Kid'S Country OF Clayton, INC

10A NCAC 09 .0901 · Violation

Name of Operation: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TANYA HERRING Operation Type: Center Case Number: 0825-154L Visit Date: 8/18/2025 Number Present: 43 Completed Date: 8/18/2025 Age: From 0 To 10 Total Minutes: 70 Time In: 11:35 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor applicable child care requirements after a complaint report was received by the Division of Child Development and Early Education was received on August 12, 2025. Upon our arrival, we were greeted by the administrator, Angela Sanders. Teraesa Leak, Licensing Supervisor, accompanied me during today's visit. Limited monitoring of the child care requirements occurred today. The license was posted. We conducted a general walk-through of the indoor outdoor environment. There were a total of forty-three (43) children present. Children were observed napping, completing routine tasks and having lunch. Today's meal was in compliance with the Meal Pattern requirements. ALLEGATIONS: -Children are in an unsafe environment -Safe sleep requirements are not being met During today's visit, we discussed the allegations with Ms. Sanders and she was given and opportunity to provide her perspective. We asked if there had been any recent complaints from parents or staff. Ms. Sanders provided information regarding a recent biting incident with an enrolled toddler. Ms. Sanders stted that she had received a parent complaint after their child had been bitten. The biter is currently receiving services from a speech therapist to assist. Ms. Sanders also provided information regarding a recent incident with the air conditioning. Ms. Sanders stated that on July 31, the air conditioner in the classroom designated for school-agers had gone out and was not working. Ms. Sanders stated that at the time, the school-aged children were not present and were on a field trip, but that upon their return, they were moved to a different classroom within the building. Ms. Sanders provided information that showed that the air conditioner was fixed the next day. During today's visit, the building thermostats were reading at 72 degrees with an outdoor temperature 85 degrees. Caregiving requirements for infants care were also monitored. We observed the facility's safe sleep policy and the classroom thermostat read 72 degrees. The policy states that the room designated for infants will be kept between 68-75 degrees. There were no safety concerns during today's visit and infant care requirements were in compliance. Based on our observations and statements made by the administrator, the allegations regarding safe environment and infant care are unconfirmed. The following violations were documented during today's visit: Violation Number Comment Rule 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. The menu posted in the classroom designated for infants was dated for October 20, 2024-November 1, 2024. The menu posted in the hallway was dated for July 2025. 10A NCAC 09 .0901(b) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In the classroom designated for infants, a can of Pepsi was observed on a high chair. .0901(i) All violations were corrected during today's visit, therefore a compliance verification letter is not required in response. Thank you for your time today. For questions concerning today's visit, please contact me at 910-624-4171 or by email at Tanya.Herring @dhhs.nc.gov. For all other questions, please contact your Child Care Consultant, Paula Davis, at 919-819-9302 or by email at Paula.Davis@dhhs.nc.gov. You may also contact the Licensing Supervisor, Teraesa Leak at 919-971-7765 or Teraesa.Leak@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 .0901 · Violation

Name of Operation: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 8/14/2024 Number Present: 50 Completed Date: 8/14/2024 Age: From 0 To 11 Total Minutes: 65 Time In: 11:35 AM Time Out: 12:40 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor applicable child care requirements after a violation for staff/child ratios was cited during a complaint visit. Paula Davis, Child Care Consultant, was also present during today's visit. Limited monitoring of the child care requirements occurred during today's visit. The license was posted. We were unaccompanied as we completed a general walk-through of the indoor environment. Children were observed having lunch and going down for a nap. Items that were documented during the initial complaint visit conducted on July 31, 2024, were monitored for compliance: Item 318- The operator had not submitted a compliance letter at the time of the visit but said that one would be submitted by COB today. Children were grouped appropriately during today's visit, therefore, an additional violation was not documented. Item 319- All classrooms, including the classroom designated for toddlers, had the staff/child ratios applicable to the classroom posted. An additional violation was not documented. Item 837-The EMC plan still had a former employee listed as the alternate person for choosing and carrying out the plan of action to obtain appropriate medical care. An additional violation was documented. Item 862- The EMC plan was reviewed with the staff member on August 14, 2024. An additional violation was not documented. Item 873- An additional violation was documented as the EMC plan did not identify how to handle illness or other medical emergencies. Item 1756- All enhanced staff/child ratios were maintained. An additional violation was not documented. Items 812, 871, and 1911 were all corrected at the time of the visit. The following violations were cited during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In the space designated for toddlers, the activity plan was dated August 5-9, 2024. GS 110-91(12); .0508(a) 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Today's lunch menu consisted of ham and cheese sandwiches, however bologna was substituted and not recorded on the menu prior to being served. 10A NCAC 09 .0901(b) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person. .0802(a)(1)(A-B); 873 Center staff did not follow the EMC plan. The current plan still does not identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) All violations must be completed immediately. A compliance letter stating how you have corrected the violations and how compliance will be maintained is due to me by August 28, 2024. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Additional technical assistance was provided during today's visit regarding the emergency medical care plan. I explained to Ms. Sanders that the plan only addresses how the facility will identify and plan for minor and major injuries. It does not however, identify how it will identify and plan for illness and medical emergencies. Specific examples of an illness or medical emergency may include a diabetic crisis, anaphylaxis, which is an acute allergic reaction to an antigen, such as a bee sting, choking, fainting or collapsing, breathing problems, seizures, severe vomiting or diarrhea, poisoning, or signs of dehydration. Please revise your plan to ensure all items are addressed in accordance to the rule. As staffing changes occur, so must the changes to your emergency medical care plan. Those changes must be reviewed with staff annually or as they occur. As a reminder, the plan must be reviewed with all staff annually, regardless of changes. The allergy lists were updated on July 31, 2024 and current allergy lists were observed during today's visit in each classroom and the kitchen. Please remember to update allergy lists quarterly or as new children are enrolled, whichever comes first. I recommended that the lists include pictures of children so that those children with allergies are easily identifiable to floaters and/or substitutes. Thank you for your time today. Should you have any questions regarding today's visit, please do not hesitate to contact me at Teraesa.Leak@dhhs.nc.gov or by phone at 919-971-7765. 