10A NCAC 09 .0601 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 10/9/2024 Number Present: 54 Completed Date: 10/9/2024 Age: From 0 To 5 Total Minutes: 85 Time In: 10:20 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Summerlin, Administrator and Bucky Bowen, Owner assisted with the visit. Fifty-four (54) children were observed in care today ranging from zero to five years old. Children were engaged free choice play with developmentally age-appropriate materials, interacting with the caregivers, eating lunch, participating in outdoor play and completing toileting, diapering and hand washing routines. Lunch consisted of nachos with beef, baked beans, applesauce and milk. One child was served apple juice. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 17, 2024, earning a superior classification. The last fire inspection was completed on May 15, 2024, and the center was approved for daytime care. The last annual compliance visit was completed on April 17, 2024. The following violations were documented today. Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one- year-old child was grouped with a three-year-old child in Space #6 10A NCAC 09 .0713(a)(6) 807 A safe indoor and outdoor environment was not provided for the children. A blue chair was cracked posing a pinching hazard was in Space #1. Two bolts were protruding from the base of the black barrier enclosing the surfacing around the swings on the preschool playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A black plastic bag was on top of a cubby less than 5ft. from the finished floor in Space #6. .0604(q) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before October 23, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 92% percent as of October 8, 2024. STAFF/CHILD INTERACTIONS: During my observation, children in Spaces #1, 3 and 4 were engaged in free choice play. Children in Space #3 were also observed in outdoor play. Children in Space #6 interacted with caregivers while reading a story about fire safety. Staff and children engaged in singing songs and doing finger plays. Infant and toddler were napping and having tummy time. Caregivers talked to children about their activities and asked questions. Each classroom had a variety of toys and materials for children to use during play. Toys and material were in good condition. Lunch was also observed. Children fed themselves independently. Infants were placed in highchairs and fed by staff. STAFF/CHILD RATIO: A one-year-old child was grouped with a three-year-old child in Space #6. You stated children were shifted around to accommodate behavior issues encountered. You added you didn’t realize three-year-old children were in the classroom. You stated the ages of children will be monitored daily to ensure children are grouped according to staff/child ratio requirements. SURFACING MAINTENANCE: Although adequate surfacing was on the playground, I advised you when weather permits to till and evenly distributed the surfacing on and around the playground equipment to ensure depth measurement is met as required. SAFE ENVIRONMENT: You were encouraged to remind staff of storing plastic bags appropriately in classroom serving children under the age of three. Also, it was recommended conducting periodic checks of classrooms and the playground to identify potential hazards and remove them prior to children accessing the space. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted in the future to monitor staff/child ratio requirements regarding grouping of children. . At the conclusion of today’s visit, the visit summary report was completed, reviewed, and left with you. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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 .0713 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 10/9/2024 Number Present: 54 Completed Date: 10/9/2024 Age: From 0 To 5 Total Minutes: 85 Time In: 10:20 AM Time Out: 11:45 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Summerlin, Administrator and Bucky Bowen, Owner assisted with the visit. Fifty-four (54) children were observed in care today ranging from zero to five years old. Children were engaged free choice play with developmentally age-appropriate materials, interacting with the caregivers, eating lunch, participating in outdoor play and completing toileting, diapering and hand washing routines. Lunch consisted of nachos with beef, baked beans, applesauce and milk. One child was served apple juice. Currently this program operates with a three-star license. The last sanitation inspection was completed on June 17, 2024, earning a superior classification. The last fire inspection was completed on May 15, 2024, and the center was approved for daytime care. The last annual compliance visit was completed on April 17, 2024. The following violations were documented today. Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. A one- year-old child was grouped with a three-year-old child in Space #6 10A NCAC 09 .0713(a)(6) 807 A safe indoor and outdoor environment was not provided for the children. A blue chair was cracked posing a pinching hazard was in Space #1. Two bolts were protruding from the base of the black barrier enclosing the surfacing around the swings on the preschool playground. 10A NCAC 09 .0601(a) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. A black plastic bag was on top of a cubby less than 5ft. from the finished floor in Space #6. .0604(q) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before October 23, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. remains current and active. I reminded you the corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 92% percent as of October 8, 2024. STAFF/CHILD INTERACTIONS: During my observation, children in Spaces #1, 3 and 4 were engaged in free choice play. Children in Space #3 were also observed in outdoor play. Children in Space #6 interacted with caregivers while reading a story about fire safety. Staff and children engaged in singing songs and doing finger plays. Infant and toddler were napping and having tummy time. Caregivers talked to children about their activities and asked questions. Each classroom had a variety of toys and materials for children to use during play. Toys and material were in good condition. Lunch was also observed. Children fed themselves independently. Infants were placed in highchairs and fed by staff. STAFF/CHILD RATIO: A one-year-old child was grouped with a three-year-old child in Space #6. You stated children were shifted around to accommodate behavior issues encountered. You added you didn’t realize three-year-old children were in the classroom. You stated the ages of children will be monitored daily to ensure children are grouped according to staff/child ratio requirements. SURFACING MAINTENANCE: Although adequate surfacing was on the playground, I advised you when weather permits to till and evenly distributed the surfacing on and around the playground equipment to ensure depth measurement is met as required. SAFE ENVIRONMENT: You were encouraged to remind staff of storing plastic bags appropriately in classroom serving children under the age of three. Also, it was recommended conducting periodic checks of classrooms and the playground to identify potential hazards and remove them prior to children accessing the space. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted in the future to monitor staff/child ratio requirements regarding grouping of children. . At the conclusion of today’s visit, the visit summary report was completed, reviewed, and left with you. