G.S.110-91 · Violation

Name of Operation: SUCCESS CORNER HOME DAYCARE Facility ID: 32002199 Consultant: MANDY ANNUNZIATA Operation Type: Family CC Home Case Number: Visit Date: 12/11/2025 Number Present: 2 Completed Date: 12/11/2025 Age: From 2 To 3 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Upon arrival, I was greeted by the provider, Hannah Adegboye, who assisted me during today’s visit. LICENSE STATUS The family child care home currently operates with a Four Star license issued on November 28, 2018. The program received seven points for Staff Education, two points for Program Standards, and one Quality Point. INSPECTIONS/DRILLS STATUS -The last annual compliance visit was conducted on 1/7/25. -The last documented monthly outdoor play area inspection was completed on 11/25/25. -The last documented monthly fire drill was conducted on 11/24/25. -The last documented quarterly lockdown/shelter-in-place drill was conducted on 10/23/25. MONITORING I completed a walk-through of the home, including the children’s space, kitchen, bathroom, and outdoor learning environment. At the time of the visit, there were two children present ranging in age from two years to three years old. There are three children enrolled. The children were observed playing with materials, playing in the outdoor learning environment, using the bathroom and washing hands, and eating lunch, Lunch was turkey and brown rice in a tomato sauce, grapes, and milk. A full assessment of child care requirements was conducted. I used a checklist to monitor all applicable requirements, including but not limited to supervision, capacity, health and safety requirements, equipment and furnishings, and program records. The provider does transport children; therefore, this requirement was monitored and violations were cited. No enrolled children have medications or medical care plans, so these requirements were not monitored. Children 12 months or younger are not enrolled; therefore, safe sleep requirements were not monitored. The provider verified that all the information on the FCCH Verification of Required Information for Operator and Additional Caregivers form was correct. INDOOR/OUTDOOR ENVIRONMENT Inside the home, children are cared for in the living room. A variety of items for learning through play are available, including manipulatives, blocks, books, art materials, and home living props. The bathroom is located within sight of the children’s play area. The outdoor play area is a fenced side yard with a variety of gross motor equipment, including a climber with swings and a slide, as well as riding toys. VIOLATIONS The following violations were observed and documented during today’s visit: Violation Number Comment Rule 910 Copy of each child's health assessment, including the operator's own preschool child(ren), was not on file within 30 days of enrollment. A child who enrolled on 8/25/25 was missing a health assessment. GS 110-91(1); 10A NCAC 09.1721(a)(1) 925 Signed and dated statement which attests that a copy of the discipline policy was given to and discussed with a parent/guardian of each child prior to enrollment was not on file in the home. A child who enrolled on 8/25/25 was missing a signed copy of the discipline policy. G.S.110-91(10); .1727(a)&(b) 1101 Operator or other transportation provider did not have written permission from each child's parents or guardian to transport the child. One child (M.S.) was missing a signed copy of the permission to transport form. .1723(5) 1103 For each child being transported, the operator or other transportation provider did not have identifying information, including the child's name, photograph, emergency contact information, and a copy of the emergency medical care information form required by Rule .1721(a )(3) in the vehicle whenever children were transported. The children's files were missing photos of the children. .1723(13) 1996 Vehicle used for transportation did not have a first aid kit. No first aid kit was in the car. .1723(11) 1997 Vehicle used for transportation did not have a fire extinguisher. No fire extinguisher was in the vehicle. .1723(11) 2031 Operator did not provide a copy of the shaken baby syndrome and abusive head trauma policy to parents at time of enrollment, and / or within fourteen days of a changes to the policy. All children's files were missing a signed copy of the shaken baby policy. .1726(b)&(c) In order to comply with the NC Laws and Rules, any violations documented today must be corrected immediately. I need to receive your compliance letter by December 25, 2025. The letter must address each violation and explain specifically when and how it was corrected, as well as how you will prevent the same violations from happening in the future. Please send this to mandy.annunziata@dhhs.nc.gov and include the following information: -Facility name -Facility ID number -Each item number COMPLIANCE HISTORY Prior to today’s visit, the facility’s compliance history score was 100%. According to NC General Statute 110-90(4)(d), all facilities must maintain a compliance history of at least 75% for the past 18 months. Failure to maintain compliance may result in an administrative action. The facility was not in compliance with all applicable minimum licensing requirements during today’s visit and violations were documented that could impact your overall compliance history score. An updated compliance history score will be generated after today’s visit, and you will be informed of the results during the next visit to your program. TECHNICAL ASSISTANCE -It is important to keep children’s medical records on file to ensure