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: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 8/14/2024 Number Present: 50 Completed Date: 8/14/2024 Age: From 0 To 11 Total Minutes: 65 Time In: 11:35 AM Time Out: 12:40 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor applicable child care requirements after a violation for staff/child ratios was cited during a complaint visit. Paula Davis, Child Care Consultant, was also present during today's visit. Limited monitoring of the child care requirements occurred during today's visit. The license was posted. We were unaccompanied as we completed a general walk-through of the indoor environment. Children were observed having lunch and going down for a nap. Items that were documented during the initial complaint visit conducted on July 31, 2024, were monitored for compliance: Item 318- The operator had not submitted a compliance letter at the time of the visit but said that one would be submitted by COB today. Children were grouped appropriately during today's visit, therefore, an additional violation was not documented. Item 319- All classrooms, including the classroom designated for toddlers, had the staff/child ratios applicable to the classroom posted. An additional violation was not documented. Item 837-The EMC plan still had a former employee listed as the alternate person for choosing and carrying out the plan of action to obtain appropriate medical care. An additional violation was documented. Item 862- The EMC plan was reviewed with the staff member on August 14, 2024. An additional violation was not documented. Item 873- An additional violation was documented as the EMC plan did not identify how to handle illness or other medical emergencies. Item 1756- All enhanced staff/child ratios were maintained. An additional violation was not documented. Items 812, 871, and 1911 were all corrected at the time of the visit. The following violations were cited during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In the space designated for toddlers, the activity plan was dated August 5-9, 2024. GS 110-91(12); .0508(a) 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Today's lunch menu consisted of ham and cheese sandwiches, however bologna was substituted and not recorded on the menu prior to being served. 10A NCAC 09 .0901(b) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person. .0802(a)(1)(A-B); 873 Center staff did not follow the EMC plan. The current plan still does not identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) All violations must be completed immediately. A compliance letter stating how you have corrected the violations and how compliance will be maintained is due to me by August 28, 2024. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Additional technical assistance was provided during today's visit regarding the emergency medical care plan. I explained to Ms. Sanders that the plan only addresses how the facility will identify and plan for minor and major injuries. It does not however, identify how it will identify and plan for illness and medical emergencies. Specific examples of an illness or medical emergency may include a diabetic crisis, anaphylaxis, which is an acute allergic reaction to an antigen, such as a bee sting, choking, fainting or collapsing, breathing problems, seizures, severe vomiting or diarrhea, poisoning, or signs of dehydration. Please revise your plan to ensure all items are addressed in accordance to the rule. As staffing changes occur, so must the changes to your emergency medical care plan. Those changes must be reviewed with staff annually or as they occur. As a reminder, the plan must be reviewed with all staff annually, regardless of changes. The allergy lists were updated on July 31, 2024 and current allergy lists were observed during today's visit in each classroom and the kitchen. Please remember to update allergy lists quarterly or as new children are enrolled, whichever comes first. I recommended that the lists include pictures of children so that those children with allergies are easily identifiable to floaters and/or substitutes. Thank you for your time today. Should you have any questions regarding today's visit, please do not hesitate to contact me at Teraesa.Leak@dhhs.nc.gov or by phone at 919-971-7765. 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: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 8/14/2024 Number Present: 50 Completed Date: 8/14/2024 Age: From 0 To 11 Total Minutes: 65 Time In: 11:35 AM Time Out: 12:40 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to monitor applicable child care requirements after a violation for staff/child ratios was cited during a complaint visit. Paula Davis, Child Care Consultant, was also present during today's visit. Limited monitoring of the child care requirements occurred during today's visit. The license was posted. We were unaccompanied as we completed a general walk-through of the indoor environment. Children were observed having lunch and going down for a nap. Items that were documented during the initial complaint visit conducted on July 31, 2024, were monitored for compliance: Item 318- The operator had not submitted a compliance letter at the time of the visit but said that one would be submitted by COB today. Children were grouped appropriately during today's visit, therefore, an additional violation was not documented. Item 319- All classrooms, including the classroom designated for toddlers, had the staff/child ratios applicable to the classroom posted. An additional violation was not documented. Item 837-The EMC plan still had a former employee listed as the alternate person for choosing and carrying out the plan of action to obtain appropriate medical care. An additional violation was documented. Item 862- The EMC plan was reviewed with the staff member on August 14, 2024. An additional violation was not documented. Item 873- An additional violation was documented as the EMC plan did not identify how to handle illness or other medical emergencies. Item 1756- All enhanced staff/child ratios were maintained. An additional violation was not documented. Items 812, 871, and 1911 were all corrected at the time of the visit. The following violations were cited during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In the space designated for toddlers, the activity plan was dated August 5-9, 2024. GS 110-91(12); .0508(a) 528 Food substitution was not of comparable food value or recorded on the menu prior to the meal or snack being served. Today's lunch menu consisted of ham and cheese sandwiches, however bologna was substituted and not recorded on the menu prior to being served. 10A NCAC 09 .0901(b) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person. .0802(a)(1)(A-B); 873 Center staff did not follow the EMC plan. The current plan still does not identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) All violations must be completed immediately. A compliance letter stating how you have corrected the violations and how compliance will be maintained is due to me by August 28, 2024. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Additional technical assistance was provided during today's visit regarding the emergency medical care plan. I explained to Ms. Sanders that the plan only addresses how the facility will identify and plan for minor and major injuries. It does not however, identify how it will identify and plan for illness and medical emergencies. Specific examples of an illness or medical emergency may include a diabetic crisis, anaphylaxis, which is an acute allergic reaction to an antigen, such as a bee sting, choking, fainting or collapsing, breathing problems, seizures, severe vomiting or diarrhea, poisoning, or signs of dehydration. Please revise your plan to ensure all items are addressed in accordance to the rule. As staffing changes occur, so must the changes to your emergency medical care plan. Those changes must be reviewed with staff annually or as they occur. As a reminder, the plan must be reviewed with all staff annually, regardless of changes. The allergy lists were updated on July 31, 2024 and current allergy lists were observed during today's visit in each classroom and the kitchen. Please remember to update allergy lists quarterly or as new children are enrolled, whichever comes first. I recommended that the lists include pictures of children so that those children with allergies are easily identifiable to floaters and/or substitutes. Thank you for your time today. Should you have any questions regarding today's visit, please do not hesitate to contact me at Teraesa.Leak@dhhs.nc.gov or by phone at 919-971-7765. 