Creative Enhancement DAY Care

10A NCAC 09 .0302 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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 .0601 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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 .0607 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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 .1102 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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 .1103 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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

G.S. 110-91 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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

GS110-91 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/1/2026 Number Present: 14 Completed Date: 4/1/2026 Age: From 0 To 4 Total Minutes: 450 Time In: 09:00 AM Time Out: 01:00 PM Time In: 02:00 PM Time Out: 05:30 PM List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 10, 2025, and prior to today’s visit, the eighteen-month compliance history score was 87% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed on March 26, 2026. Fire Classification of Approved for Daytime Care Only was completed on September 15, 2025. I was greeted by Joseph Flood, Administrator, and Tiffany Armfield, Legal Designee. Fourteen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. In Space #1, children were observed participating in tummy-time activities and resting in individual cribs. Documentation of visual sleep checks and infant feeding plans were available for review. In the refrigerator, bottles were appropriately labeled with each child’s name and today’s date. The thermometer in the refrigerator read 40 degrees Fahrenheit. The teacher was observed sitting in a chair while holding an infant and gently rocking him to sleep. The group from Space #2 was observed in the outdoor environment. The children were participating in the facility’s spring festival. The outdoor environment was observed with inflatable bounce houses and various activity areas. The group moved around to each activity; ring toss, limbo, tug of war, bean bag toss, and face painting. Decorative balloons were observed in the outdoor environment, accessible to children. A cotton candy machine and cotton candy sugar was stored on a table in the outdoor environment, within the reach of children. Additionally, in the outdoor learning environment, foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation at the base of the stationary slide was exposed, causing a tripping hazard. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with wooden blocks. A current activity plan, daily schedule, and attendance record were available for review. Cracks were observed on the ceiling. Space #5 was not used for child care. However, it was monitored for general health and safety requirements. Cracks and water stains were observed on the ceiling. Routine care and handwashing practices were observed. Lunch consisted of hamburger on whole wheat bun, broccoli, pineapple chunks, and milk. Seven staff files were reviewed. One staff member did not have a signed acknowledgement on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. One staff member did not have documentation of orientation on file. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. One staff member did not have documentation of orientation on file. Six staff members did not have documentation on file of reviewing the Emergency Care Plan and the Emergency Preparedness and Response Plan at least annually. Three staff members did not have documentation on file of completing ITS-SIDS training within the past three years. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 05, 2026. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. The most recent playground inspection was completed on March 05, 2026. The most recent sanitation inspection report was received during today's visit. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In Spaces #4 and #5, cracks and water stains were observed on the ceiling. 15A NCAC 18A .2825(a) 721 All equipment and furnishings were not in good repair. Foundation anchors and nails were exposed on the stationary school bus, creating protrusions and tripping hazards. The cement foundation on the base of the stationary slide was exposed, creating a tripping hazard. G.S. 110-91(6); .0601(b) 860 Balloons were accessible to children. Decorative balloon stands were observed in the outdoor environment during a spring festival celebration. When the spring festival ended, the balloons were taken off the premises. .0604(q) 898 All electrical appliances were not used in accordance with the manufacturers instruction. Appliances with heating elements, such as bottle warmers, crock pots, curling irons, irons, coffee pots, and/or their cords were accessible to preschool-age children. A table containing a cotton candy machine and cotton candy sugar was observed in the outdoor environment during a spring festival celebration. When the festival ended, the cotton candy machine was removed from the premises. .0604(e) 1065 Child care providers scheduled to work in the infant room, did not complete ITS-SIDS training within two months of employment or did not complete the training every three years. Child care administrators did not complete the ITS-SIDS training within 90 days of employment and every three years thereafter. Three staff members did not compete ITS-SIDS training within the past three years. .1102(f) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a valid health assessment/medical report on file. GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent quarterly (shelter-in-place) drill was completed on December 23, 2025. .0604(u);.0302(d)(8) 1824 The trained staff did not review the EPR Plan annually or when information in the plan changed to ensure all information was current. The EPR plan was not reviewed with all staff members at least annually. For six staff members, the most recent EPR plan review was completed on March 27, 2025. .0607(e) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member did not have a signed acknowledgement on file, stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with her prior to caring for children. .0608(d)(1-4) 1899 Health and safety training