children are healthy and able to participate in activities. Today, one child was missing a health assessment. You said you had given the child’s parent a blank copy of the health assessment form to take to the doctor, but they lost it, so you just gave them another one. I recommend using the children’s file checklist under “Provider Documents” on the DCDEE website and checking files regularly to help you keep track of required records. Health assessments are due no more than 30 days after a new child enrolls, but you could also require parents to submit all forms at the time children begin care. -It is important for parents to understand the vulnerabilities of children to help prevent injuries and properly handle infants. Therefore, parents of children ages birth-five years old must review and sign the “Shaken Baby Head Trauma Policy” when children enroll in your FCCH. This form was missing from all the children’s files today. I gave you a copy of the policy and signature form to share with parents. Please include the signed signature form in all children’s files. -Transporting children is a big responsibility. If you choose to transport children, you must bring their identifying information with you in the vehicle: each child’s name, photograph, emergency contact information, and emergency medical care information, as well as the permission to transport form. Be sure to include a first aid kit and fire extinguisher as well. Today, all required information was not in the vehicle. You said that you do bring the children’s files with you, and you will add children’s photos and permission to transport forms to their files. You also stated that the car you usually use had been borrowed by your daughter, and you had forgotten to move the fire extinguisher and first aid kit to the car you are temporarily using to transport the children. I noted that the booster seats you are using in the car are not recommended for children under five years old or under 40 lbs. Instead, safety experts recommend using age-appropriate carseats with a five-point harness to keep young children from slipping out of the seatbelt in the event of a crash. I recommend speaking with the children’s parents about obtaining new car seats. -To prevent misunderstandings, discipline policies should be clearly stated and signed by parents upon a child’s enrollment. Today, one child was missing a signed discipline policy. You said you didn’t realize it was missing. I suggest using the Children’s File Checklist under “Provider Documents and Forms” to help you keep track of all required forms. CONSULTATION -We reviewed QRIS information and completed a form stating that you will pursue Pathway #2, with a planned license transition date of June 2026. -The Clean Classrooms for Carolina Kids Program provides free facility-wide testing for lead in water and inspections for asbestos and lead-based paint hazards without any out-of-pocket costs. Visit www.cleanwaterforuskids.org/carolina to enroll. You last tested your water for lead on 5/31/24, and no mitigation efforts were required. -You can access and update your EPR plan by using your NCID to log into the North Carolina Risk Management Portal at https://rmp.nc.gov/portal/portal.aspx. Please review and update your EPR plan yearly. -Criminal Backgrounds Checks for the provider and all household members 16 years of age and older should be completed every five years. Your qualifying letter is valid until 11/7/30. TRAINING REMINDERS -Training from 1/7/25 to 12/10/25 was reviewed today and documented on the Verification of Required Information for Operator and Additional Caregivers form. You have completed all required hours and have 2.5 hours to carry over to next year. -CPR and First Aid must be renewed every two years. Your CPR and First Aid certification expires 9/20/27. -ITS-SIDS training must be renewed every three years. Your training expires on 1/30/26. -Health and Safety Training must be renewed every five years. Your training must be completed in 2026. You can find this training in Moodle on the DCDEE website. Also, “Recognizing and Responding to Suspicions of Child Maltreatment” (part of the Health and Safety Training) should be completed within 90 days of hire and renewed every five years. This training can be found on the Positive Child Alliance NC website: https://preventchildabusenc.org/online-trainings/ RATED LICENSE STATUS Providers will be assessed for a new rated license in 2026 and can choose from three pathways. Before my next visit, be sure to update your WORKS account with all your relevant education information. You can also visit the North Carolina Rated License Project website (https://www.ncrlap.org) for resources regarding the rated license assessment process and the FCCH self-study. AGENCY UPDATES Please check the Division of Child Development and Early Education’s website frequently for any new policies or rules. Go to https://ncchildcare.ncdhhs.gov/, and click on the “What’s New” tab for all agency updates, including QRIS Modernization. I recommend exploring the new pathway options to obtain a rated license. New QRIS rules are in effect, and the Division is preparing for a gradual transition to the new requirements. Resources, forms, and training will be provided to support you in preparing for new options to earn your Two- through Five-Star Rated License. All the newest information will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. CONTACT INFORMATION If you have questions or need further assistance, please contact me at (919) 971-6255 or mandy.annunziata@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.