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: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 7/31/2024 Number Present: 36 Completed Date: 7/31/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:45 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit is to investigate a complaint received by the Division of Child Development and Early Education on July 22, 2024. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival we were greeted by, a caregiver in the classroom designated for the infants. She stated that the administrator, was down the hall. The administrator, later identified as A. Sanders, was observed exiting the classroom designated for toddlers. We explained the purpose of our visit and asked if she could accompany us during the walk-through. Ms. Sanders stated that she was currently being counted for ratio. Ms. Sanders was observed walking to the kitchen and requested that the cook go into what we believed was the classroom designated for toddlers. However, it was then determined that Ms. Sanders was needed for ratios in the classroom designated for infants and that there was only one caregiver present in a room with eight (8) children, including a school-aged child. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We were/were not accompanied as we conducted a general walk-through of the indoor and outdoor environments. A total of thirty-six (36) children were present during today’s visit. ALLEGATION(S): There is a concern that the Emergency Medical Care plan was not followed. We spoke with Ms. Sanders and interviewed one (1) employee. Each was given an opportunity to provide their perspective surrounding the allegation. In addition, we monitored two (2) staff files and one (1) children’s records. We requested a copy of the facilities emergency medical care plan and incident log. We determined that on or about July 11, 2024, a caregiver, M. Morgan, designated to work in the classroom for preschool aged children stated that a child had complained of itching prior to nap time. She went on to state that during nap time, the child began sneezing a lot and appeared to "not feel well". Ms. Morgan stated that because Thursday's are her early days, she left a note for the child's mom informing her that the child did not feel well. Some time after nap, the child was observed to have welts, hives, a rash and swollen eyes. Ms. Sanders stated that she reviewed the child's file to determine if the child had any known allergies. When she confirmed that there were no allergies documented, she placed a call to the child's mother and requested that she come to the facility immediately to pick up the child. The child did not return the next day, but was at the center the following week at which time the child's mother informed the facility that the child had in fact suffered from an allergic reaction. Ms. Sanders stated that she was told she still didn't know what the child was allergic to. During our interview with Ms. Morgan, she stated that the parent informed her that the child was not to have any of the particular food items resulting in the initial reaction until such time an allergy was confirmed. According to Ms. Morgan, those those items included pizza, green beans and pineapple. Ms. Morgan stated that the classroom menu was highlighted reflecting those particular foods, but that no changes were made to the allergy list. During our visit today, allergy lists were observed in each classroom and in the kitchen. Each of those lists stated that they were last updated on April 4, 2024. Additional names were added to the list in the kitchen but did not reflect when the names were added. During the week of July 15, 2024, the child was placed in a different classroom, and that caregiver was told what foods not to serve the child. However, the new caregiver forgot and the child was accidentally served pineapple. A call was placed to the child's mom immediately to inform her that the child had been served pineapple and was asked to pick the child up. The child no longer attends the facility. Based on statements made by staff and observations during today’s visit, the allegation is SUBSTANTIATED. The following violations were cited during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A seven (7)year old child was grouped with the infants. 10A NCAC 09 .0713(a)(6) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. The classroom designated for toddlers did not have the staff/child ratios form posted. .0713(a)(10), (c) & (f)(3); .2818(e) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One electrical outlet was uncovered in the classroom designated for toddlers. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person after the Assistant Director left her employment. .0802(a)(1)(A-B); 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last documented review of the EMC plan in one (1) staff file was completed on 01/27/2023. 10A NCAC 09 .0802(a) 871 Center staff did not comply with the safe sleep policy. Toys and stuffed animals were in a crib with a sleeping infant. 10A NCAC 09 .0606(a) 873 Center staff did not follow the EMC plan. The current plan does not have identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) 1756 Enhanced staff/child ratios and group sizes were not met. There were seven (7) infants in the classroom with one (1) teacher. 10A NCAC 09 .2818 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. The director did not mail the completed incident form to the Child Care Consultant. .0802(f) All violations must be corrected immediately. By August 14, 2024, please submit a compliance letter stating how you have corrected the violation and how compliance will be maintained in the future. In your letter, be sure to include your facility name, ID number, and item number for each violation. Should your compliance letter not be received by the imposed date, a return visit will occur, and the violations cited again. Failure to comply with the child care requirements may result in an Administrative Action against the facility. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Child Care Rule .0802 states that each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. (b) One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall: (1) be on the premises at all times; and (2) accompany children for off-premises activities. Child care rule .0802 (a)(1) requires that the plan identify one person and at least an alternate responsible for carrying out the plan. The facilities plan lists the director an assistant director, however Ms. Sanders stated that she currently does not have an Assistant Director and is currently looking to hire someone. Additionally, the plan only addresses serious injury and does not include instructions on how to address illness or other medical emergency. I stated to Ms. Sanders that the emergency medical care plan must be updated and include all items in accordance with the rule. As a reminder, any time medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven (7) calendar days after the incident. Please review the posted allergy forms throughout the facility, including the kitchen, and revise each one to reflect current allergy information for each child where applicable. This should be done routinely to ensure you have the most current information for the children enrolled at your facility. Due to the violations cited during today's visit, a return visit will occur in the near future to ensure compliance has been maintained. Should you have any questions regarding today's visit, please do not hesitate to contact me at the email address above. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0606 · Violation