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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 .1003 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 4/17/2024 Number Present: 58 Completed Date: 4/17/2024 Age: From 0 To 5 Total Minutes: 230 Time In: 08:45 AM Time Out: 12:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. C. Summerlin, Administrator assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one points in the program standard component and 1 quality point for the administrator competing a business training course of at least 30 clock hours. The last annual compliance visit was completed on May 17, 2023. The last sanitation inspection was completed on December 13, 2023, earning a “Superior” classification. The last fire inspection was completed on May 17, 2023, and the center was approved for daytime care only. Fifty-eight (58) children were observed in care today. Children were engaged in morning activities, free choice play with developmentally age-appropriate materials in various activity areas, completing toileting, diapering, and hand washing routines, interacting with teachers, and eating breakfast and lunch. Breakfast consisted of blueberry muffins, applesauce, and milk. Lunch consisted of meatballs, noodles, salad, peaches and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 94% as of April 16, 2024. The following violations were documented. Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Three milk bottles were not labeled in Space #1. 15A NCAC 18A .2804(d) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. Photographs were not included with the identifying information for ten children transported. 10A NCAC 09 .1003(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The medical assessment for one child enrolled on 9/26/2022 was dated for November 10, 2022. GS110-91(1) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before May 1, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. CORPORATION STATUS: Kinder Kastle, Inc is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. remains Current and Active. Prior to making any changes to the corporation status, please contact me to discuss change of ownership procedures. The corporation status for your program must always remain Current and Active. Failure to comply may affect your Star Rated License. FACILITY PROFILE INFORMATION: You verified the phone number email address and mailing address listed on the facility profile are correct. If changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. HEALTH ASSESSMENT: A health assessment for one child was more than thirty days old. We discussed developing a system for tracking dates to ensure health assessments and other documents are received within the required timeframe. BOTTLE LABELS: Three milk bottles for infants enrolled were not labeled. Staff stated when the bottles are brought in already prepared, they do not have labels. I suggested creating labels prior to children arriving and when the bottles are received, those missing labels could be added. It is important for bottles to be labeled to ensure it is provided to the correct child. TRANSPORTATION REQUIRMENTS: You stated bus cards were being updated for the year and you were waiting for new photographs. I recommended keeping the old photographs until new pictures are received to replace them this will ensure compliance is maintained. I explained that photographs of children identify them in the event of an emergency. CLASSROOM MANAGEMENT AND GUIDANCE: We discussed observation and concerns in the two-year-old classrooms. I explained staff were completing non caregiving tasks such as cleaning while trying to monitor and direct the children. Children were observed standing in chairs, running around the classrooms, crawling under tables, and walking in and out of the restroom while other children were utilizing it. Staff provided redirection; however, children did not follow instructions and continued to exhibit the behaviors observed. Staff appeared to be frustrated with trying to get children to listen to instruction. It was recommended you ask staff to focus on children and complete non-caregiving tasks if possible, at a later time. Also, the third caregiver could be used to assist with those non caregiving tasks during routines. It was suggested you continue to conduct observations and provide feedback to staff. You stated a third staff member was added to that space to assist caregiver. It was also recommended having staff to obtain training on topics related to classroom management and structure. HEALTH TRAININGS: Regional Child Care Health Consultant, Stacy Rosser is offering the following training for providers in your county. These trainings will provide staff with the information, tools and skills needed in health and sanitation requirements as well as receiving ongoing training hours. •Handwashing module (.5 hours) •Diapering module (.5 hours) •Toileting module (.5 hours) •Sanitation module (1 hour) •Food module (1 hour) LEAD WATER/PAINT AND ASBESTOS: We discussed the rule requirements and information concerning Lead in Water/Paint and Asbestos. The Clean Water for Carolina Kids program is expanding to the Clean Classrooms for Carolina Kids program. This is a legislatively mandated effort to address lead and asbestos hazards in North Carolina public schools, licensed child care centers, and licensed family child care homes. Participation allows facilities to meet all rule requirements for identified lead and asbestos hazards, as required by law. Rules 10A NCAC 41C .1001 through .1007 require all programs to be free of lead and asbestos hazards. RTI is coordinating all the lead in water, paint and asbestos testing and remediation. There are webinars that child care providers can watch to get instructions. Go to https://www.cleanwaterforuskids.org/en/carolina/ for more information. Currently operating child care facilities are required to test for lead in paint and asbestos once unless the consultant notes a concern during a visit and refers the program to environmental health. All existing licensed programs must complete the application summary for their program regarding lead paint and asbestos by May 1, 2024. The application is on the https://www.cleanwaterforuskids.org/en/carolina/ website. CHILD CARE RULE UPDATES EFFECTIVE JANUARY 2024: Please ensure you are using the updated rule book dated January 1, 2024, and review information in the DCDEE Moodle regarding the updated rule changes. You will need to have an NCID - the same NCID that you use for the health & safety training, WORKS login, and/or the CBC Portal - to participate in Moodle training. If you do not have an NCID, use this link to get one: https://ncid.nc.gov. Rule training modules can be found in the same course as the October 2017 Child Care Rule Rollout. If you are unfamiliar with the Child Care Rule Rollout within Moodle and how to navigate, please visit: https://ncchildcare.ncdhhs.gov/Learning-Resources/How-to-Navigate-Moodle. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-9326. PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM DCDEE has launched the Provider Portal for ABCMS effective February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. EQUIVALENCY EXAM OFFLINE for MAINTENANCE: The NC Early Childhood Equivalency exam located in Moodle will be unavailable until further notice for updates. In the meantime, earn the Early Childhood Education Certificate by enrolling in EDU 119 at a local community college. Better yet, take advantage of DCDEE’s offer of a No-Cost Professional Development Teacher Membership and earn your CDA! The NC Early Childhood Equivalency exam located in Moodle will be unavailable until further notice for updates. In the meantime, earn the Early Childhood Education Certificate by enrolling in EDU 119 at a local community college. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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.

