next five years they will count towards on-going training. Environmental Health Presentation - I shared the website to locate the environmental health presentations regarding the updated rules. Please contact me with any questions, Andrea Anderson PO Box 49335 Charlotte, NC 28277 andrea.anderson@dhhs.nc.gov (704)594-0039 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.