Name of Operation: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 7/31/2024 Number Present: 36 Completed Date: 7/31/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:45 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit is to investigate a complaint received by the Division of Child Development and Early Education on July 22, 2024. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival we were greeted by, a caregiver in the classroom designated for the infants. She stated that the administrator, was down the hall. The administrator, later identified as A. Sanders, was observed exiting the classroom designated for toddlers. We explained the purpose of our visit and asked if she could accompany us during the walk-through. Ms. Sanders stated that she was currently being counted for ratio. Ms. Sanders was observed walking to the kitchen and requested that the cook go into what we believed was the classroom designated for toddlers. However, it was then determined that Ms. Sanders was needed for ratios in the classroom designated for infants and that there was only one caregiver present in a room with eight (8) children, including a school-aged child. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We were/were not accompanied as we conducted a general walk-through of the indoor and outdoor environments. A total of thirty-six (36) children were present during today’s visit. ALLEGATION(S): There is a concern that the Emergency Medical Care plan was not followed. We spoke with Ms. Sanders and interviewed one (1) employee. Each was given an opportunity to provide their perspective surrounding the allegation. In addition, we monitored two (2) staff files and one (1) children’s records. We requested a copy of the facilities emergency medical care plan and incident log. We determined that on or about July 11, 2024, a caregiver, M. Morgan, designated to work in the classroom for preschool aged children stated that a child had complained of itching prior to nap time. She went on to state that during nap time, the child began sneezing a lot and appeared to "not feel well". Ms. Morgan stated that because Thursday's are her early days, she left a note for the child's mom informing her that the child did not feel well. Some time after nap, the child was observed to have welts, hives, a rash and swollen eyes. Ms. Sanders stated that she reviewed the child's file to determine if the child had any known allergies. When she confirmed that there were no allergies documented, she placed a call to the child's mother and requested that she come to the facility immediately to pick up the child. The child did not return the next day, but was at the center the following week at which time the child's mother informed the facility that the child had in fact suffered from an allergic reaction. Ms. Sanders stated that she was told she still didn't know what the child was allergic to. During our interview with Ms. Morgan, she stated that the parent informed her that the child was not to have any of the particular food items resulting in the initial reaction until such time an allergy was confirmed. According to Ms. Morgan, those those items included pizza, green beans and pineapple. Ms. Morgan stated that the classroom menu was highlighted reflecting those particular foods, but that no changes were made to the allergy list. During our visit today, allergy lists were observed in each classroom and in the kitchen. Each of those lists stated that they were last updated on April 4, 2024. Additional names were added to the list in the kitchen but did not reflect when the names were added. During the week of July 15, 2024, the child was placed in a different classroom, and that caregiver was told what foods not to serve the child. However, the new caregiver forgot and the child was accidentally served pineapple. A call was placed to the child's mom immediately to inform her that the child had been served pineapple and was asked to pick the child up. The child no longer attends the facility. Based on statements made by staff and observations during today’s visit, the allegation is SUBSTANTIATED. The following violations were cited during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A seven (7)year old child was grouped with the infants. 10A NCAC 09 .0713(a)(6) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. The classroom designated for toddlers did not have the staff/child ratios form posted. .0713(a)(10), (c) & (f)(3); .2818(e) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One electrical outlet was uncovered in the classroom designated for toddlers. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person after the Assistant Director left her employment. .0802(a)(1)(A-B); 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last documented review of the EMC plan in one (1) staff file was completed on 01/27/2023. 10A NCAC 09 .0802(a) 871 Center staff did not comply with the safe sleep policy. Toys and stuffed animals were in a crib with a sleeping infant. 10A NCAC 09 .0606(a) 873 Center staff did not follow the EMC plan. The current plan does not have identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) 1756 Enhanced staff/child ratios and group sizes were not met. There were seven (7) infants in the classroom with one (1) teacher. 10A NCAC 09 .2818 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. The director did not mail the completed incident form to the Child Care Consultant. .0802(f) All violations must be corrected immediately. By August 14, 2024, please submit a compliance letter stating how you have corrected the violation and how compliance will be maintained in the future. In your letter, be sure to include your facility name, ID number, and item number for each violation. Should your compliance letter not be received by the imposed date, a return visit will occur, and the violations cited again. Failure to comply with the child care requirements may result in an Administrative Action against the facility. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Child Care Rule .0802 states that each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. (b) One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall: (1) be on the premises at all times; and (2) accompany children for off-premises activities. Child care rule .0802 (a)(1) requires that the plan identify one person and at least an alternate responsible for carrying out the plan. The facilities plan lists the director an assistant director, however Ms. Sanders stated that she currently does not have an Assistant Director and is currently looking to hire someone. Additionally, the plan only addresses serious injury and does not include instructions on how to address illness or other medical emergency. I stated to Ms. Sanders that the emergency medical care plan must be updated and include all items in accordance with the rule. As a reminder, any time medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven (7) calendar days after the incident. Please review the posted allergy forms throughout the facility, including the kitchen, and revise each one to reflect current allergy information for each child where applicable. This should be done routinely to ensure you have the most current information for the children enrolled at your facility. Due to the violations cited during today's visit, a return visit will occur in the near future to ensure compliance has been maintained. Should you have any questions regarding today's visit, please do not hesitate to contact me at the email address above. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0713 · Violation