GS110-91 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 4/17/2024 Number Present: 58 Completed Date: 4/17/2024 Age: From 0 To 5 Total Minutes: 230 Time In: 08:45 AM Time Out: 12:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during an annual compliance visit. C. Summerlin, Administrator assisted with the visit. This center currently operates with a three-star license, earning five points in the education component, one points in the program standard component and 1 quality point for the administrator competing a business training course of at least 30 clock hours. The last annual compliance visit was completed on May 17, 2023. The last sanitation inspection was completed on December 13, 2023, earning a “Superior” classification. The last fire inspection was completed on May 17, 2023, and the center was approved for daytime care only. Fifty-eight (58) children were observed in care today. Children were engaged in morning activities, free choice play with developmentally age-appropriate materials in various activity areas, completing toileting, diapering, and hand washing routines, interacting with teachers, and eating breakfast and lunch. Breakfast consisted of blueberry muffins, applesauce, and milk. Lunch consisted of meatballs, noodles, salad, peaches and milk. The center’s compliance history score was reviewed with the operator. The program’s compliance history was 94% as of April 16, 2024. The following violations were documented. Violation Number Comment Rule 533 Human milk, formula and other bottled beverages including sippy cups, sent from child's home were not fully prepared, dated, and labeled for the appropriate child. Three milk bottles were not labeled in Space #1. 15A NCAC 18A .2804(d) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. Photographs were not included with the identifying information for ten children transported. 10A NCAC 09 .1003(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. The medical assessment for one child enrolled on 9/26/2022 was dated for November 10, 2022. GS110-91(1) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before May 1, 2024. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. CORPORATION STATUS: Kinder Kastle, Inc is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. remains Current and Active. Prior to making any changes to the corporation status, please contact me to discuss change of ownership procedures. The corporation status for your program must always remain Current and Active. Failure to comply may affect your Star Rated License. FACILITY PROFILE INFORMATION: You verified the phone number email address and mailing address listed on the facility profile are correct. If changes in your facility’s information occur in the future, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure accurate information is updated in our system. HEALTH ASSESSMENT: A health assessment for one child was more than thirty days old. We discussed developing a system for tracking dates to ensure health assessments and other documents are received within the required timeframe. BOTTLE LABELS: Three milk bottles for infants enrolled were not labeled. Staff stated when the bottles are brought in already prepared, they do not have labels. I suggested creating labels prior to children arriving and when the bottles are received, those missing labels could be added. It is important for bottles to be labeled to ensure it is provided to the correct child. TRANSPORTATION REQUIRMENTS: You stated bus cards were being updated for the year and you were waiting for new photographs. I recommended keeping the old photographs until new pictures are received to replace them this will ensure compliance is maintained. I explained that photographs of children identify them in the event of an emergency. CLASSROOM MANAGEMENT AND GUIDANCE: We discussed observation and concerns in the two-year-old classrooms. I explained staff were completing non caregiving tasks such as cleaning while trying to monitor and direct the children. Children were observed standing in chairs, running around the classrooms, crawling under tables, and walking in and out of the restroom while other children were utilizing it. Staff provided redirection; however, children did not follow instructions and continued to exhibit the behaviors observed. Staff appeared to be frustrated with trying to get children to listen to instruction. It was recommended you ask staff to focus on children and complete non-caregiving tasks if possible, at a later time. Also, the third caregiver could be used to assist with those non caregiving tasks during routines. It was suggested you continue to conduct observations and provide feedback to staff. You stated a third staff member was added to that space to assist caregiver. It was also recommended having staff to obtain training on topics related to classroom management and structure. HEALTH TRAININGS: Regional Child Care Health Consultant, Stacy Rosser is offering the following training for providers in your county. These trainings will provide staff with the information, tools and skills needed in health and sanitation requirements as well as receiving ongoing training hours. •Handwashing module (.5 hours) •Diapering module (.5 hours) •Toileting module (.5 hours) •Sanitation module (1 hour) •Food module (1 hour) LEAD WATER/PAINT AND ASBESTOS: We discussed the rule requirements and information concerning Lead in Water/Paint and Asbestos. The Clean Water for Carolina Kids program is expanding to the Clean Classrooms for Carolina Kids program. This is a legislatively mandated effort to address lead and asbestos hazards in North Carolina public schools, licensed child care centers, and licensed family child care homes. Participation allows facilities to meet all rule requirements for identified lead and asbestos hazards, as required by law. Rules 10A NCAC 41C .1001 through .1007 require all programs to be free of lead and asbestos hazards. RTI is coordinating all the lead in water, paint and asbestos testing and remediation. There are webinars that child care providers can watch to get instructions. Go to https://www.cleanwaterforuskids.org/en/carolina/ for more information. Currently operating child care facilities are required to test for lead in paint and asbestos once unless the consultant notes a concern during a visit and refers the program to environmental health. All existing licensed programs must complete the application summary for their program regarding lead paint and asbestos by May 1, 2024. The application is on the https://www.cleanwaterforuskids.org/en/carolina/ website. CHILD CARE RULE UPDATES EFFECTIVE JANUARY 2024: Please ensure you are using the updated rule book dated January 1, 2024, and review information in the DCDEE Moodle regarding the updated rule changes. You will need to have an NCID - the same NCID that you use for the health & safety training, WORKS login, and/or the CBC Portal - to participate in Moodle training. If you do not have an NCID, use this link to get one: https://ncid.nc.gov. Rule training modules can be found in the same course as the October 2017 Child Care Rule Rollout. If you are unfamiliar with the Child Care Rule Rollout within Moodle and how to navigate, please visit: https://ncchildcare.ncdhhs.gov/Learning-Resources/How-to-Navigate-Moodle. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-9326. PROVIDER ACCESS to the BACKGROUND CHECK MANAGEMENT SYSTEM DCDEE has launched the Provider Portal for ABCMS effective February 1, 2024. This access will allow providers to: •See applicants that associate themselves with their facility and allow them to “hire” the applicant to their roster •See the real-time background check status of staff members •Run a printable report of the staff roster to assist with compliance visits To gain access to the Provider Portal complete the ABCMS Child Care Provider Portal Training on DCDEE's Moodle. The training consists of watching a short video then taking a test about the video. A certificate will be issued upon successful completion of the test. Email the certificate along with your full name, position and Facility ID to DCDEE_ABCMS_Provider@dhhs.nc.gov to get access to the portal. We will grant your access within 2 business days. Please do not use this email account to ask background check questions. If you have general questions, please continue to use DHHS.CBC.Unit@dhhs.nc.gov. EQUIVALENCY EXAM OFFLINE for MAINTENANCE: The NC Early Childhood Equivalency exam located in Moodle will be unavailable until further notice for updates. In the meantime, earn the Early Childhood Education Certificate by enrolling in EDU 119 at a local community college. Better yet, take advantage of DCDEE’s offer of a No-Cost Professional Development Teacher Membership and earn your CDA! The NC Early Childhood Equivalency exam located in Moodle will be unavailable until further notice for updates. In the meantime, earn the Early Childhood Education Certificate by enrolling in EDU 119 at a local community college. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. Be reminded you are responsible for maintaining compliance with all applicable child care requirements whether they have been discussed or reviewed with you in the past. CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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 .0302 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 11/8/2023 Number Present: 50 Completed Date: 11/8/2023 Age: From 0 To 5 Total Minutes: 170 Time In: 09:00 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Summerlin, Administrator assisted with the visit. Fifty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, outdoor play, interacting with the caregivers, completing toileting, and hand washing routines, napping and eating breakfast. Breakfast consisted of bagels, pears, and milk. Children were cared for in a positive and nurturing environment. Currently this program operates with a Three-Star License earning five points in education the component, one point in program standards component and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not documented for eleven children between the dates of October 5, 2023, to October 27, 2023. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. An infant eleven-month infant was observed grouped with children two years old in Space #1. GS 110-91(7);.0713(a-d) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before November 22, 2023. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 96% percent as of November 7, 2023. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. was current and active. I reminded you the corporation status must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. ADMINISTRATIVE ACTION: You stated the written warning administrative action was received on November 6, 2023. During the visit you, Mr. Bowen and I reviewed the administrative action including the corrective action plan. I explained the appeal process to you and Mr. Bowen. I informed shared you have the right to appeal. Mr. Bowen stated he did not plan to file an appeal. I notified you that the written plan you must develop is due to me on or before November 20, 2023. I observed the administrative action and cover letter posted on the parent board to the right at the entrance of the facility. You stated you understood the information provided and did not have any questions or concerns at this time. STAFF/CHILD RATIO REQUIREMENTS: An eleven-month-old infant was observed grouped in care with children two years old in Space #1. I informed you children under one year of age shall be kept separate from children two years of age and over. I reviewed child care rule 10A NCAC 09 .0713 (5) with you during the visit. You transitioned the eleven-month-old infant back to Space #1 with the other infants. We discussed the importance of maintaining staff/child ratio requirements as required. Strategies should be implemented to ensure staff/child ratio requirements are always met. One strategy could be to monitor the ages and grouping of children when done. You could also develop a tracking system that keeps up with the staff to child ratio. Be reminded staff/child ratio requirements must always be met. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. ARRIVAL/DEPARTURE: Based on my review of arrival and departure records, departure times for eleven children were not documented. I reminded you arrival and departure times must be documented for all children present daily. I recommended having staff monitor the sign in/out logs as periodically throughout the day to ensure the times are captured. If parents do not document the times, staff can do so and add their initials or signatures to reflect who is recording the information. CRIMINAL BACKGROUND CHECK REVISIONS: Please take time to read the updated Child Care Rule 10A NCAC 09 .2703 Criminal History Record Check Requirements for Child Care Providers that was revised and amended effective October 1, 2023. Read the entire rule at https://ncchildcare.ncdhhs.gov/Home/Child-Care-Commission/Rule-Changes WEBINAR: CREATING SPPORTIVE ENVIRONMENTS: A Healthy Social Behaviors Webinar is being offered on Thursday November 16, 2023, from 7:00 pm to 8:00pm. You can access the training using the following information: https://ccrinc.zoom.us/j/926189206 Meeting ID: 326 189 6206 NEW FREE ONLINE TEACHER PROFESSIONAL DEVELOPMENT MEMBERSHIP! NC child care teachers and staff are eligible for an online professional development membership program for early educators. DCDEE covers the cost! Membership includes 200+ hours including all training required for a CDA. Learning is engaging, interactive and includes relevant content, games, and videos. Courses are available in English and Spanish. To learn more, register now! North Carolina Teacher Professional Development Resources Webinar Nov 30, 2023 at 1:00 PM Eastern Time Space is limited. Register in advance for this webinar: https://teachingstrategies.zoom.us/webinar/register/WN_RjOYSOSBRxur5dhunfZDpA Meeting ID: 987 6848 1576 Passcode: 370896 MENTAL HEALTH FIRST AID TRAININGS: The North Carolina Association for the Education of Young Children (NCAEYC) in partnership with ITTI is planning several Mental Health First Aid trainings for child care administrators to be held between November 2023 and June 2024. To best organize where to hold the training, NCAEYC is asking directors to fill out a short form to see where interest falls across the state. After completing the form, please share the link to the form and/or the flyer with QR code with your network. Reference the email blast sent to access the noted form. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. You can also complete training modules located in the MOODLE platform, access provider's documents, and the child care rules and laws. At the end of this visit, the visit summary report was printed, reviewed with you, and a copy left for your records. CONTACT INFORMATION: If you have any questions about today’s visit, my contact information is listed above. You may also contact Licensing Supervisor Susan Fuller at 252-373-9809 or email susan.fuller@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 .0713 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 11/8/2023 Number Present: 50 Completed Date: 11/8/2023 Age: From 0 To 5 Total Minutes: 170 Time In: 09:00 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Summerlin, Administrator assisted with the visit. Fifty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, outdoor play, interacting with the caregivers, completing toileting, and hand washing routines, napping and eating breakfast. Breakfast consisted of bagels, pears, and milk. Children were cared for in a positive and nurturing environment. Currently this program operates with a Three-Star License earning five points in education the component, one point in program standards component and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not documented for eleven children between the dates of October 5, 2023, to October 27, 2023. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. An infant eleven-month infant was observed grouped with children two years old in Space #1. GS 110-91(7);.0713(a-d) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before November 22, 2023. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 96% percent as of November 7, 2023. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. was current and active. I reminded you the corporation status must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. ADMINISTRATIVE ACTION: You stated the written warning administrative action was received on November 6, 2023. During the visit you, Mr. Bowen and I reviewed the administrative action including the corrective action plan. I explained the appeal process to you and Mr. Bowen. I informed shared you have the right to appeal. Mr. Bowen stated he did not plan to file an appeal. I notified you that the written plan you must develop is due to me on or before November 20, 2023. I observed the administrative action and cover letter posted on the parent board to the right at the entrance of the facility. You stated you understood the information provided and did not have any questions or concerns at this time. STAFF/CHILD RATIO REQUIREMENTS: An eleven-month-old infant was observed grouped in care with children two years old in Space #1. I informed you children under one year of age shall be kept separate from children two years of age and over. I reviewed child care rule 10A NCAC 09 .0713 (5) with you during the visit. You transitioned the eleven-month-old infant back to Space #1 with the other infants. We discussed the importance of maintaining staff/child ratio requirements as required. Strategies should be implemented to ensure staff/child ratio requirements are always met. One strategy could be to monitor the ages and grouping of children when done. You could also develop a tracking system that keeps up with the staff to child ratio. Be reminded staff/child ratio requirements must always be met. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. ARRIVAL/DEPARTURE: Based on my review of arrival and departure records, departure times for eleven children were not documented. I reminded you arrival and departure times must be documented for all children present daily. I recommended having staff monitor the sign in/out logs as periodically throughout the day to ensure the times are captured. If parents do not document the times, staff can do so and add their initials or signatures to reflect who is recording the information. CRIMINAL BACKGROUND CHECK REVISIONS: Please take time to read the updated Child Care Rule 10A NCAC 09 .2703 Criminal History Record Check Requirements for Child Care Providers that was revised and amended effective October 1, 2023. Read the entire rule at https://ncchildcare.ncdhhs.gov/Home/Child-Care-Commission/Rule-Changes WEBINAR: CREATING SPPORTIVE ENVIRONMENTS: A Healthy Social Behaviors Webinar is being offered on Thursday November 16, 2023, from 7:00 pm to 8:00pm. You can access the training using the following information: https://ccrinc.zoom.us/j/926189206 Meeting ID: 326 189 6206 NEW FREE ONLINE TEACHER PROFESSIONAL DEVELOPMENT MEMBERSHIP! NC child care teachers and staff are eligible for an online professional development membership program for early educators. DCDEE covers the cost! Membership includes 200+ hours including all training required for a CDA. Learning is engaging, interactive and includes relevant content, games, and videos. Courses are available in English and Spanish. To learn more, register now! North Carolina Teacher Professional Development Resources Webinar Nov 30, 2023 at 1:00 PM Eastern Time Space is limited. Register in advance for this webinar: https://teachingstrategies.zoom.us/webinar/register/WN_RjOYSOSBRxur5dhunfZDpA Meeting ID: 987 6848 1576 Passcode: 370896 MENTAL HEALTH FIRST AID TRAININGS: The North Carolina Association for the Education of Young Children (NCAEYC) in partnership with ITTI is planning several Mental Health First Aid trainings for child care administrators to be held between November 2023 and June 2024. To best organize where to hold the training, NCAEYC is asking directors to fill out a short form to see where interest falls across the state. After completing the form, please share the link to the form and/or the flyer with QR code with your network. Reference the email blast sent to access the noted form. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. You can also complete training modules located in the MOODLE platform, access provider's documents, and the child care rules and laws. At the end of this visit, the visit summary report was printed, reviewed with you, and a copy left for your records. CONTACT INFORMATION: If you have any questions about today’s visit, my contact information is listed above. You may also contact Licensing Supervisor Susan Fuller at 252-373-9809 or email susan.fuller@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 .2703 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 11/8/2023 Number Present: 50 Completed Date: 11/8/2023 Age: From 0 To 5 Total Minutes: 170 Time In: 09:00 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Summerlin, Administrator assisted with the visit. Fifty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, outdoor play, interacting with the caregivers, completing toileting, and hand washing routines, napping and eating breakfast. Breakfast consisted of bagels, pears, and milk. Children were cared for in a positive and nurturing environment. Currently this program operates with a Three-Star License earning five points in education the component, one point in program standards component and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not documented for eleven children between the dates of October 5, 2023, to October 27, 2023. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. An infant eleven-month infant was observed grouped with children two years old in Space #1. GS 110-91(7);.0713(a-d) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before November 22, 2023. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 96% percent as of November 7, 2023. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. was current and active. I reminded you the corporation status must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. ADMINISTRATIVE ACTION: You stated the written warning administrative action was received on November 6, 2023. During the visit you, Mr. Bowen and I reviewed the administrative action including the corrective action plan. I explained the appeal process to you and Mr. Bowen. I informed shared you have the right to appeal. Mr. Bowen stated he did not plan to file an appeal. I notified you that the written plan you must develop is due to me on or before November 20, 2023. I observed the administrative action and cover letter posted on the parent board to the right at the entrance of the facility. You stated you understood the information provided and did not have any questions or concerns at this time. STAFF/CHILD RATIO REQUIREMENTS: An eleven-month-old infant was observed grouped in care with children two years old in Space #1. I informed you children under one year of age shall be kept separate from children two years of age and over. I reviewed child care rule 10A NCAC 09 .0713 (5) with you during the visit. You transitioned the eleven-month-old infant back to Space #1 with the other infants. We discussed the importance of maintaining staff/child ratio requirements as required. Strategies should be implemented to ensure staff/child ratio requirements are always met. One strategy could be to monitor the ages and grouping of children when done. You could also develop a tracking system that keeps up with the staff to child ratio. Be reminded staff/child ratio requirements must always be met. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. ARRIVAL/DEPARTURE: Based on my review of arrival and departure records, departure times for eleven children were not documented. I reminded you arrival and departure times must be documented for all children present daily. I recommended having staff monitor the sign in/out logs as periodically throughout the day to ensure the times are captured. If parents do not document the times, staff can do so and add their initials or signatures to reflect who is recording the information. CRIMINAL BACKGROUND CHECK REVISIONS: Please take time to read the updated Child Care Rule 10A NCAC 09 .2703 Criminal History Record Check Requirements for Child Care Providers that was revised and amended effective October 1, 2023. Read the entire rule at https://ncchildcare.ncdhhs.gov/Home/Child-Care-Commission/Rule-Changes WEBINAR: CREATING SPPORTIVE ENVIRONMENTS: A Healthy Social Behaviors Webinar is being offered on Thursday November 16, 2023, from 7:00 pm to 8:00pm. You can access the training using the following information: https://ccrinc.zoom.us/j/926189206 Meeting ID: 326 189 6206 NEW FREE ONLINE TEACHER PROFESSIONAL DEVELOPMENT MEMBERSHIP! NC child care teachers and staff are eligible for an online professional development membership program for early educators. DCDEE covers the cost! Membership includes 200+ hours including all training required for a CDA. Learning is engaging, interactive and includes relevant content, games, and videos. Courses are available in English and Spanish. To learn more, register now! North Carolina Teacher Professional Development Resources Webinar Nov 30, 2023 at 1:00 PM Eastern Time Space is limited. Register in advance for this webinar: https://teachingstrategies.zoom.us/webinar/register/WN_RjOYSOSBRxur5dhunfZDpA Meeting ID: 987 6848 1576 Passcode: 370896 MENTAL HEALTH FIRST AID TRAININGS: The North Carolina Association for the Education of Young Children (NCAEYC) in partnership with ITTI is planning several Mental Health First Aid trainings for child care administrators to be held between November 2023 and June 2024. To best organize where to hold the training, NCAEYC is asking directors to fill out a short form to see where interest falls across the state. After completing the form, please share the link to the form and/or the flyer with QR code with your network. Reference the email blast sent to access the noted form. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. You can also complete training modules located in the MOODLE platform, access provider's documents, and the child care rules and laws. At the end of this visit, the visit summary report was printed, reviewed with you, and a copy left for your records. CONTACT INFORMATION: If you have any questions about today’s visit, my contact information is listed above. You may also contact Licensing Supervisor Susan Fuller at 252-373-9809 or email susan.fuller@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

GS 110-91 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: Visit Date: 11/8/2023 Number Present: 50 Completed Date: 11/8/2023 Age: From 0 To 5 Total Minutes: 170 Time In: 09:00 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your facility for compliance with applicable child care requirements during a routine unannounced visit. C. Summerlin, Administrator assisted with the visit. Fifty-six children were observed in care today ranging from ages zero to five years old. Children were engaged in morning activities, free-choice play, outdoor play, interacting with the caregivers, completing toileting, and hand washing routines, napping and eating breakfast. Breakfast consisted of bagels, pears, and milk. Children were cared for in a positive and nurturing environment. Currently this program operates with a Three-Star License earning five points in education the component, one point in program standards component and one quality point for the administrator completing a business training course of at least 30 clock hours. The following violations were documented today. Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. Departure times were not documented for eleven children between the dates of October 5, 2023, to October 27, 2023. 