topics were not included as part of on-going training within five years of completing the previous health and safety training topics. Two staff members did not have documentation on file of completing all Health and Safety training topics within the past five years. .1103(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 15, 2026, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 407 Hope Mills, NC 28348 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA: Safe Environment A violation was cited today for the foundation anchors and nails being exposed on a piece of stationary equipment. The physical structure where children spend each day can present caregivers/teachers with special safety concerns if the structure is not kept in good repair and maintained in a safe condition. For example, peeling paint in an older building may be ingested, floor surfaces in disrepair could cause falls and other injury, bulging ceilings can collapse and cause injuries, and playground equipment and fences in poor repair can create entanglement, entrapment, and tripping hazards. Additionally, appliances with heating elements should not be accessible to children, because they create a burn hazard. For more information about safety requirements, refer to child care rule 10A NCAC 09 .0601. Health and Safety Training A violation was cited today for an additional caregiver not completing the required health and safety training courses within one year of employment. Caregivers should be knowledgeable about infectious disease and immunizations because properly implemented health policies can reduce the spread of disease, not only among the children but also among staff members, family members, and the greater community. Knowledge of injury prevention measures in child care is essential to control known risks. Medication administration and knowledge about caring for children with special health care needs are essential to maintaining the health and safety of children with special health care needs. More information about health and safety training requirements can be found in child care rule 10A NCAC 09 .1103(b). ITS-SIDS Training A violation was cited today for staff members not taking an ITS-SIDS course within the past three years. Most SIDS deaths in child care occur within the first week of child care due to unaccustomed prone (on the stomach) sleeping; the risk of SIDS increases eighteen times when an infant who sleeps supine (on the back) at home is placed in the prone position in child care. Use of safe sleep policies, training of caregivers, continued education of parents/guardians, expanded training efforts for child care professionals, statewide regulations and mandates, and increased monitoring and observation of infants while they are sleeping are critical to reduce the risk of SIDS in child care. More information about ITS-SIDS training requirements can be found in child care rule 10A NCAC 09 .1102(f). Emergency Drill Requirements A violation was cited today for not conducting and documenting quarterly emergency drills. Regular emergency and evacuation drills are important safety practices in areas where these natural or human generated disasters might occur. The routine practice of such drills fosters a calm, competent response to a natural or human generated disaster when it occurs. The extensive turnover of both staff and children, in addition to the changing developmental abilities of the children to participant in evacuation procedures in child care, necessitates frequent practice of the drills. More information about emergency drill requirements can be found in child care rules 10A NCAC 09 .0302(d) and .0604(u). Children’s Records A violation was cited today for a child not having a valid medical report on file. The health and safety of individual children requires that medical information regarding each child in care be kept and made available on a need-to-know basis. The requirement of a health report for each child reflecting completion of health assessments and immunizations is a valid way to ensure timely preventive care for children who might not otherwise receive it and can be used in decision-making at the time of admission and during ongoing care. The legal designee stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. For more information about this rule requirement, refer to NC General Statute 110-91(1). Staff Records Multiple violations were cited today regarding staff files. Maintaining complete records on each staff person employed at the facility is a sound administrative practice. Orientation ensures that all staff members receive specific and basic training for the work they will be doing and are informed about their new responsibilities. Health training for child care staff protects the children in care, staff, and the families of the children enrolled. Ongoing training is an essential component to ensure that staff members develop and maintain the skills needed to perform their job duties. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. For more information regarding staff records, refer to child care rules 10A NCAC 09 .0607, .0608, .0701, .1101, and .1102. Reminders: NCDHHS Responds to Increase in Measles Cases Measles is on the rise globally and in North Carolina. As a highly contagious, airborne disease, even one case is a major priority for public health. NCDHHS is taking action by launching new outreach resources for child care providers, families, and community stakeholder to help curb the spread. Child care providers can share information about vaccinations with the families served and be informed with the most current information. For more information and to access tools and resources, visit NCDHHS at dph.ncdhhs.gov/measles. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@dhhs.nc.gov. Rhonda Blackmon, Licensing Supervisor, may also be contacted at 910-709-4168 or Rhonda.blackmon@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 .0601 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 11/7/2025 Number Present: 12 Completed Date: 11/7/2025 Age: From 0 To 3 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 10, 2025. Prior to today’s visit, the eighteen-month compliance history score was 86%, which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director/Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed August 08, 2025. Fire Classification of Approved for Day Time Care Only was completed September 15, 2025. T. Armfield, Assistant Director, was present while I observed the indoor and outdoor areas. Upon my arrival, twelve (12) children and three (3) teachers were present. Groups of children were observed participating in free-choice indoor and outdoor activities. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. No children were enrolled In Space #1, but the space was monitored for general health and safety requirements. In Space #2, children were observed sitting at a table while engaging in an art activity. The children colored on construction paper with crayons. When the group finished coloring, they cleaned up the materials, put their drawings in their cubbies, and transitioned to outdoor play. Space #3 was not being used for child care, but was monitored for general health and safety requirements. In Space #4, children were observed dancing to music on a Bluetooth speaker. The children danced and sang along to “The Wheels on the Bus”, “Row Your Boat”, and “Head, Shoulders, Knees, and Toes”. In Space #5, a toddler was observed engaging in free-choice activities. An infant was observed asleep in a baby swing/rocker. Another infant was observed alert, awake, and crying in a crib. When the assistant director came into the room to check why the infant was crying, she took the infant out of the crib and placed him on the floor to engage in tummy-time activities. A diaper change was observed and all diapering procedures were followed. Cords, from a camera and from a bottle warmer, were accessible to infants and toddlers. In the outdoor learning environment, children had access to stationary slides, stationary bouncers, a climbing dome, and sand play materials. Vegetation with thorns was observed growing into the outdoor learning environment, around the perimeter of the fence. Anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. Routine care and handwashing practices were observed. Lunch consisted of pepperoni pizza, green beans, mixed tropical fruit, and milk. One recently hired staff file was reviewed, and all documentation was observed in compliance. The most recent fire inspection was received during today’s visit. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was received today, and was completed on 9/15/2025. The previous fire inspection was completed on 9/12/2024. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In the outdoor learning environment, anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. .0601(c) 807 A safe indoor and outdoor environment was not provided for the children. In the outdoor learning environment, a tree and plants with thorns were observed growing into the outdoor learning environment, around the perimeter of the fence. 10A NCAC 09 .0601(a) 815 Electrical cords were accessible to infants and toddlers. In Space #5, cords, from a ceiling camera and from a bottle warmer, were accessible to infants and toddlers. 10A NCAC 09 .0604(f) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on November 21, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Safe Indoor and Outdoor Environment A violation was cited today for not maintaining a safe indoor and outdoor environment. Providing a safe environment is important for children’s growth and development. Plants are important to our health and well-being and are a great lesson in learning to understand and respect our environment. However, some plants can be harmful when eaten or touched. Potentially harmful plants are prohibited in any part of a child care facility that is accessible to children. Additionally, equipment and furnishings that are not sturdy, safe, or in good repair, may create tripping hazards, falling hazards, entrapment hazards, sharp points, corners, or edges. If equipment and furnishings have deteriorated to a state of disrepair, where they are no longer sturdy or safe, they should be removed from all areas of a child care facility to which children have access. I encouraged the assistant director to use the monthly playground inspection checklist to closely monitor the condition of equipment and outdoor learning environment and to report and fix any maintenance issues as they are discovered. For more information about maintaining a safe indoor and outdoor environment, refer to Child Care Rule 10A NCAC 09 .0604. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #2. I suggested that teachers should look for learning opportunities to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. QRIS Modernization Discussion During today’s visit an overview of section .3200 of the child care rules was provided. Each of the following pathway options were discussed: Program Assessment Pathway, Classroom and Instructional Quality Pathway, and Accreditation and Head Start Pathway. Education requirements were also reviewed. Based on today’s conversation, the facility will pursue the Classroom and Instructional Quality Pathway. The assistant director will further discuss the pathway options with the administrator before making a final decision. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .0604 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 11/7/2025 Number Present: 12 Completed Date: 11/7/2025 Age: From 0 To 3 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 10, 2025. Prior to today’s visit, the eighteen-month compliance history score was 86%, which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director/Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed August 08, 2025. Fire Classification of Approved for Day Time Care Only was completed September 15, 2025. T. Armfield, Assistant Director, was present while I observed the indoor and outdoor areas. Upon my arrival, twelve (12) children and three (3) teachers were present. Groups of children were observed participating in free-choice indoor and outdoor activities. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. No children were enrolled In Space #1, but the space was monitored for general health and safety requirements. In Space #2, children were observed sitting at a table while engaging in an art activity. The children colored on construction paper with crayons. When the group finished coloring, they cleaned up the materials, put their drawings in their cubbies, and transitioned to outdoor play. Space #3 was not being used for child care, but was monitored for general health and safety requirements. In Space #4, children were observed dancing to music on a Bluetooth speaker. The children danced and sang along to “The Wheels on the Bus”, “Row Your Boat”, and “Head, Shoulders, Knees, and Toes”. In Space #5, a toddler was observed engaging in free-choice activities. An infant was observed asleep in a baby swing/rocker. Another infant was observed alert, awake, and crying in a crib. When the assistant director came into the room to check why the infant was crying, she took the infant out of the crib and placed him on the floor to engage in tummy-time activities. A diaper change was observed and all diapering procedures were followed. Cords, from a camera and from a bottle warmer, were accessible to infants and toddlers. In the outdoor learning environment, children had access to stationary slides, stationary bouncers, a climbing dome, and sand play materials. Vegetation with thorns was observed growing into the outdoor learning environment, around the perimeter of the fence. Anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. Routine care and handwashing practices were observed. Lunch consisted of pepperoni pizza, green beans, mixed tropical fruit, and milk. One recently hired staff file was reviewed, and all documentation was observed in compliance. The most recent fire inspection was received during today’s visit. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was received today, and was completed on 9/15/2025. The previous fire inspection was completed on 9/12/2024. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In the outdoor learning environment, anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. .0601(c) 807 A safe indoor and outdoor environment was not provided for the children. In the outdoor learning environment, a tree and plants with thorns were observed growing into the outdoor learning environment, around the perimeter of the fence. 10A NCAC 09 .0601(a) 815 Electrical cords were accessible to infants and toddlers. In Space #5, cords, from a ceiling camera and from a bottle warmer, were accessible to infants and toddlers. 10A NCAC 09 .0604(f) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on November 21, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Safe Indoor and Outdoor Environment A violation was cited today for not maintaining a safe indoor and outdoor environment. Providing a safe environment is important for children’s growth and development. Plants are important to our health and well-being and are a great lesson in learning to understand and respect our environment. However, some plants can be harmful when eaten or touched. Potentially harmful plants are prohibited in any part of a child care facility that is accessible to children. Additionally, equipment and furnishings that are not sturdy, safe, or in good repair, may create tripping hazards, falling hazards, entrapment hazards, sharp points, corners, or edges. If equipment and furnishings have deteriorated to a state of disrepair, where they are no longer sturdy or safe, they should be removed from all areas of a child care facility to which children have access. I encouraged the assistant director to use the monthly playground inspection checklist to closely monitor the condition of equipment and outdoor learning environment and to report and fix any maintenance issues as they are discovered. For more information about maintaining a safe indoor and outdoor environment, refer to Child Care Rule 10A NCAC 09 .0604. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #2. I suggested that teachers should look for learning opportunities to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. QRIS Modernization Discussion During today’s visit an overview of section .3200 of the child care rules was provided. Each of the following pathway options were discussed: Program Assessment Pathway, Classroom and Instructional Quality Pathway, and Accreditation and Head Start Pathway. Education requirements were also reviewed. Based on today’s conversation, the facility will pursue the Classroom and Instructional Quality Pathway. The assistant director will further discuss the pathway options with the administrator before making a final decision. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .0304 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 11/7/2025 Number Present: 12 Completed Date: 11/7/2025 Age: From 0 To 3 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 10, 2025. Prior to today’s visit, the eighteen-month compliance history score was 86%, which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director/Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed August 08, 2025. Fire Classification of Approved for Day Time Care Only was completed September 15, 2025. T. Armfield, Assistant Director, was present while I observed the indoor and outdoor areas. Upon my arrival, twelve (12) children and three (3) teachers were present. Groups of children were observed participating in free-choice indoor and outdoor activities. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. No children were enrolled In Space #1, but the space was monitored for general health and safety requirements. In Space #2, children were observed sitting at a table while engaging in an art activity. The children colored on construction paper with crayons. When the group finished coloring, they cleaned up the materials, put their drawings in their cubbies, and transitioned to outdoor play. Space #3 was not being used for child care, but was monitored for general health and safety requirements. In Space #4, children were observed dancing to music on a Bluetooth speaker. The children danced and sang along to “The Wheels on the Bus”, “Row Your Boat”, and “Head, Shoulders, Knees, and Toes”. In Space #5, a toddler was observed engaging in free-choice activities. An infant was observed asleep in a baby swing/rocker. Another infant was observed alert, awake, and crying in a crib. When the assistant director came into the room to check why the infant was crying, she took the infant out of the crib and placed him on the floor to engage in tummy-time activities. A diaper change was observed and all diapering procedures were followed. Cords, from a camera and from a bottle warmer, were accessible to infants and toddlers. In the outdoor learning environment, children had access to stationary slides, stationary bouncers, a climbing dome, and sand play materials. Vegetation with thorns was observed growing into the outdoor learning environment, around the perimeter of the fence. Anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. Routine care and handwashing practices were observed. Lunch consisted of pepperoni pizza, green beans, mixed tropical fruit, and milk. One recently hired staff file was reviewed, and all documentation was observed in compliance. The most recent fire inspection was received during today’s visit. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was received today, and was completed on 9/15/2025. The previous fire inspection was completed on 9/12/2024. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In the outdoor learning environment, anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. .0601(c) 807 A safe indoor and outdoor environment was not provided for the children. In the outdoor learning environment, a tree and plants with thorns were observed growing into the outdoor learning environment, around the perimeter of the fence. 10A NCAC 09 .0601(a) 815 Electrical cords were accessible to infants and toddlers. In Space #5, cords, from a ceiling camera and from a bottle warmer, were accessible to infants and toddlers. 10A NCAC 09 .0604(f) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on November 21, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Safe Indoor and Outdoor Environment A violation was cited today for not maintaining a safe indoor and outdoor environment. Providing a safe environment is important for children’s growth and development. Plants are important to our health and well-being and are a great lesson in learning to understand and respect our environment. However, some plants can be harmful when eaten or touched. Potentially harmful plants are prohibited in any part of a child care facility that is accessible to children. Additionally, equipment and furnishings that are not sturdy, safe, or in good repair, may create tripping hazards, falling hazards, entrapment hazards, sharp points, corners, or edges. If equipment and furnishings have deteriorated to a state of disrepair, where they are no longer sturdy or safe, they should be removed from all areas of a child care facility to which children have access. I encouraged the assistant director to use the monthly playground inspection checklist to closely monitor the condition of equipment and outdoor learning environment and to report and fix any maintenance issues as they are discovered. For more information about maintaining a safe indoor and outdoor environment, refer to Child Care Rule 10A NCAC 09 .0604. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #2. I suggested that teachers should look for learning opportunities to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. QRIS Modernization Discussion During today’s visit an overview of section .3200 of the child care rules was provided. Each of the following pathway options were discussed: Program Assessment Pathway, Classroom and Instructional Quality Pathway, and Accreditation and Head Start Pathway. Education requirements were also reviewed. Based on today’s conversation, the facility will pursue the Classroom and Instructional Quality Pathway. The assistant director will further discuss the pathway options with the administrator before making a final decision. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .0604 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 11/7/2025 Number Present: 12 Completed Date: 11/7/2025 Age: From 0 To 3 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 10, 2025. Prior to today’s visit, the eighteen-month compliance history score was 86%, which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director/Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed August 08, 2025. Fire Classification of Approved for Day Time Care Only was completed September 15, 2025. T. Armfield, Assistant Director, was present while I observed the indoor and outdoor areas. Upon my arrival, twelve (12) children and three (3) teachers were present. Groups of children were observed participating in free-choice indoor and outdoor activities. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. No children were enrolled In Space #1, but the space was monitored for general health and safety requirements. In Space #2, children were observed sitting at a table while engaging in an art activity. The children colored on construction paper with crayons. When the group finished coloring, they cleaned up the materials, put their drawings in their cubbies, and transitioned to outdoor play. Space #3 was not being used for child care, but was monitored for general health and safety requirements. In Space #4, children were observed dancing to music on a Bluetooth speaker. The children danced and sang along to “The Wheels on the Bus”, “Row Your Boat”, and “Head, Shoulders, Knees, and Toes”. In Space #5, a toddler was observed engaging in free-choice activities. An infant was observed asleep in a baby swing/rocker. Another infant was observed alert, awake, and crying in a crib. When the assistant director came into the room to check why the infant was crying, she took the infant out of the crib and placed him on the floor to engage in tummy-time activities. A diaper change was observed and all diapering procedures were followed. Cords, from a camera and from a bottle warmer, were accessible to infants and toddlers. In the outdoor learning environment, children had access to stationary slides, stationary bouncers, a climbing dome, and sand play materials. Vegetation with thorns was observed growing into the outdoor learning environment, around the perimeter of the fence. Anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. Routine care and handwashing practices were observed. Lunch consisted of pepperoni pizza, green beans, mixed tropical fruit, and milk. One recently hired staff file was reviewed, and all documentation was observed in compliance. The most recent fire inspection was received during today’s visit. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was received today, and was completed on 9/15/2025. The previous fire inspection was completed on 9/12/2024. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In the outdoor learning environment, anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. .0601(c) 807 A safe indoor and outdoor environment was not provided for the children. In the outdoor learning environment, a tree and plants with thorns were observed growing into the outdoor learning environment, around the perimeter of the fence. 10A NCAC 09 .0601(a) 815 Electrical cords were accessible to infants and toddlers. In Space #5, cords, from a ceiling camera and from a bottle warmer, were accessible to infants and toddlers. 10A NCAC 09 .0604(f) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on November 21, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Safe Indoor and Outdoor Environment A violation was cited today for not maintaining a safe indoor and outdoor environment. Providing a safe environment is important for children’s growth and development. Plants are important to our health and well-being and are a great lesson in learning to understand and respect our environment. However, some plants can be harmful when eaten or touched. Potentially harmful plants are prohibited in any part of a child care facility that is accessible to children. Additionally, equipment and furnishings that are not sturdy, safe, or in good repair, may create tripping hazards, falling hazards, entrapment hazards, sharp points, corners, or edges. If equipment and furnishings have deteriorated to a state of disrepair, where they are no longer sturdy or safe, they should be removed from all areas of a child care facility to which children have access. I encouraged the assistant director to use the monthly playground inspection checklist to closely monitor the condition of equipment and outdoor learning environment and to report and fix any maintenance issues as they are discovered. For more information about maintaining a safe indoor and outdoor environment, refer to Child Care Rule 10A NCAC 09 .0604. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #2. I suggested that teachers should look for learning opportunities to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. QRIS Modernization Discussion During today’s visit an overview of section .3200 of the child care rules was provided. Each of the following pathway options were discussed: Program Assessment Pathway, Classroom and Instructional Quality Pathway, and Accreditation and Head Start Pathway. Education requirements were also reviewed. Based on today’s conversation, the facility will pursue the Classroom and Instructional Quality Pathway. The assistant director will further discuss the pathway options with the administrator before making a final decision. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 11/7/2025 Number Present: 12 Completed Date: 11/7/2025 Age: From 0 To 3 Total Minutes: 270 Time In: 09:00 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 10, 2025. Prior to today’s visit, the eighteen-month compliance history score was 86%, which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director/Legal Designee. Current Inspections are as follows: Sanitation Classification of Superior was completed August 08, 2025. Fire Classification of Approved for Day Time Care Only was completed September 15, 2025. T. Armfield, Assistant Director, was present while I observed the indoor and outdoor areas. Upon my arrival, twelve (12) children and three (3) teachers were present. Groups of children were observed participating in free-choice indoor and outdoor activities. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. No children were enrolled In Space #1, but the space was monitored for general health and safety requirements. In Space #2, children were observed sitting at a table while engaging in an art activity. The children colored on construction paper with crayons. When the group finished coloring, they cleaned up the materials, put their drawings in their cubbies, and transitioned to outdoor play. Space #3 was not being used for child care, but was monitored for general health and safety requirements. In Space #4, children were observed dancing to music on a Bluetooth speaker. The children danced and sang along to “The Wheels on the Bus”, “Row Your Boat”, and “Head, Shoulders, Knees, and Toes”. In Space #5, a toddler was observed engaging in free-choice activities. An infant was observed asleep in a baby swing/rocker. Another infant was observed alert, awake, and crying in a crib. When the assistant director came into the room to check why the infant was crying, she took the infant out of the crib and placed him on the floor to engage in tummy-time activities. A diaper change was observed and all diapering procedures were followed. Cords, from a camera and from a bottle warmer, were accessible to infants and toddlers. In the outdoor learning environment, children had access to stationary slides, stationary bouncers, a climbing dome, and sand play materials. Vegetation with thorns was observed growing into the outdoor learning environment, around the perimeter of the fence. Anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. Routine care and handwashing practices were observed. Lunch consisted of pepperoni pizza, green beans, mixed tropical fruit, and milk. One recently hired staff file was reviewed, and all documentation was observed in compliance. The most recent fire inspection was received during today’s visit. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The most recent fire inspection was received today, and was completed on 9/15/2025. The previous fire inspection was completed on 9/12/2024. 10A NCAC 09 .0304(a) 705 Equipment and furnishings were not sturdy, stable and free of hazards. In the outdoor learning environment, anchor footings were exposed under the stationary slides, the stationary race car bouncer, and the stationary school bus bouncer, creating tripping hazards. .0601(c) 807 A safe indoor and outdoor environment was not provided for the children. In the outdoor learning environment, a tree and plants with thorns were observed growing into the outdoor learning environment, around the perimeter of the fence. 