Name of Operation: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 7/31/2024 Number Present: 36 Completed Date: 7/31/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:45 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit is to investigate a complaint received by the Division of Child Development and Early Education on July 22, 2024. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival we were greeted by, a caregiver in the classroom designated for the infants. She stated that the administrator, was down the hall. The administrator, later identified as A. Sanders, was observed exiting the classroom designated for toddlers. We explained the purpose of our visit and asked if she could accompany us during the walk-through. Ms. Sanders stated that she was currently being counted for ratio. Ms. Sanders was observed walking to the kitchen and requested that the cook go into what we believed was the classroom designated for toddlers. However, it was then determined that Ms. Sanders was needed for ratios in the classroom designated for infants and that there was only one caregiver present in a room with eight (8) children, including a school-aged child. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We were/were not accompanied as we conducted a general walk-through of the indoor and outdoor environments. A total of thirty-six (36) children were present during today’s visit. ALLEGATION(S): There is a concern that the Emergency Medical Care plan was not followed. We spoke with Ms. Sanders and interviewed one (1) employee. Each was given an opportunity to provide their perspective surrounding the allegation. In addition, we monitored two (2) staff files and one (1) children’s records. We requested a copy of the facilities emergency medical care plan and incident log. We determined that on or about July 11, 2024, a caregiver, M. Morgan, designated to work in the classroom for preschool aged children stated that a child had complained of itching prior to nap time. She went on to state that during nap time, the child began sneezing a lot and appeared to "not feel well". Ms. Morgan stated that because Thursday's are her early days, she left a note for the child's mom informing her that the child did not feel well. Some time after nap, the child was observed to have welts, hives, a rash and swollen eyes. Ms. Sanders stated that she reviewed the child's file to determine if the child had any known allergies. When she confirmed that there were no allergies documented, she placed a call to the child's mother and requested that she come to the facility immediately to pick up the child. The child did not return the next day, but was at the center the following week at which time the child's mother informed the facility that the child had in fact suffered from an allergic reaction. Ms. Sanders stated that she was told she still didn't know what the child was allergic to. During our interview with Ms. Morgan, she stated that the parent informed her that the child was not to have any of the particular food items resulting in the initial reaction until such time an allergy was confirmed. According to Ms. Morgan, those those items included pizza, green beans and pineapple. Ms. Morgan stated that the classroom menu was highlighted reflecting those particular foods, but that no changes were made to the allergy list. During our visit today, allergy lists were observed in each classroom and in the kitchen. Each of those lists stated that they were last updated on April 4, 2024. Additional names were added to the list in the kitchen but did not reflect when the names were added. During the week of July 15, 2024, the child was placed in a different classroom, and that caregiver was told what foods not to serve the child. However, the new caregiver forgot and the child was accidentally served pineapple. A call was placed to the child's mom immediately to inform her that the child had been served pineapple and was asked to pick the child up. The child no longer attends the facility. Based on statements made by staff and observations during today’s visit, the allegation is SUBSTANTIATED. The following violations were cited during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A seven (7)year old child was grouped with the infants. 10A NCAC 09 .0713(a)(6) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. The classroom designated for toddlers did not have the staff/child ratios form posted. .0713(a)(10), (c) & (f)(3); .2818(e) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One electrical outlet was uncovered in the classroom designated for toddlers. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person after the Assistant Director left her employment. .0802(a)(1)(A-B); 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last documented review of the EMC plan in one (1) staff file was completed on 01/27/2023. 10A NCAC 09 .0802(a) 871 Center staff did not comply with the safe sleep policy. Toys and stuffed animals were in a crib with a sleeping infant. 10A NCAC 09 .0606(a) 873 Center staff did not follow the EMC plan. The current plan does not have identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) 1756 Enhanced staff/child ratios and group sizes were not met. There were seven (7) infants in the classroom with one (1) teacher. 10A NCAC 09 .2818 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. The director did not mail the completed incident form to the Child Care Consultant. .0802(f) All violations must be corrected immediately. By August 14, 2024, please submit a compliance letter stating how you have corrected the violation and how compliance will be maintained in the future. In your letter, be sure to include your facility name, ID number, and item number for each violation. Should your compliance letter not be received by the imposed date, a return visit will occur, and the violations cited again. Failure to comply with the child care requirements may result in an Administrative Action against the facility. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Child Care Rule .0802 states that each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. (b) One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall: (1) be on the premises at all times; and (2) accompany children for off-premises activities. Child care rule .0802 (a)(1) requires that the plan identify one person and at least an alternate responsible for carrying out the plan. The facilities plan lists the director an assistant director, however Ms. Sanders stated that she currently does not have an Assistant Director and is currently looking to hire someone. Additionally, the plan only addresses serious injury and does not include instructions on how to address illness or other medical emergency. I stated to Ms. Sanders that the emergency medical care plan must be updated and include all items in accordance with the rule. As a reminder, any time medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven (7) calendar days after the incident. Please review the posted allergy forms throughout the facility, including the kitchen, and revise each one to reflect current allergy information for each child where applicable. This should be done routinely to ensure you have the most current information for the children enrolled at your facility. Due to the violations cited during today's visit, a return visit will occur in the near future to ensure compliance has been maintained. Should you have any questions regarding today's visit, please do not hesitate to contact me at the email address above. 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: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 7/31/2024 Number Present: 36 Completed Date: 7/31/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:45 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit is to investigate a complaint received by the Division of Child Development and Early Education on July 22, 2024. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival we were greeted by, a caregiver in the classroom designated for the infants. She stated that the administrator, was down the hall. The administrator, later identified as A. Sanders, was observed exiting the classroom designated for toddlers. We explained the purpose of our visit and asked if she could accompany us during the walk-through. Ms. Sanders stated that she was currently being counted for ratio. Ms. Sanders was observed walking to the kitchen and requested that the cook go into what we believed was the classroom designated for toddlers. However, it was then determined that Ms. Sanders was needed for ratios in the classroom designated for infants and that there was only one caregiver present in a room with eight (8) children, including a school-aged child. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We were/were not accompanied as we conducted a general walk-through of the indoor and outdoor environments. A total of thirty-six (36) children were present during today’s visit. ALLEGATION(S): There is a concern that the Emergency Medical Care plan was not followed. We spoke with Ms. Sanders and interviewed one (1) employee. Each was given an opportunity to provide their perspective surrounding the allegation. In addition, we monitored two (2) staff files and one (1) children’s records. We requested a copy of the facilities emergency medical care plan and incident log. We determined that on or about July 11, 2024, a caregiver, M. Morgan, designated to work in the classroom for preschool aged children stated that a child had complained of itching prior to nap time. She went on to state that during nap time, the child began sneezing a lot and appeared to "not feel well". Ms. Morgan stated that because Thursday's are her early days, she left a note for the child's mom informing her that the child did not feel well. Some time after nap, the child was observed to have welts, hives, a rash and swollen eyes. Ms. Sanders stated that she reviewed the child's file to determine if the child had any known allergies. When she confirmed that there were no allergies documented, she placed a call to the child's mother and requested that she come to the facility immediately to pick up the child. The child did not return the next day, but was at the center the following week at which time the child's mother informed the facility that the child had in fact suffered from an allergic reaction. Ms. Sanders stated that she was told she still didn't know what the child was allergic to. During our interview with Ms. Morgan, she stated that the parent informed her that the child was not to have any of the particular food items resulting in the initial reaction until such time an allergy was confirmed. According to Ms. Morgan, those those items included pizza, green beans and pineapple. Ms. Morgan stated that the classroom menu was highlighted reflecting those particular foods, but that no changes were made to the allergy list. During our visit today, allergy lists were observed in each classroom and in the kitchen. Each of those lists stated that they were last updated on April 4, 2024. Additional names were added to the list in the kitchen but did not reflect when the names were added. During the week of July 15, 2024, the child was placed in a different classroom, and that caregiver was told what foods not to serve the child. However, the new caregiver forgot and the child was accidentally served pineapple. A call was placed to the child's mom immediately to inform her that the child had been served pineapple and was asked to pick the child up. The child no longer attends the facility. Based on statements made by staff and observations during today’s visit, the allegation is SUBSTANTIATED. The following violations were cited during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A seven (7)year old child was grouped with the infants. 10A NCAC 09 .0713(a)(6) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. The classroom designated for toddlers did not have the staff/child ratios form posted. .0713(a)(10), (c) & (f)(3); .2818(e) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One electrical outlet was uncovered in the classroom designated for toddlers. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person after the Assistant Director left her employment. .0802(a)(1)(A-B); 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last documented review of the EMC plan in one (1) staff file was completed on 01/27/2023. 10A NCAC 09 .0802(a) 871 Center staff did not comply with the safe sleep policy. Toys and stuffed animals were in a crib with a sleeping infant. 10A NCAC 09 .0606(a) 873 Center staff did not follow the EMC plan. The current plan does not have identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) 1756 Enhanced staff/child ratios and group sizes were not met. There were seven (7) infants in the classroom with one (1) teacher. 10A NCAC 09 .2818 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. The director did not mail the completed incident form to the Child Care Consultant. .0802(f) All violations must be corrected immediately. By August 14, 2024, please submit a compliance letter stating how you have corrected the violation and how compliance will be maintained in the future. In your letter, be sure to include your facility name, ID number, and item number for each violation. Should your compliance letter not be received by the imposed date, a return visit will occur, and the violations cited again. Failure to comply with the child care requirements may result in an Administrative Action against the facility. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Child Care Rule .0802 states that each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. (b) One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall: (1) be on the premises at all times; and (2) accompany children for off-premises activities. Child care rule .0802 (a)(1) requires that the plan identify one person and at least an alternate responsible for carrying out the plan. The facilities plan lists the director an assistant director, however Ms. Sanders stated that she currently does not have an Assistant Director and is currently looking to hire someone. Additionally, the plan only addresses serious injury and does not include instructions on how to address illness or other medical emergency. I stated to Ms. Sanders that the emergency medical care plan must be updated and include all items in accordance with the rule. As a reminder, any time medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven (7) calendar days after the incident. Please review the posted allergy forms throughout the facility, including the kitchen, and revise each one to reflect current allergy information for each child where applicable. This should be done routinely to ensure you have the most current information for the children enrolled at your facility. Due to the violations cited during today's visit, a return visit will occur in the near future to ensure compliance has been maintained. Should you have any questions regarding today's visit, please do not hesitate to contact me at the email address above. 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 .2818 · Violation