10A NCAC 09 .0302(d)(4) 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. An infant eleven-month infant was observed grouped with children two years old in Space #1. GS 110-91(7);.0713(a-d) The violations documented must be corrected immediately. Please send a compliance verification letter to me describing how the violations were corrected. You can submit the compliance verification letter by postal mail to Keshia Hayward, PO Box 1504 Greenville NC 27834, or email keshia.hayward@dhhs.nc.gov. The compliance verification letter must be received on or before November 22, 2023. The two-week time frame is established to allow you time for submitting your compliance verification letter. This timeframe is not intended to be used as a guide for correcting violations, as they should be corrected immediately. Please be aware that any written information submitted by you regarding correction of violations documented during the visit is legal documentation. Therefore, it is important that all information submitted be accurate and truthful. Please be aware that if it is determined information submitted was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility's Star Rated License could be issued. If sufficient information is not received by the due date, a follow-up visit will be conducted. COMPLIANCE HISTORY: The program's compliance history was reviewed with the operator. The program’s compliance history was 96% percent as of November 7, 2023. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. was current and active. I reminded you the corporation status must always remain Current and Active. Failure to comply may affect your child care license. FACILITY PROFILE INFORMATION: You stated the mailing address, phone number and email address listed for your program are correct. If changes in your facility information occurs, please contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov to discuss the changes and ensure the information is updated in the system. ADMINISTRATIVE ACTION: You stated the written warning administrative action was received on November 6, 2023. During the visit you, Mr. Bowen and I reviewed the administrative action including the corrective action plan. I explained the appeal process to you and Mr. Bowen. I informed shared you have the right to appeal. Mr. Bowen stated he did not plan to file an appeal. I notified you that the written plan you must develop is due to me on or before November 20, 2023. I observed the administrative action and cover letter posted on the parent board to the right at the entrance of the facility. You stated you understood the information provided and did not have any questions or concerns at this time. STAFF/CHILD RATIO REQUIREMENTS: An eleven-month-old infant was observed grouped in care with children two years old in Space #1. I informed you children under one year of age shall be kept separate from children two years of age and over. I reviewed child care rule 10A NCAC 09 .0713 (5) with you during the visit. You transitioned the eleven-month-old infant back to Space #1 with the other infants. We discussed the importance of maintaining staff/child ratio requirements as required. Strategies should be implemented to ensure staff/child ratio requirements are always met. One strategy could be to monitor the ages and grouping of children when done. You could also develop a tracking system that keeps up with the staff to child ratio. Be reminded staff/child ratio requirements must always be met. UNANNOUNCED FOLLOW-UP VISIT: An unannounced follow-up visit will be conducted to monitor staff/child ratio requirements. ARRIVAL/DEPARTURE: Based on my review of arrival and departure records, departure times for eleven children were not documented. I reminded you arrival and departure times must be documented for all children present daily. I recommended having staff monitor the sign in/out logs as periodically throughout the day to ensure the times are captured. If parents do not document the times, staff can do so and add their initials or signatures to reflect who is recording the information. CRIMINAL BACKGROUND CHECK REVISIONS: Please take time to read the updated Child Care Rule 10A NCAC 09 .2703 Criminal History Record Check Requirements for Child Care Providers that was revised and amended effective October 1, 2023. Read the entire rule at https://ncchildcare.ncdhhs.gov/Home/Child-Care-Commission/Rule-Changes WEBINAR: CREATING SPPORTIVE ENVIRONMENTS: A Healthy Social Behaviors Webinar is being offered on Thursday November 16, 2023, from 7:00 pm to 8:00pm. You can access the training using the following information: https://ccrinc.zoom.us/j/926189206 Meeting ID: 326 189 6206 NEW FREE ONLINE TEACHER PROFESSIONAL DEVELOPMENT MEMBERSHIP! NC child care teachers and staff are eligible for an online professional development membership program for early educators. DCDEE covers the cost! Membership includes 200+ hours including all training required for a CDA. Learning is engaging, interactive and includes relevant content, games, and videos. Courses are available in English and Spanish. To learn more, register now! North Carolina Teacher Professional Development Resources Webinar Nov 30, 2023 at 1:00 PM Eastern Time Space is limited. Register in advance for this webinar: https://teachingstrategies.zoom.us/webinar/register/WN_RjOYSOSBRxur5dhunfZDpA Meeting ID: 987 6848 1576 Passcode: 370896 MENTAL HEALTH FIRST AID TRAININGS: The North Carolina Association for the Education of Young Children (NCAEYC) in partnership with ITTI is planning several Mental Health First Aid trainings for child care administrators to be held between November 2023 and June 2024. To best organize where to hold the training, NCAEYC is asking directors to fill out a short form to see where interest falls across the state. After completing the form, please share the link to the form and/or the flyer with QR code with your network. Reference the email blast sent to access the noted form. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. You can also complete training modules located in the MOODLE platform, access provider's documents, and the child care rules and laws. At the end of this visit, the visit summary report was printed, reviewed with you, and a copy left for your records. CONTACT INFORMATION: If you have any questions about today’s visit, my contact information is listed above. You may also contact Licensing Supervisor Susan Fuller at 252-373-9809 or email susan.fuller@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 .0606 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: 0823-440L Visit Date: 9/25/2023 Number Present: 50 Completed Date: 9/25/2023 Age: From 0 To 5 Total Minutes: 180 Time In: 07:40 AM Time Out: 10:40 AM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Follow-Up Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor this program for compliance with applicable child care requirements during a complaint follow-up visit. C. Summerlin, Administrator assisted me with the visit. Fifty (50) children were observed in care today ranging from ages zero (0) to five (5) years old. Children were engaged in free-choice play, interacting with caregivers, eating breakfast, napping, and completing toileting, diapering and hand washing routines. Breakfast consisted of waffles, apple sauce and milk. I completed a general walk-through of the child care facility and conducted observation of indoor spaces used by children and staff/child interactions. Limited monitoring of the child care requirements was completed today. COMPLIANCE HISTORY SCORE: The program’s compliance history score was reviewed with the operator. The programs compliance history was (97%) as of September 24, 2023. The following violation was documented today. Violation Number Comment Rule 895 Infants under the age of 12 months were not placed on their backs for sleeping unless the center had obtained the appropriate written waiver. An infant in Space #1 was not placed down on his back for sleeping. .0606(a)(1)(A-B) OBSERVATION, TECHNICAL ASSISTANCE/GUIDANCE: During the walk-through and observations of the indoor space and staff interactions, no hazards were observed. Children were actively engaged in free-choice play using developmentally age-appropriate materials. Staff were interacting with children in a positive and nurturing manner. Staff were also observed holding children by their hands when walking around the classroom as well as lifting them by their arms instead of their waist. One caregiver was observed placing an infant down to sleep on his stomach; however, she changed the position to the back within a approximately two minutes. We discussed reminding staff to place infants under twelve months down on their backs for sleeping unless a waiver is in place. I reviewed child care requirement 10A NCAC 09 .0606(a)(1) (A-B) regarding safe sleep practices. It was suggested placing another person in the infant classroom, if possible, to assist with bottle prepping and diaper changing. This will allow assigned caregivers the opportunity to focus directly on the children and ensure children's needs and compliance with applicable child care requirements are met. I explained due to the classroom having a mixture of mobile and non-mobile children close monitoring is required in the infant classroom. We talked about staff holding children by their arms or hands while walking throughout the classroom completing tasks. We also discussed the appropriate way of lifting children as well. You reviewed video footage with me for a short period of time and observed the actions shared. During the visit, you reminded staff of the appropriate way to handle children in keeping with their developmental