G.S. 110-90 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 11/18/2025 Number Present: 90 Completed Date: 11/18/2025 Age: From 0 To 5 Total Minutes: 118 Time In: 09:57 AM Time Out: 11:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Amy Sigmon, Administrator, assisted me with today’s visit. Your program currently operates with a notice of compliance issued August 10, 2015. The permit restrictions were in compliance, including first shift (daytime care). The Secretary of State website was checked on November 18, 2025, and your business, Cramerton Free Will Baptist Church, Inc., was active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. The last sanitation inspection was conducted on May 5, 2025, 2025. A “superior” classification was issued with zero (0) demerits noted on the grade card. The last fire inspection was conducted on September 3, 2025. The most recent fire drill was conducted on November 11, 2025, the most recent emergency drill was conducted on September 11, 2025, and the most recent playground inspection was conducted on September 5, 2025. You received the results of your most recent lead water testing showing no levels of lead above the allowed amount, on August 2, 2023. Per the facility data on the Clean Classrooms for Carolina Kids website, your facility is exempt from lead-based paint and asbestos testing. I reviewed the ABCMS provider portal for your facility during the visit. Eight (8) current staff members are entered. You stated you have completed the Moodle Training for the ABCMS Provider Portal and have been unable to get staff members who had an existing qualifying letter entered into the portal. I provided you with the ABCMS Provider Portal Access Guide via email during the visit. Information in the ABCMS Provider Portal should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-6401 and someone will assist you. A walk-through of the facility was completed today, and all indoor and outdoor areas were monitored. I observed children in the indoor and outdoor learning environment. Children throughout the facility were participating in routines, lunch, group time, free play, and outdoor play during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training, and Criminal Background Checks. Three (3) new staff members were hired since the last visit. The following violation was observed/documented during the visit: Violation Number Comment Rule 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The most recent playground inspection was conducted on September 5, 2025. .0605(q) The violation documented must be corrected immediately. On or before December 2, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected, and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit, and license ID number in the letter. 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, it may be considered falsification of information. If sufficient information is not received by the due date, an unannounced follow-up visit may be conducted. 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. Please send your letter to christine.rosinski@dhhs.nc.gov. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 90%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. A monthly playground inspection must be conducted by an individual trained in playground safety requirements. A trained administrator or staff person must make a record of each inspection using a playground inspection checklist provided by the Division. The checklist is to be signed by the person who conducts the inspection and must be maintained for 12 months in the center's files for review by a representative of the Division. Continue to use the playground inspection checklist provided by DCDEE. This checklist may also be accessed through the following link: https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/P/Playground_Inspection_Checklist.pdf?ver=CxfeyCmo15O0_ztbu2--ng%3d%3d. I suggested you plan to conduct the playground inspections on the same day fire drills are conducted to ensure a month does not get skipped. After completion of the inspection, I suggested you immediately complete the documentation of the check on the checklist and place the inspection checklist in your playground inspection folder to ensure it is on file and available for review at all times. Consultation We discussed the QRIS Modernization and the Pathway to the Stars. I encouraged you to visit the QRIS Modernization website to review information regarding the changes to the rated license process. Information on the three (3) pathway options, as well as links to upcoming webinars may be found on the DCDEE QRIS Modernization website: https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization. You stated you do not wish to apply for a two (2) through five (5) star rated license and will maintain your notice of compliance. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 6/4/2025 Number Present: 69 Completed Date: 6/4/2025 Age: From 0 To 5 Total Minutes: 242 Time In: 08:23 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements for a religious sponsored facility. Your facility does not accept subsidy. You, Amy Sigmon, Administrator, assisted with today’s visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a notice of compliance issued August 10, 2015. The permit restrictions were in compliance including First Shift (daytime care). The Secretary of State website was checked on June 4, 2025, and your business, Cramerton Free Will Baptist Church, Inc., was active an in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today. All indoor and outdoor areas were monitored. I observed children throughout the facility participating in infant feeding, routines, group time, outdoor play, free play, lunch, and nap during the visit. During nap today, all staff members were instructed to allow enough light into the room through the windows or use overhead lighting to be able to visualize and respond to all children as needed throughout the room at all times during nap. The last sanitation inspection was conducted on May 5, 2025. A “superior” classification was issued with zero (0) demerits noted on the grade card. The last fire inspection was conducted on June 3, 2025. The last fire drill was conducted on May 8, 2025. The last emergency drill was conducted on March 6, 2025. The last playground inspection was conducted on May 2, 2025. You received the results of your most recent lead water testing showing no levels of lead above the allowed amount, on August 2, 2023. Per the facility data on the Clean Classrooms for Carolina Kids website, your facility is exempt from lead-based paint and asbestos testing. Nine (9) children’s files were reviewed during the visit. Two (2) new staff files and two (2) existing staff files were reviewed during the visit. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #2, there was no thermometer in the mini refrigerator used to store food and beverages for children. 15A NCAC 18A .2806(j)(2) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space #5, one (1) bottle of Gorilla Wood Glue with multiple warnings, was in an unlocked drawer to the right of the food preparation area, accessible to children. In Space #5, one (1) bottle of Elmers No Wrinkle Rubber Cement with multiple warnings, was in an unlocked cabinet behind the diaper changing table, accessible to children. .2820(b) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. The First Aid certification for one (1) staff member, employed on August 11, 2021, expired February 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. The CPR certification for one (1) staff member, employed on August 11, 2021, expired February 2025. .1102(d) The violations documented must be corrected immediately. On or before June 18, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected, and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit, and license ID number in the letter. 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, it may be considered falsification of information. If sufficient information is not received by the due date, an unannounced follow-up visit may be conducted. 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. Please send your letter to christine.rosinski@dhhs.nc.gov. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 87%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. All hazardous items with multiple warnings and items in aerosol containers must be kept in locked storage. Items labeled “keep out of reach of children” with no other warnings may be stored five (5) feet off the ground. I suggested you remind staff check their classroom thoroughly each morning to ensure all hazardous products are stored properly. I also suggested you review this information with all staff members to ensure they can understand which items need to be locked based on warning labels. You removed the hazardous products from the classroom and placed them in locked storage during the visit. 2. Potentially hazardous food requiring refrigeration after preparation, including infant bottles, must be stored at a temperature of 45°F or below. I reminded you that in order to monitor refrigerator temperature, a thermometer must be placed in every refrigerator used to store food and bottles for infants and children to ensure the proper temperature is maintained. I suggested you keep extra thermometers on site to replace any thermometers in refrigerators when needed. You had an extra thermometer on-site and placed it in the refrigerator in Space #2 during the visit. 3. All staff members must maintain active CPR/First Aid certification. New staff members have ninety days from their date of hire to complete the training. I suggested you schedule CPR/First Aid Training for all new staff during their hiring process. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. I suggested you review the Partnership for Children of Lincoln and Gaston County’s training calendar at https://www.eventbrite.com/o/partnership-for-children-of-lincoln-amp-gaston-counties-45331112 for upcoming CPR/First Aid Training Courses. Consultation: As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. I provided you with a copy of the North Carolina Foundations for Early Learning and Development Book during the visit. Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 12/2/2024 Number Present: 80 Completed Date: 12/2/2024 Age: From 0 To 5 Total Minutes: 141 Time In: 08:34 AM Time Out: 10:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Amy Sigmon, Administrator, assisted me with today’s visit. Your program currently operates with a notice of compliance issued August 10, 2015. The permit restrictions were in compliance including First Shift (daytime care). The Secretary of State website was checked on December 2, 2024, and your business, Cramerton Free Will Baptist Church, Inc., was active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. The last sanitation inspection was conducted on October 29, 2024. A “superior” classification was issued with zero (0) demerits noted on the grade card. The last fire inspection was conducted on February 16, 2024. The most recent fire drill was conducted on November 22, 2024, the most recent emergency drill was conducted on September 6, 2024, and the most recent playground inspection was conducted on November 4, 2024. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor and outdoor learning environment. Children throughout the facility were participating in routines, breakfast, free play, group time and outdoor play during the visit. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training, and Criminal Background Checks. No new staff members were hired since the last visit. The following violation was observed/documented during the visit: Violation Number Comment Rule 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space #6a, there was no permission to administer medication form for one (1) bottle of Children’s Tylenol Oral Suspension. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) The violation documented must be corrected immediately. On or before December 16, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violation was corrected, and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit, and license ID number in the letter. 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, it may be considered falsification of information. If sufficient information is not received by the due date, an unannounced follow-up visit may be conducted. 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. Please send your letter to christine.rosinski@dhhs.nc.gov. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 86%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Standing permission to administer medications for chronic illnesses may be given for up to six (6) months. I suggested you remind teachers to check medications and permission to administer medication forms when initially brought in and regularly thereafter to ensure all medications have an accompanying permission to administer medication from and that the forms have not expired. I also suggested you keep extra permission to administer medication forms in each classroom for parents to complete when a new medication is brought into the facility. Consultation For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 6/25/2024 Number Present: 60 Completed Date: 6/25/2024 Age: From 0 To 5 Total Minutes: 227 Time In: 08:08 AM Time Out: 11:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety requirements. You, Amy Sigmon, Administrator, assisted with today’s visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a notice of compliance issued August 10, 2015. The permit restrictions were in compliance including First Shift (daytime care). The Secretary of State website was checked on June 25, 2024, and your business, Cramerton Free Will Baptist Church, Inc, was active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor and outdoor learning environment. Children throughout the facility were participating in routines, group time, free play, nap and outdoor play during the visit. The last sanitation inspection was conducted on January 30, 2024. A “superior” classification was issued with two (2) demerits noted on the grade card. The last fire inspection was conducted on February 16, 2024. The last fire drill was conducted on June 12, 2024. The last emergency drill was conducted on June 7, 2024. The last playground inspection was conducted on June 6, 2024. Nine (9) children’s files were reviewed during the visit. Six (6) new staff files and three (3) existing staff files were reviewed during the visit. The following violation was observed/documented during today’s visit: Violation Number Comment Rule 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space #1, the Permission to Administer Medication Form for one (1) tube of Gentle Steps Maximum Strength Diaper Rash Paste expired on June 21, 2024. In Space #2, the Permission to Administer Medication Form for one (1) container of Aquaphor Healing Ointment Baby did not include a parent signature, the date the parent signed the form, or the date the permission expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) The violation documented must be corrected immediately. On or before June 9, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violation was corrected, and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit, and license ID number in the letter. 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, it may be considered falsification of information. If sufficient information is not received by the due date, an unannounced follow-up visit may be conducted. 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. Please send your letter to christine.rosinski@dhhs.nc.gov. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 81%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Standing permission to administer medications for chronic illnesses may be given for up to six (6) months. A new Permission to Administer Medication for Chronic Medical Conditions form must be completed by the child’s guardian at least every six (6) months. Standing permission to administer over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, may be given for up to twelve (12) months. I suggested you have teachers check medications and permission forms on the date the monthly fire inspection occurs (or on a date at least monthly) to ensure no medication or permission forms are expired. Staff members should also check Permission to Administer Medication Forms when brought into the facility to ensure they are filled out completely. Consultation: Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .0304 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 2/7/2024 Number Present: 84 Completed Date: 2/7/2024 Age: From 0 To 5 Total Minutes: 152 Time In: 10:18 AM Time Out: 12:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Amy Sigmon, Administrator, assisted me with today’s visit. Your program currently operates with a notice of compliance issued August 10, 2015. The permit restrictions were in compliance including First Shift (daytime care). The Secretary of State website was checked on February 7, 2024, and your business, Cramerton Free Will Baptist Church, was active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment. Children throughout the facility were participating in routines, lunch, free play, group time, and nap. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training, and Criminal Background Checks. Eight (8) new staff members were hired since the last visit. The most recent sanitation inspection for your facility was conducted on January 30, 2024. A superior sanitation classification was issued with two (2) demerits. The most recent approved fire inspection for your facility was conducted on October 7, 2022. You stated the fire doors in the facility were in need of repair prior to an inspection. You stated the fire doors have been repaired and the Fire Marshal has been contacted to request an inspection. The following violations were observed/documented during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last approved fire inspection of the facility was conducted on October 7, 2022. 10A NCAC 09 .0304(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space #6a, one (1) bottle of St. Ives Hydrating Vitamin E and Avocado Body Lotion with multiple warnings, was on top of the five (5) draw filing cabinet to the right of the teacher’s desk. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space #1, one (1) tube of Aquaphor Healing Ointment Baby Advanced Therapy expired June 2022. In Space #1, the Permission to Administer Medication Form for one (1) container of Aquaphor Healing Ointment Baby Advanced Therapy expired on January 4, 2024. In Space #5, the Permission to Administer Medication Form for one (1) container of Earth Mama Baby Organic Diaper Balm expired on January 2, 2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member, employed on September 11, 2023, one (1) staff member, employed on October 16, 2023, one (1) staff member, employed on October 18, 2023, and two (2) staff members, both employed on October 26, 2023, did not complete First Aid Training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member, employed on September 11, 2023, one (1) staff member, employed on October 16, 2023, one (1) staff member, employed on October 18, 2023, and two (2) staff members, employed on October 26, 2023, did not complete CPR Training. .1102(d) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by February 21, 2024. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. 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. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 85%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Each operator must schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. The operator must notify the local fire inspector when it is time for the center's annual fire inspection. The operator must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. I suggested you contact the Fire Inspector at least one (1) month prior to the due date of the next fire inspection to ensure an approved inspection is obtained in a timely manner. 2. All hazardous items with multiple warnings and items in aerosol containers must be kept in locked storage. Items labeled “keep out of reach of children” with no other warnings can be stored five (5) feet off the ground. Have staff check their classroom thoroughly each morning to ensure all hazardous products are stored properly. The lotion was removed from the classroom and placed in locked storage during the visit. You stated all items with multiple warnings will be kept in locked storage. 3. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization or medication has expired must be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, should be discarded. Standing permission to administer medications for chronic illnesses may be given for up to six (6) months. Standing permission to administer over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, may be given for up to twelve (12) months. Teachers should periodically check medications and permission forms to ensure no medication or permission forms are expired. Continue to use the Permission to Administer Medication for Chronic Medical Conditions form and the Medication Administration Permission for Over-the-Counter Topical Medications and Fluoridated Toothpaste form found on the Division of Child Development and Early Education’s website under the “Provider” tab. 4. All staff members must maintain active CPR/First Aid certification. New staff members have ninety days from their date of hire to complete the training. For existing staff, schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. One (1) staff member who has not completed CPR/First Aid Training is scheduled to complete the training on February 13, 2024, through the Partnership for Children of Lincoln and Gaston Counties (PFCLG). I suggested to reach out to PFCLG to register additional staff members for the upcoming training. Consultation For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 2/7/2024 Number Present: 84 Completed Date: 2/7/2024 Age: From 0 To 5 Total Minutes: 152 Time In: 10:18 AM Time Out: 12:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Amy Sigmon, Administrator, assisted me with today’s visit. Your program currently operates with a notice of compliance issued August 10, 2015. The permit restrictions were in compliance including First Shift (daytime care). The Secretary of State website was checked on February 7, 2024, and your business, Cramerton Free Will Baptist Church, was active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in the indoor learning environment. Children throughout the facility were participating in routines, lunch, free play, group time, and nap. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, Special Training, and Criminal Background Checks. Eight (8) new staff members were hired since the last visit. The most recent sanitation inspection for your facility was conducted on January 30, 2024. A superior sanitation classification was issued with two (2) demerits. The most recent approved fire inspection for your facility was conducted on October 7, 2022. You stated the fire doors in the facility were in need of repair prior to an inspection. You stated the fire doors have been repaired and the Fire Marshal has been contacted to request an inspection. The following violations were observed/documented during today's visit: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The last approved fire inspection of the facility was conducted on October 7, 2022. 10A NCAC 09 .0304(a) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space #6a, one (1) bottle of St. Ives Hydrating Vitamin E and Avocado Body Lotion with multiple warnings, was on top of the five (5) draw filing cabinet to the right of the teacher’s desk. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In Space #1, one (1) tube of Aquaphor Healing Ointment Baby Advanced Therapy expired June 2022. In Space #1, the Permission to Administer Medication Form for one (1) container of Aquaphor Healing Ointment Baby Advanced Therapy expired on January 4, 2024. In Space #5, the Permission to Administer Medication Form for one (1) container of Earth Mama Baby Organic Diaper Balm expired on January 2, 2024. .0803(12) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One (1) staff member, employed on September 11, 2023, one (1) staff member, employed on October 16, 2023, one (1) staff member, employed on October 18, 2023, and two (2) staff members, both employed on October 26, 2023, did not complete First Aid Training. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One (1) staff member, employed on September 11, 2023, one (1) staff member, employed on October 16, 2023, one (1) staff member, employed on October 18, 2023, and two (2) staff members, employed on October 26, 2023, did not complete CPR Training. .1102(d) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by February 21, 2024. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. 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. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 85%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Each operator must schedule and obtain a fire inspection within 12 months of the facility’s previous fire inspection. The operator must notify the local fire inspector when it is time for the center's annual fire inspection. The operator must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. I suggested you contact the Fire Inspector at least one (1) month prior to the due date of the next fire inspection to ensure an approved inspection is obtained in a timely manner. 2. All hazardous items with multiple warnings and items in aerosol containers must be kept in locked storage. Items labeled “keep out of reach of children” with no other warnings can be stored five (5) feet off the ground. Have staff check their classroom thoroughly each morning to ensure all hazardous products are stored properly. The lotion was removed from the classroom and placed in locked storage during the visit. You stated all items with multiple warnings will be kept in locked storage. 3. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization or medication has expired must be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, should be discarded. Standing permission to administer medications for chronic illnesses may be given for up to six (6) months. Standing permission to administer over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, may be given for up to twelve (12) months. Teachers should periodically check medications and permission forms to ensure no medication or permission forms are expired. Continue to use the Permission to Administer Medication for Chronic Medical Conditions form and the Medication Administration Permission for Over-the-Counter Topical Medications and Fluoridated Toothpaste form found on the Division of Child Development and Early Education’s website under the “Provider” tab. 4. All staff members must maintain active CPR/First Aid certification. New staff members have ninety days from their date of hire to complete the training. For existing staff, schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. One (1) staff member who has not completed CPR/First Aid Training is scheduled to complete the training on February 13, 2024, through the Partnership for Children of Lincoln and Gaston Counties (PFCLG). I suggested to reach out to PFCLG to register additional staff members for the upcoming training. Consultation For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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 .0802 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 7/18/2023 Number Present: 60 Completed Date: 7/18/2023 Age: From 0 To 5 Total Minutes: 215 Time In: 08:20 AM Time Out: 11:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety requirements. You, Amy Sigmon, Administrator, assisted me with today’s visit. A checklist was used to note the requirements I monitored today. The NC Secretary of State website was viewed before the visit and Cramerton Free Will Baptist Church, Inc. was current/active. You reported no changes in ownership to the facility. The last sanitation inspection was conducted on May 3, 2023. A “superior” classification was issued with two (2) demerits noted on the grade card. The last fire inspection was conducted on October 7, 2022. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The facility’s Emergency Medical Care Plan was not reviewed with any staff members within the past year. 10A NCAC 09 .0802(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information for one (1) child, enrolled on June 2, 2022, was last updated on June 28, 2022. The emergency information for one (1) child, enrolled on April 12, 2021, was last updated on June 29, 2022. The emergency information for one (1) child, enrolled on December 9, 2020 was last updated on June 28, 2022. The emergency information for one (1) child, enrolled on January 18, 2021 was last updated on June 30, 2022. The emergency information for one (1) child, enrolled on January 31, 2022 was last updated on June 27, 2022. .0802(c) 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. The facility’s Emergency Preparedness and Response plan was not reviewed with any staff members within the past year. .0607(f) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space #1, the Permission to Administer Medication Forms for one (1) container of Triple Paste Diaper Rash Cream expired on April 7, 2023, one (1) bottle of Boogie Diaper Rash Spray expired on May 31, 2023, and one (1) bottle of Zarbees Childrens Cough Syrup expired on February 1, 2023. In Space #2, the Permission to Administer Medication Forms for One (1) Albuterol Sulfate Inhalation Aerosol expired on May 15, 2023, and one (1) tube of Aquaphor Healing Ointment Baby Diaper Rash Cream expired on February 1, 2023. In Space #6a, the Permission to Administer Medication Forms for one (1) bottle of Childrens Motrin Oral Suspension expired on June 30, 2023, and one (1) bottle of Childrens Benadryl Antihistamine Oral Solution expired on June 30, 2023. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by August 1, 2023. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. 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. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 89%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan must 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 is to 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. I suggested you review the facility’s Emergency Medical Care Plan with all staff at the same time that you review the facility’s Emergency Preparedness and Response Plan. Keep an agenda and a sign in sheet indicating the information reviewed and the staff members present during the review. 2. Emergency medical care information must be on file for each child. That information must include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information must be on file in the center on the child's first day of attendance and must be updated as changes occur and at least annually. I suggested you create a schedule to have all families update emergency information regularly to ensure the information is updated at least annually. You stated updated emergency information forms have been disseminated to families and you are waiting for them to be turned in. 3. All staff members must review the center's Emergency Preparedness and Response Plan when hired and on an annual basis thereafter with the staff member trained in Emergency Preparedness and Response. Documentation of the review must be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. All substitutes and volunteers counted in ratio must be informed of the child care center's Emergency Preparedness and Response Plan and its location. Documentation of this notice must be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. I suggested you review your facility’s Emergency Preparedness and Response Plan during a staff meeting with all staff members after you review and update the plan each year. Keep an agenda and a sign in sheet indicating the information reviewed and the staff members present during the review. 4. Standing permission to administer medications for chronic illnesses may be given for up to six (6) months. A new Permission to Administer Medication for Chronic Medical Conditions form must be completed by the child’s guardian at least every six (6) months. Standing permission to administer over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, may be given for up to twelve (12) months. I suggested that teachers check medications and permission forms at least once a month to ensure no medication or permission forms are expired. I suggested you continue to use the Permission to Administer Medication for Chronic Medical Conditions form and the Medication Administration Permission for Over-the-Counter Topical Medications and Fluoridated Toothpaste forms found on the Division’s website under the “Provider” tab. Consultation: Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: CRAMERTON FWB CHILD CARE Facility ID: 3659017 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 7/18/2023 Number Present: 60 Completed Date: 7/18/2023 Age: From 0 To 5 Total Minutes: 215 Time In: 08:20 AM Time Out: 11:55 AM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety requirements. You, Amy Sigmon, Administrator, assisted me with today’s visit. A checklist was used to note the requirements I monitored today. The NC Secretary of State website was viewed before the visit and Cramerton Free Will Baptist Church, Inc. was current/active. You reported no changes in ownership to the facility. The last sanitation inspection was conducted on May 3, 2023. A “superior” classification was issued with two (2) demerits noted on the grade card. The last fire inspection was conducted on October 7, 2022. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The facility’s Emergency Medical Care Plan was not reviewed with any staff members within the past year. 10A NCAC 09 .0802(a) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information for one (1) child, enrolled on June 2, 2022, was last updated on June 28, 2022. The emergency information for one (1) child, enrolled on April 12, 2021, was last updated on June 29, 2022. The emergency information for one (1) child, enrolled on December 9, 2020 was last updated on June 28, 2022. The emergency information for one (1) child, enrolled on January 18, 2021 was last updated on June 30, 2022. The emergency information for one (1) child, enrolled on January 31, 2022 was last updated on June 27, 2022. .0802(c) 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. The facility’s Emergency Preparedness and Response plan was not reviewed with any staff members within the past year. .0607(f) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In Space #1, the Permission to Administer Medication Forms for one (1) container of Triple Paste Diaper Rash Cream expired on April 7, 2023, one (1) bottle of Boogie Diaper Rash Spray expired on May 31, 2023, and one (1) bottle of Zarbees Childrens Cough Syrup expired on February 1, 2023. In Space #2, the Permission to Administer Medication Forms for One (1) Albuterol Sulfate Inhalation Aerosol expired on May 15, 2023, and one (1) tube of Aquaphor Healing Ointment Baby Diaper Rash Cream expired on February 1, 2023. In Space #6a, the Permission to Administer Medication Forms for one (1) bottle of Childrens Motrin Oral Suspension expired on June 30, 2023, and one (1) bottle of Childrens Benadryl Antihistamine Oral Solution expired on June 30, 2023. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by August 1, 2023. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. 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. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 89%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan must 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 is to 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. I suggested you review the facility’s Emergency Medical Care Plan with all staff at the same time that you review the facility’s Emergency Preparedness and Response Plan. Keep an agenda and a sign in sheet indicating the information reviewed and the staff members present during the review. 2. Emergency medical care information must be on file for each child. That information must include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information must be on file in the center on the child's first day of attendance and must be updated as changes occur and at least annually. I suggested you create a schedule to have all families update emergency information regularly to ensure the information is updated at least annually. You stated updated emergency information forms have been disseminated to families and you are waiting for them to be turned in. 3. All staff members must review the center's Emergency Preparedness and Response Plan when hired and on an annual basis thereafter with the staff member trained in Emergency Preparedness and Response. Documentation of the review must be maintained at the center in the individual's personnel file or in a file designated for emergency preparedness and response plan documents. All substitutes and volunteers counted in ratio must be informed of the child care center's Emergency Preparedness and Response Plan and its location. Documentation of this notice must be maintained in the individual personnel files or in a file designated for emergency preparedness and response plan documents. I suggested you review your facility’s Emergency Preparedness and Response Plan during a staff meeting with all staff members after you review and update the plan each year. Keep an agenda and a sign in sheet indicating the information reviewed and the staff members present during the review. 4. Standing permission to administer medications for chronic illnesses may be given for up to six (6) months. A new Permission to Administer Medication for Chronic Medical Conditions form must be completed by the child’s guardian at least every six (6) months. Standing permission to administer over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, may be given for up to twelve (12) months. I suggested that teachers check medications and permission forms at least once a month to ensure no medication or permission forms are expired. I suggested you continue to use the Permission to Administer Medication for Chronic Medical Conditions form and the Medication Administration Permission for Over-the-Counter Topical Medications and Fluoridated Toothpaste forms found on the Division’s website under the “Provider” tab. Consultation: Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, tammy.mcgalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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