GS 110-91 · Violation

Name of Operation: SUCCESS CORNER HOME DAYCARE Facility ID: 32002199 Consultant: MANDY ANNUNZIATA Operation Type: Family CC Home Case Number: Visit Date: 12/11/2025 Number Present: 2 Completed Date: 12/11/2025 Age: From 2 To 3 Total Minutes: 205 Time In: 10:00 AM Time Out: 01:25 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Upon arrival, I was greeted by the provider, Hannah Adegboye, who assisted me during today’s visit. LICENSE STATUS The family child care home currently operates with a Four Star license issued on November 28, 2018. The program received seven points for Staff Education, two points for Program Standards, and one Quality Point. INSPECTIONS/DRILLS STATUS -The last annual compliance visit was conducted on 1/7/25. -The last documented monthly outdoor play area inspection was completed on 11/25/25. -The last documented monthly fire drill was conducted on 11/24/25. -The last documented quarterly lockdown/shelter-in-place drill was conducted on 10/23/25. MONITORING I completed a walk-through of the home, including the children’s space, kitchen, bathroom, and outdoor learning environment. At the time of the visit, there were two children present ranging in age from two years to three years old. There are three children enrolled. The children were observed playing with materials, playing in the outdoor learning environment, using the bathroom and washing hands, and eating lunch, Lunch was turkey and brown rice in a tomato sauce, grapes, and milk. A full assessment of child care requirements was conducted. I used a checklist to monitor all applicable requirements, including but not limited to supervision, capacity, health and safety requirements, equipment and furnishings, and program records. The provider does transport children; therefore, this requirement was monitored and violations were cited. No enrolled children have medications or medical care plans, so these requirements were not monitored. Children 12 months or younger are not enrolled; therefore, safe sleep requirements were not monitored. The provider verified that all the information on the FCCH Verification of Required Information for Operator and Additional Caregivers form was correct. INDOOR/OUTDOOR ENVIRONMENT Inside the home, children are cared for in the living room. A variety of items for learning through play are available, including manipulatives, blocks, books, art materials, and home living props. The bathroom is located within sight of the children’s play area. The outdoor play area is a fenced side yard with a variety of gross motor equipment, including a climber with swings and a slide, as well as riding toys. VIOLATIONS The following violations were observed and documented during today’s visit: Violation Number Comment Rule 910 Copy of each child's health assessment, including the operator's own preschool child(ren), was not on file within 30 days of enrollment. A child who enrolled on 8/25/25 was missing a health assessment. GS 110-91(1); 10A NCAC 09.1721(a)(1) 925 Signed and dated statement which attests that a copy of the discipline policy was given to and discussed with a parent/guardian of each child prior to enrollment was not on file in the home. A child who enrolled on 8/25/25 was missing a signed copy of the discipline policy. G.S.110-91(10); .1727(a)&(b) 1101 Operator or other transportation provider did not have written permission from each child's parents or guardian to transport the child. One child (M.S.) was missing a signed copy of the permission to transport form. .1723(5) 1103 For each child being transported, the operator or other transportation provider did not have identifying information, including the child's name, photograph, emergency contact information, and a copy of the emergency medical care information form required by Rule .1721(a )(3) in the vehicle whenever children were transported. The children's files were missing photos of the children. .1723(13) 1996 Vehicle used for transportation did not have a first aid kit. No first aid kit was in the car. .1723(11) 1997 Vehicle used for transportation did not have a fire extinguisher. No fire extinguisher was in the vehicle. .1723(11) 2031 Operator did not provide a copy of the shaken baby syndrome and abusive head trauma policy to parents at time of enrollment, and / or within fourteen days of a changes to the policy. All children's files were missing a signed copy of the shaken baby policy. .1726(b)&(c) In order to comply with the NC Laws and Rules, any violations documented today must be corrected immediately. I need to receive your compliance letter by December 25, 2025. The letter must address each violation and explain specifically when and how it was corrected, as well as how you will prevent the same violations from happening in the future. Please send this to mandy.annunziata@dhhs.nc.gov and include the following information: -Facility name -Facility ID number -Each item number COMPLIANCE HISTORY Prior to today’s visit, the facility’s compliance history score was 100%. According to NC General Statute 110-90(4)(d), all facilities must maintain a compliance history of at least 75% for the past 18 months. Failure to maintain compliance may result in an administrative action. The facility was not in compliance with all applicable minimum licensing requirements during today’s visit and violations were documented that could impact your overall compliance history score. An updated compliance history score will be generated after today’s visit, and you will be informed of the results during the next visit to your program. TECHNICAL ASSISTANCE -It is important to keep children’s medical records on file to ensure children are healthy