needs. You printed a flyer with techniques for lifting and holding infants and toddlers. The flyer was copied and placed in each classroom for the appropriate age group. You stated no training has been found for staff relating to the topic. I recommended contacting your local partnership for children to inquire about training. You could also contact the Southwestern Child Development Commission to ask if they offer training in the topic area. Be reminded you and staff are responsible for ensuring the safety of all children in care. ADMINISTRATIVE ACTION: I informed you an administrative action may be recommended for your program. I explained if an administrative action is issued, you will be notified by the Division of Child Development and Early Education. COMPLAINT OUTCOME: I shared with you via email and telephone call on September 15, 2023, the allegation of the complaint was substantiated based on my observation, review of the video and staff interviews. You stated during the visit you had no questions or concerns about any information provided regarding the investigation. FOLLOW-UP VISITS: Unannounced follow-up visits will be conducted to monitor compliance with applicable child care requirements in the future. STAFFING CHANGES: You stated one new staff member has been hired since the last visit. The staff file was reviewed, and a staff/training worksheet was completed. Based on my review of the staff file, all requirements were met. DCDEE RESOURCES: I recommended you periodically visit the DCDEE website at https://ncchildcare.ncdhhs.gov/ under the "What's New" tab to stay abreast of updated information provided. CONTACT INFORMATION: If you have any questions about today’s visit, contact me at 252-214-2709 or email keshia.hayward@dhhs.nc.gov. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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. 110-91 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: 0823-440L Visit Date: 9/11/2023 Number Present: 54 Completed Date: 9/11/2023 Age: From 0 To 5 Total Minutes: 160 Time In: 11:20 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. B. Bowen, Owner, and C. Summerlin, Administrator was present and assisted with the visit. Fifty-four (54) children were observed in care ranging from ages zero (0) to five (5) years old. Children were observed engaged in story-time, completing toileting and hand-washing routines, interacting with caregivers, eating lunch and napping. Lunch consisted of hamburger on the bun, potatoes, corn, and milk. The allegation is as follows: There is a concern that children were not attended to in a nurturing and appropriate manner or in keeping with their developmental needs. Supervision, staff/child ratios, use of indoor spaces designated for child care, and license restrictions were monitored. The license and emergency care plan were posted. The following violation was documented. Violation Number Comment Rule 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report was not completed and submitted for an incident that occurred on August 28, 2023 where a child sustained an injury. .0802 (e) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on my observation of video footage from August 28, 2023, and interviews with staff, it was determined a child sustained an injury as a result of being handled in an inappropriate manner by a staff member. G.S. 110-91(10) Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation documented today must be corrected immediately. On or before September 25, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Keshia Hayward, Child Care Consultant, PO Box 1504, Greenville, NC 27834 keshia.hayward@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. COMMENTS: The center's compliance history was reviewed with the operator. The program’s compliance history was ninety-two percent (99%) as of September 11, 2023. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. The corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. STAFF INTERVIEW: I interviewed you, the owner (Bucky Bowen) and one other staff member regarding the allegation. You and staff were given the opportunity to answer questions and express concerns. During the interview it was reported a caregiver was holding a two-year-old child by the hand while walking her from the backdoor to another location in the classroom. The caregiver was talking to the second staff member while walking the child to the location. The child stopped, sat down on the floor and the caregiver pulled her back up by the arm. Mr. Bowen stated staff informed him the child started crying after being pulled back up; however, they did not know the reason she was crying at the time. According to Mr. Bowen, the incident happened at the end of the day during departure. He added the parent of the child contacted the administrator the same night to report the child was being taken to the emergency room because she was still whining about her arm. Mr. Bowen stated he was told by the parent the child’s elbow was pulled out of socket and the doctor had to pop it back into place. It was reported the video footage was reviewed and it revealed caregiver did pull the child up by the arm, the child immediately started whining and grabbed her arm. Mr. Bowen stated the video was reviewed with the parent, in addition they had a discussion regarding what happened. He added based on his observation it appeared to be truly an accident. You stated you did not work on the day of the incident. You added you were notified of the incident by the parent and you reviewed the video. The other staff member interviewed stated she had no knowledge of the allegation. You and Mr. Bowen stated an incident report was not completed. You stated you thought the incident report should only be completed and submitted when the child is taken for medical attention by the provider. I advised you to complete the incident report, review it with the parent and submit it to me once signed. I also informed you a violation would be documented because an incident report was not submitted as required. Mr. Bowen stated since the incident, he talked with all staff about appropriate ways to handle children to prevent an injury or causing harm. He added the video footage was used (with the parent permission) as reference when talking to staff about handling children. Mr. Bowen stated he reiterated children should not be held by the hand or arm at any time. According to you and Mr. Bowen no other strategies have been put in place since the incident occurred. You both reported no other concerns or issues have been presented or addressed. You and Mr. Bowen stated classroom observations are conducted randomly and feedback is given to staff as needed. During the visit, I reviewed video footage of the incident and conducted observation in classrooms. The video observation confirmed information provided today regarding the incident. Based on my observation in classrooms, children were cared for in a positive and nurturing manner. Two staff members with knowledge of the allegation were not present today. You provided contact information for both caregivers. I informed you the investigation will remain open until interviews were completed. At which time you will be notified orally and in writing of the outcome. INCIDENT REPORTS: We discussed ensuring incident reports are completed and submitted as required within the recommended timeframe. I shared the incident report should be completed on the form provided by the Division. The incident report must be reviewed with the parent(s) or guardian(s) and a copy should be given unless declined. If the parent/guardian declines a copy of the incident report, they should initial the appropriate box. A copy of the incident report should be placed in the child’s file. The incident must be recorded on the incident log. CARING FOR YOUNG CHILDREN: Because young children's bones and muscles are still developing, it typically takes very little force to pull the bones of the elbow partially out of place, making this injury very common. It occurs most often in children ages one (1) to four (4) but can happen any time from birth up to age six (6) or seven (7) years old. Examples of the most common causes of nurse maids’ elbow include when a person: •trying to catch a child by the hand to stop a fall or pull them away from a dangerous situation. •holding a child's hand when the child suddenly steps off a curb or stair step. •lifting a child up by the hands or wrists. •pulling a child's arm too roughly through a jacket sleeve. •swinging a child by the arms or hands; or •yanking on a child's arm to make them walk faster. Awareness of the most common causes of nursemaid's elbow (listed above) will help staff to handle young children more safely. It is recommended when working with young children. Individuals providing care to young children should implement some of the following strategies: being patient with children when putting on their coats during the winter; making sure to gently place their hands on either side of children’s torso near the rib cage when lifting them; and using verbal cues to get a child's attention instead of pulling them by their arm. Children are tough but often that toughness causes injuries to go unnoticed. The information was retrieved from the Division’s website at https://ncchildcare.ncdhhs.gov/ CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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.