Name of Operation: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 7/31/2024 Number Present: 36 Completed Date: 7/31/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:45 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit is to investigate a complaint received by the Division of Child Development and Early Education on July 22, 2024. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival we were greeted by, a caregiver in the classroom designated for the infants. She stated that the administrator, was down the hall. The administrator, later identified as A. Sanders, was observed exiting the classroom designated for toddlers. We explained the purpose of our visit and asked if she could accompany us during the walk-through. Ms. Sanders stated that she was currently being counted for ratio. Ms. Sanders was observed walking to the kitchen and requested that the cook go into what we believed was the classroom designated for toddlers. However, it was then determined that Ms. Sanders was needed for ratios in the classroom designated for infants and that there was only one caregiver present in a room with eight (8) children, including a school-aged child. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We were/were not accompanied as we conducted a general walk-through of the indoor and outdoor environments. A total of thirty-six (36) children were present during today’s visit. ALLEGATION(S): There is a concern that the Emergency Medical Care plan was not followed. We spoke with Ms. Sanders and interviewed one (1) employee. Each was given an opportunity to provide their perspective surrounding the allegation. In addition, we monitored two (2) staff files and one (1) children’s records. We requested a copy of the facilities emergency medical care plan and incident log. We determined that on or about July 11, 2024, a caregiver, M. Morgan, designated to work in the classroom for preschool aged children stated that a child had complained of itching prior to nap time. She went on to state that during nap time, the child began sneezing a lot and appeared to "not feel well". Ms. Morgan stated that because Thursday's are her early days, she left a note for the child's mom informing her that the child did not feel well. Some time after nap, the child was observed to have welts, hives, a rash and swollen eyes. Ms. Sanders stated that she reviewed the child's file to determine if the child had any known allergies. When she confirmed that there were no allergies documented, she placed a call to the child's mother and requested that she come to the facility immediately to pick up the child. The child did not return the next day, but was at the center the following week at which time the child's mother informed the facility that the child had in fact suffered from an allergic reaction. Ms. Sanders stated that she was told she still didn't know what the child was allergic to. During our interview with Ms. Morgan, she stated that the parent informed her that the child was not to have any of the particular food items resulting in the initial reaction until such time an allergy was confirmed. According to Ms. Morgan, those those items included pizza, green beans and pineapple. Ms. Morgan stated that the classroom menu was highlighted reflecting those particular foods, but that no changes were made to the allergy list. During our visit today, allergy lists were observed in each classroom and in the kitchen. Each of those lists stated that they were last updated on April 4, 2024. Additional names were added to the list in the kitchen but did not reflect when the names were added. During the week of July 15, 2024, the child was placed in a different classroom, and that caregiver was told what foods not to serve the child. However, the new caregiver forgot and the child was accidentally served pineapple. A call was placed to the child's mom immediately to inform her that the child had been served pineapple and was asked to pick the child up. The child no longer attends the facility. Based on statements made by staff and observations during today’s visit, the allegation is SUBSTANTIATED. The following violations were cited during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A seven (7)year old child was grouped with the infants. 10A NCAC 09 .0713(a)(6) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. The classroom designated for toddlers did not have the staff/child ratios form posted. .0713(a)(10), (c) & (f)(3); .2818(e) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One electrical outlet was uncovered in the classroom designated for toddlers. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person after the Assistant Director left her employment. .0802(a)(1)(A-B); 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last documented review of the EMC plan in one (1) staff file was completed on 01/27/2023. 10A NCAC 09 .0802(a) 871 Center staff did not comply with the safe sleep policy. Toys and stuffed animals were in a crib with a sleeping infant. 10A NCAC 09 .0606(a) 873 Center staff did not follow the EMC plan. The current plan does not have identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) 1756 Enhanced staff/child ratios and group sizes were not met. There were seven (7) infants in the classroom with one (1) teacher. 10A NCAC 09 .2818 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. The director did not mail the completed incident form to the Child Care Consultant. .0802(f) All violations must be corrected immediately. By August 14, 2024, please submit a compliance letter stating how you have corrected the violation and how compliance will be maintained in the future. In your letter, be sure to include your facility name, ID number, and item number for each violation. Should your compliance letter not be received by the imposed date, a return visit will occur, and the violations cited again. Failure to comply with the child care requirements may result in an Administrative Action against the facility. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Child Care Rule .0802 states that each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. (b) One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall: (1) be on the premises at all times; and (2) accompany children for off-premises activities. Child care rule .0802 (a)(1) requires that the plan identify one person and at least an alternate responsible for carrying out the plan. The facilities plan lists the director an assistant director, however Ms. Sanders stated that she currently does not have an Assistant Director and is currently looking to hire someone. Additionally, the plan only addresses serious injury and does not include instructions on how to address illness or other medical emergency. I stated to Ms. Sanders that the emergency medical care plan must be updated and include all items in accordance with the rule. As a reminder, any time medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven (7) calendar days after the incident. Please review the posted allergy forms throughout the facility, including the kitchen, and revise each one to reflect current allergy information for each child where applicable. This should be done routinely to ensure you have the most current information for the children enrolled at your facility. Due to the violations cited during today's visit, a return visit will occur in the near future to ensure compliance has been maintained. Should you have any questions regarding today's visit, please do not hesitate to contact me at the email address above. 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: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: TERAESA LEAK Operation Type: Center Case Number: 0724-256L Visit Date: 7/31/2024 Number Present: 36 Completed Date: 7/31/2024 Age: From 0 To 11 Total Minutes: 150 Time In: 09:45 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit is to investigate a complaint received by the Division of Child Development and Early Education on July 22, 2024. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival we were greeted by, a caregiver in the classroom designated for the infants. She stated that the administrator, was down the hall. The administrator, later identified as A. Sanders, was observed exiting the classroom designated for toddlers. We explained the purpose of our visit and asked if she could accompany us during the walk-through. Ms. Sanders stated that she was currently being counted for ratio. Ms. Sanders was observed walking to the kitchen and requested that the cook go into what we believed was the classroom designated for toddlers. However, it was then determined that Ms. Sanders was needed for ratios in the classroom designated for infants and that there was only one caregiver present in a room with eight (8) children, including a school-aged child. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We were/were not accompanied as we conducted a general walk-through of the indoor and outdoor environments. A total of thirty-six (36) children were present during today’s visit. ALLEGATION(S): There is a concern that the Emergency Medical Care plan was not followed. We spoke with Ms. Sanders and interviewed one (1) employee. Each was given an opportunity to provide their perspective surrounding the allegation. In addition, we monitored two (2) staff files and one (1) children’s records. We requested a copy of the facilities emergency medical care plan and incident log. We determined that on or about July 11, 2024, a caregiver, M. Morgan, designated to work in the classroom for preschool aged children stated that a child had complained of itching prior to nap time. She went on to state that during nap time, the child began sneezing a lot and appeared to "not feel well". Ms. Morgan stated that because Thursday's are her early days, she left a note for the child's mom informing her that the child did not feel well. Some time after nap, the child was observed to have welts, hives, a rash and swollen eyes. Ms. Sanders stated that she reviewed the child's file to determine if the child had any known allergies. When she confirmed that there were no allergies documented, she placed a call to the child's mother and requested that she come to the facility immediately to pick up the child. The child did not return the next day, but was at the center the following week at which time the child's mother informed the facility that the child had in fact suffered from an allergic reaction. Ms. Sanders stated that she was told she still didn't know what the child was allergic to. During our interview with Ms. Morgan, she stated that the parent informed her that the child was not to have any of the particular food items resulting in the initial reaction until such time an allergy was confirmed. According to Ms. Morgan, those those items included pizza, green beans and pineapple. Ms. Morgan stated that the classroom menu was highlighted reflecting those particular foods, but that no changes were made to the allergy list. During our visit today, allergy lists were observed in each classroom and in the kitchen. Each of those lists stated that they were last updated on April 4, 2024. Additional names were added to the list in the kitchen but did not reflect when the names were added. During the week of July 15, 2024, the child was placed in a different classroom, and that caregiver was told what foods not to serve the child. However, the new caregiver forgot and the child was accidentally served pineapple. A call was placed to the child's mom immediately to inform her that the child had been served pineapple and was asked to pick the child up. The child no longer attends the facility. Based on statements made by staff and observations during today’s visit, the allegation is SUBSTANTIATED. The following violations were cited during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A seven (7)year old child was grouped with the infants. 10A NCAC 09 .0713(a)(6) 319 Staff/child ratios applicable to a classroom, were not posted in each classroom. The classroom designated for toddlers did not have the staff/child ratios form posted. .0713(a)(10), (c) & (f)(3); .2818(e) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. One electrical outlet was uncovered in the classroom designated for toddlers. 10A NCAC 09 .0604(c) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The plan was not revised to identify an alternate person after the Assistant Director left her employment. .0802(a)(1)(A-B); 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The last documented review of the EMC plan in one (1) staff file was completed on 01/27/2023. 10A NCAC 09 .0802(a) 871 Center staff did not comply with the safe sleep policy. Toys and stuffed animals were in a crib with a sleeping infant. 10A NCAC 09 .0606(a) 873 Center staff did not follow the EMC plan. The current plan does not have identify how to handle illness or other medical emergencies. 10A NCAC 09.0802(a) 1756 Enhanced staff/child ratios and group sizes were not met. There were seven (7) infants in the classroom with one (1) teacher. 10A NCAC 09 .2818 1911 An incident report was not completed and mailed to a Division representative within seven days after the incident when medical treatment was required. The director did not mail the completed incident form to the Child Care Consultant. .0802(f) All violations must be corrected immediately. By August 14, 2024, please submit a compliance letter stating how you have corrected the violation and how compliance will be maintained in the future. In your letter, be sure to include your facility name, ID number, and item number for each violation. Should your compliance letter not be received by the imposed date, a return visit will occur, and the violations cited again. Failure to comply with the child care requirements may result in an Administrative Action against the facility. You may submit the letter to me by email at Teraesa.Leak@dhhs.nc.gov. TECHNICAL ASSISTANCE: Child Care Rule .0802 states that each child care center shall have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information shall be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. (b) One person identified as the person or alternate responsible for carrying out the emergency medical care plan and ensuring that appropriate medical care is given shall: (1) be on the premises at all times; and (2) accompany children for off-premises activities. Child care rule .0802 (a)(1) requires that the plan identify one person and at least an alternate responsible for carrying out the plan. The facilities plan lists the director an assistant director, however Ms. Sanders stated that she currently does not have an Assistant Director and is currently looking to hire someone. Additionally, the plan only addresses serious injury and does not include instructions on how to address illness or other medical emergency. I stated to Ms. Sanders that the emergency medical care plan must be updated and include all items in accordance with the rule. As a reminder, any time medical treatment is required by a health care professional, community clinic, or local health department as a result of an incident occurring while the child is in care, a copy of the incident report shall be mailed to a representative of the Division within seven (7) calendar days after the incident. Please review the posted allergy forms throughout the facility, including the kitchen, and revise each one to reflect current allergy information for each child where applicable. This should be done routinely to ensure you have the most current information for the children enrolled at your facility. Due to the violations cited during today's visit, a return visit will occur in the near future to ensure compliance has been maintained. Should you have any questions regarding today's visit, please do not hesitate to contact me at the email address above. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: KID'S COUNTRY OF CLAYTON, INC Facility ID: 51000847 Consultant: KATISHA FARMER Operation Type: Center Case Number: 0224-192A Visit Date: 2/21/2024 Number Present: 41 Completed Date: 2/21/2024 Age: From 0 To 5 Total Minutes: 75 Time In: 11:00 AM Time Out: 12:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of this unannounced visit was to investigate allegations of violations of child care requirements at this child care facility. Angela Sanders, Director, accompanied me during a walk-through of the facility. During the visit, I discussed the allegations with Ms. Sanders. Limited monitoring of child care requirements occurred during today’s visit. No violations were observed and/or confirmed during today’s visit. Violation Number Comment Rule 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. A staff member grabbed a one-year-old child by one arm as well as aggressively placed a child on the changing table, resulting in the two-year-old child hitting their head. G.S. 110-91(10) You may contact me Katisha Farmer, Investigations Consultant, 252 373-8547, email Katisha.farmer@dhhs.nc.gov or Supervisor, Corrie Davenport at corrie.davenport@dhhs.nc.gov Thank you for your time. 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