and able to participate in activities. Today, one child was missing a health assessment. You said you had given the child’s parent a blank copy of the health assessment form to take to the doctor, but they lost it, so you just gave them another one. I recommend using the children’s file checklist under “Provider Documents” on the DCDEE website and checking files regularly to help you keep track of required records. Health assessments are due no more than 30 days after a new child enrolls, but you could also require parents to submit all forms at the time children begin care. -It is important for parents to understand the vulnerabilities of children to help prevent injuries and properly handle infants. Therefore, parents of children ages birth-five years old must review and sign the “Shaken Baby Head Trauma Policy” when children enroll in your FCCH. This form was missing from all the children’s files today. I gave you a copy of the policy and signature form to share with parents. Please include the signed signature form in all children’s files. -Transporting children is a big responsibility. If you choose to transport children, you must bring their identifying information with you in the vehicle: each child’s name, photograph, emergency contact information, and emergency medical care information, as well as the permission to transport form. Be sure to include a first aid kit and fire extinguisher as well. Today, all required information was not in the vehicle. You said that you do bring the children’s files with you, and you will add children’s photos and permission to transport forms to their files. You also stated that the car you usually use had been borrowed by your daughter, and you had forgotten to move the fire extinguisher and first aid kit to the car you are temporarily using to transport the children. I noted that the booster seats you are using in the car are not recommended for children under five years old or under 40 lbs. Instead, safety experts recommend using age-appropriate carseats with a five-point harness to keep young children from slipping out of the seatbelt in the event of a crash. I recommend speaking with the children’s parents about obtaining new car seats. -To prevent misunderstandings, discipline policies should be clearly stated and signed by parents upon a child’s enrollment. Today, one child was missing a signed discipline policy. You said you didn’t realize it was missing. I suggest using the Children’s File Checklist under “Provider Documents and Forms” to help you keep track of all required forms. CONSULTATION -We reviewed QRIS information and completed a form stating that you will pursue Pathway #2, with a planned license transition date of June 2026. -The Clean Classrooms for Carolina Kids Program provides free facility-wide testing for lead in water and inspections for asbestos and lead-based paint hazards without any out-of-pocket costs. Visit www.cleanwaterforuskids.org/carolina to enroll. You last tested your water for lead on 5/31/24, and no mitigation efforts were required. -You can access and update your EPR plan by using your NCID to log into the North Carolina Risk Management Portal at https://rmp.nc.gov/portal/portal.aspx. Please review and update your EPR plan yearly. -Criminal Backgrounds Checks for the provider and all household members 16 years of age and older should be completed every five years. Your qualifying letter is valid until 11/7/30. TRAINING REMINDERS -Training from 1/7/25 to 12/10/25 was reviewed today and documented on the Verification of Required Information for Operator and Additional Caregivers form. You have completed all required hours and have 2.5 hours to carry over to next year. -CPR and First Aid must be renewed every two years. Your CPR and First Aid certification expires 9/20/27. -ITS-SIDS training must be renewed every three years. Your training expires on 1/30/26. -Health and Safety Training must be renewed every five years. Your training must be completed in 2026. You can find this training in Moodle on the DCDEE website. Also, “Recognizing and Responding to Suspicions of Child Maltreatment” (part of the Health and Safety Training) should be completed within 90 days of hire and renewed every five years. This training can be found on the Positive Child Alliance NC website: https://preventchildabusenc.org/online-trainings/ RATED LICENSE STATUS Providers will be assessed for a new rated license in 2026 and can choose from three pathways. Before my next visit, be sure to update your WORKS account with all your relevant education information. You can also visit the North Carolina Rated License Project website (https://www.ncrlap.org) for resources regarding the rated license assessment process and the FCCH self-study. AGENCY UPDATES Please check the Division of Child Development and Early Education’s website frequently for any new policies or rules. Go to https://ncchildcare.ncdhhs.gov/, and click on the “What’s New” tab for all agency updates, including QRIS Modernization. I recommend exploring the new pathway options to obtain a rated license. New QRIS rules are in effect, and the Division is preparing for a gradual transition to the new requirements. Resources, forms, and training will be provided to support you in preparing for new options to earn your Two- through Five-Star Rated License. All the newest information will be posted at https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/QRIS-Modernization and will also be provided through emails and Raise NC newsletters. CONTACT INFORMATION If you have questions or need further assistance, please contact me at (919) 971-6255 or mandy.annunziata@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.