NC GS 110-90 · Violation

Name of Operation: KINDER KASTLE Facility ID: 98000050 Consultant: KESHIA HAYWARD Operation Type: Center Case Number: 0823-440L Visit Date: 9/11/2023 Number Present: 54 Completed Date: 9/11/2023 Age: From 0 To 5 Total Minutes: 160 Time In: 11:20 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to obtain information regarding alleged violations of child care requirements. B. Bowen, Owner, and C. Summerlin, Administrator was present and assisted with the visit. Fifty-four (54) children were observed in care ranging from ages zero (0) to five (5) years old. Children were observed engaged in story-time, completing toileting and hand-washing routines, interacting with caregivers, eating lunch and napping. Lunch consisted of hamburger on the bun, potatoes, corn, and milk. The allegation is as follows: There is a concern that children were not attended to in a nurturing and appropriate manner or in keeping with their developmental needs. Supervision, staff/child ratios, use of indoor spaces designated for child care, and license restrictions were monitored. The license and emergency care plan were posted. The following violation was documented. Violation Number Comment Rule 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report was not completed and submitted for an incident that occurred on August 28, 2023 where a child sustained an injury. .0802 (e) 902 Each child was not attended to in a nurturing and appropriate manner, or in keeping with the child's developmental needs. Based on my observation of video footage from August 28, 2023, and interviews with staff, it was determined a child sustained an injury as a result of being handled in an inappropriate manner by a staff member. G.S. 110-91(10) Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violation documented today must be corrected immediately. On or before September 25, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Keshia Hayward, Child Care Consultant, PO Box 1504, Greenville, NC 27834 keshia.hayward@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. COMMENTS: The center's compliance history was reviewed with the operator. The program’s compliance history was ninety-two percent (99%) as of September 11, 2023. CORPORATION STATUS: Kinder Kastle, Inc. is listed as the current owner of this center. According to information verified on the North Carolina Secretary of State’s website, Kinder Kastle, Inc. remains Current and Active. Prior to making any changes in the corporation status, please contact me to discuss change of ownership procedures. The corporation status for your program must always remain Current and Active. Failure to comply may affect your child care license. STAFF INTERVIEW: I interviewed you, the owner (Bucky Bowen) and one other staff member regarding the allegation. You and staff were given the opportunity to answer questions and express concerns. During the interview it was reported a caregiver was holding a two-year-old child by the hand while walking her from the backdoor to another location in the classroom. The caregiver was talking to the second staff member while walking the child to the location. The child stopped, sat down on the floor and the caregiver pulled her back up by the arm. Mr. Bowen stated staff informed him the child started crying after being pulled back up; however, they did not know the reason she was crying at the time. According to Mr. Bowen, the incident happened at the end of the day during departure. He added the parent of the child contacted the administrator the same night to report the child was being taken to the emergency room because she was still whining about her arm. Mr. Bowen stated he was told by the parent the child’s elbow was pulled out of socket and the doctor had to pop it back into place. It was reported the video footage was reviewed and it revealed caregiver did pull the child up by the arm, the child immediately started whining and grabbed her arm. Mr. Bowen stated the video was reviewed with the parent, in addition they had a discussion regarding what happened. He added based on his observation it appeared to be truly an accident. You stated you did not work on the day of the incident. You added you were notified of the incident by the parent and you reviewed the video. The other staff member interviewed stated she had no knowledge of the allegation. You and Mr. Bowen stated an incident report was not completed. You stated you thought the incident report should only be completed and submitted when the child is taken for medical attention by the provider. I advised you to complete the incident report, review it with the parent and submit it to me once signed. I also informed you a violation would be documented because an incident report was not submitted as required. Mr. Bowen stated since the incident, he talked with all staff about appropriate ways to handle children to prevent an injury or causing harm. He added the video footage was used (with the parent permission) as reference when talking to staff about handling children. Mr. Bowen stated he reiterated children should not be held by the hand or arm at any time. According to you and Mr. Bowen no other strategies have been put in place since the incident occurred. You both reported no other concerns or issues have been presented or addressed. You and Mr. Bowen stated classroom observations are conducted randomly and feedback is given to staff as needed. During the visit, I reviewed video footage of the incident and conducted observation in classrooms. The video observation confirmed information provided today regarding the incident. Based on my observation in classrooms, children were cared for in a positive and nurturing manner. Two staff members with knowledge of the allegation were not present today. You provided contact information for both caregivers. I informed you the investigation will remain open until interviews were completed. At which time you will be notified orally and in writing of the outcome. INCIDENT REPORTS: We discussed ensuring incident reports are completed and submitted as required within the recommended timeframe. I shared the incident report should be completed on the form provided by the Division. The incident report must be reviewed with the parent(s) or guardian(s) and a copy should be given unless declined. If the parent/guardian declines a copy of the incident report, they should initial the appropriate box. A copy of the incident report should be placed in the child’s file. The incident must be recorded on the incident log. CARING FOR YOUNG CHILDREN: Because young children's bones and muscles are still developing, it typically takes very little force to pull the bones of the elbow partially out of place, making this injury very common. It occurs most often in children ages one (1) to four (4) but can happen any time from birth up to age six (6) or seven (7) years old. Examples of the most common causes of nurse maids’ elbow include when a person: •trying to catch a child by the hand to stop a fall or pull them away from a dangerous situation. •holding a child's hand when the child suddenly steps off a curb or stair step. •lifting a child up by the hands or wrists. •pulling a child's arm too roughly through a jacket sleeve. •swinging a child by the arms or hands; or •yanking on a child's arm to make them walk faster. Awareness of the most common causes of nursemaid's elbow (listed above) will help staff to handle young children more safely. It is recommended when working with young children. Individuals providing care to young children should implement some of the following strategies: being patient with children when putting on their coats during the winter; making sure to gently place their hands on either side of children’s torso near the rib cage when lifting them; and using verbal cues to get a child's attention instead of pulling them by their arm. Children are tough but often that toughness causes injuries to go unnoticed. The information was retrieved from the Division’s website at https://ncchildcare.ncdhhs.gov/ CONTACT INFORMATION: If you have questions regarding today’s visit, my contact information is listed above. You may also contact Licensing Supervisor, Susan Fuller at 252-373-9809 or email susan.fuller@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