10A NCAC 09 .0601(a) 815 Electrical cords were accessible to infants and toddlers. In Space #5, cords, from a ceiling camera and from a bottle warmer, were accessible to infants and toddlers. 10A NCAC 09 .0604(f) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on November 21, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Safe Indoor and Outdoor Environment A violation was cited today for not maintaining a safe indoor and outdoor environment. Providing a safe environment is important for children’s growth and development. Plants are important to our health and well-being and are a great lesson in learning to understand and respect our environment. However, some plants can be harmful when eaten or touched. Potentially harmful plants are prohibited in any part of a child care facility that is accessible to children. Additionally, equipment and furnishings that are not sturdy, safe, or in good repair, may create tripping hazards, falling hazards, entrapment hazards, sharp points, corners, or edges. If equipment and furnishings have deteriorated to a state of disrepair, where they are no longer sturdy or safe, they should be removed from all areas of a child care facility to which children have access. I encouraged the assistant director to use the monthly playground inspection checklist to closely monitor the condition of equipment and outdoor learning environment and to report and fix any maintenance issues as they are discovered. For more information about maintaining a safe indoor and outdoor environment, refer to Child Care Rule 10A NCAC 09 .0604. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #2. I suggested that teachers should look for learning opportunities to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. QRIS Modernization Discussion During today’s visit an overview of section .3200 of the child care rules was provided. Each of the following pathway options were discussed: Program Assessment Pathway, Classroom and Instructional Quality Pathway, and Accreditation and Head Start Pathway. Education requirements were also reviewed. Based on today’s conversation, the facility will pursue the Classroom and Instructional Quality Pathway. The assistant director will further discuss the pathway options with the administrator before making a final decision. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .0508 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .0604 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .0701 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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 .1101 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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

GS110-91 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/10/2025 Number Present: 17 Completed Date: 4/10/2025 Age: From 1 To 4 Total Minutes: 330 Time In: 09:00 AM Time Out: 02:30 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 compliance with applicable child care requirements pertinent to an Annual Compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 16, 2024, and prior to today’s visit, the eighteen-month compliance history score was 84% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Joe Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Approved was completed on May 14, 2024. Fire Classification of Approved for Daytime and Night Care was completed on September 12, 2024. I was greeted today by a teacher from Space #2. Seventeen children and three teachers were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms and in the outdoor learning environment. Children had access to blocks, fine motor, dramatic play, creative art, and literacy materials. There were no children enrolled in Space #1. However, it was monitored for general health and safety requirements. A refrigerator with a broken door was observed in the classroom, containing an unlabeled sippy cup, a container of plant-based milk, a container of apple juice, and staff's personal food items. The thermometer that was stored in the refrigerator read at 60 degrees Fahrenheit. The group from Space #2 was observed in the outdoor learning environment. The children were observed participating in sand play activities and exploring the stationary equipment. A daily schedule was not posted in the classroom. Space #3 was not used for child care. However, it was monitored for general health and safety requirements. In Space #4, children were observed participating in free-choice activities. The children built various structures with mega blocks and completed puzzles in a carpeted area. The teacher read a book titled “Monkeys” to a small group of children who were interested. A daily schedule was not posted in the classroom. In Space #5, the children and teacher were observed sitting in a carpeted area while completing knob puzzles. One of the puzzles contained farm animals. As the teacher picked each piece up, she reviewed the name of the farm animal and asked a child to put the piece in its correct place on the puzzle board. A daily schedule was not posted in the classroom. Tiffany Armfield, Assistant Administrator, arrived at the facility at 10:30am. Joe Flood, Administrator, arrived at the facility at 11:00am. In both bathrooms used by the children, baseboards were observed peeling from the wall. Paint was also observed peeling near the baseboards. Routine care and handwashing practices were observed. Lunch consisted of cheese pizza, green beans, diced peaches, and milk. Three staff files were reviewed. Two staff members did not have a medical report or TB test completed on or before the first day of work. Two staff members did not have signed acknowledgements on file stating that the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was reviewed with them prior to caring for children. Two staff members did not have documentation of orientation on file. Four children’s records were reviewed. One child did not have a valid health assessment on file. Program files, including the EPR plan, were reviewed. The most recent fire drill was completed on March 20, 2025. The most recent shelter-in-place/lockdown drill was completed on December 18, 2024. The most recent playground inspection was completed on March 25, 2025. This program does not currently provide transportation services to children. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 415 A current schedule was not posted for each group of children for reference. Daily schedules were not posted in Spaces #2, #4, and #5. GS 110-91(12);.0508(a) 504 Perishable foods were not stored to protect against spoilage. In Space #1, plant-based milk, apple juice, Cheez-It crackers, and personal food items were stored in a refrigerator with a temperature that read 60 degrees Fahrenheit. When this was brought to the administrator's attention, he immediately disposed of all items. 15A NCAC 18A .2806 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. In Space #1, an unlabeled sippy cup was observed stored in the refrigerator. When this was brought to the administrator's attention, he explained that the space did not currently have any enrolled children and immediately disposed of the sippy cup. 15A NCAC 18A .2804(d) 601 Refrigerator(s) did not maintain a temperature of 45 degrees F. or below. In Space #1, the refrigerator temperature read at 60 degrees Fahrenheit. When this was brought to the administrator's attention, he fixed the refrigerator door. After a couple of hours, the refrigerator temperature read at 43 degrees Fahrenheit. 15A NCAC 18A .2806(j)(2) 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. In the boys bathroom and girls bathroom, the baseboards were observed peeling from the wall, and paint was observed peeling near the baseboards. 15A NCAC 18A .2825(a) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. Two staff members (T.B. and T.M.) did not have a medical report on file prior to employment. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. Two staff members (T.B. and T.M.) did not have a TB test completed on or before their first day of work. .0701(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. Two staff members (T.B. and T.M.) did not have documentation of orientation on file, that has been completed since their rehire dates. .1101(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child (A.J.) did not have a valid health assessment on file within 30 days of enrollment (DOE: 1/06/25). GS110-91(1) 1811 Shelter-in-place or lockdown drills were not practiced every three months and/or drill record was incomplete. The most recent shelter-in-place/lockdown drill was completed on 12/18/2024. The previous shelter-in-place/lockdown drill was completed on 8/23/24. .0604(u);.0302(d)(8) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 24, 2025, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Condition of Walls A violation was cited today for the condition of the walls in the boys bathroom and girls bathroom. According to child care sanitation rule 15A NCAC 18A .2825(a), the walls and ceilings, including doors and windows, of all rooms and areas shall be kept clean, free of visible fungal growth, and in good repair. All walls and ceilings shall be free of peeling, flaking, chalking, or otherwise deteriorating paint. We discussed conducting monthly maintenance checks of the building to ensure that walls, floors, and ceilings are maintained in good repair. Daily Schedule A violation was cited for not having daily schedules posted in Spaces #2, #4, and #5. According to child care rule 10A NCAC 09 .0508(a), all centers shall have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. The schedule and activity plan may be combined in a single document. The assistant administrator stated that the schedules should have been posted, and she didn’t know what happened to them. The assistant administrator stated that she will print copies of the daily schedules for each group and post them in each space. Documentation of Orientation A violation was cited today for staff members not having documentation of orientation on file. According to child care rule 10A NCAC 09 .1101(a), each center shall ensure that each new employee who is expected to have contact with children receives 16 hours of on-site orientation within the first six weeks of employment. As part of this orientation, each new employee shall complete six hours of orientation within the first two weeks of employment. The assistant administrator stated that both of the staff are rehires, and she was not aware that staff needed to have an updated orientation when they return after 12 months of absence. The assistant administrator stated that she will give both staff members an updated orientation as soon as possible. Emergency Drill Requirements A violation was cited today for not completing either a shelter-in-place or lockdown drill every three months. According to child care rule 10A NCAC 09 .0604(u), a "shelter in place drill" or "lockdown drill" shall be conducted at least every three months and records shall be maintained for at least one year. We discussed either recording dates on a calendar with dates that emergency drills are due, or setting reminders for when emergency drills are due on a digital device. Children’s Records A violation was cited today for a child not having a valid medical report on file. According to NC General Statute 110-91(1), each child shall have a health assessment before being admitted or within 30 days following admission to a child care facility. The assessment shall be done by: (i) a licensed physician, (ii) the physician's authorized agent who is currently approved by the North Carolina Medical Board, or comparable certifying board in any state contiguous to North Carolina, (iii) a certified nurse practitioner, or (iv) a public health nurse meeting the Departments Standards for Early Periodic Screening, Diagnosis, and Treatment Program. The assistant administrator stated that the parent forgot to bring a copy of the child’s medical report. She stated that she will call the parent to remind her to bring the child’s health assessment to the facility during pickup time today. We discussed using the staff file checklist and child file checklist to periodically monitor the documentation that is required to be in the files, and each item’s due date and/or expiration date. Blank copies of the staff file checklist and child file checklist were left with the administrator. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 5/14/2025. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Teaching the Whole Child: Supporting the Social-Emotional Wellness of Preschool and School-Aged Children This free course explores the connection between students’ social-emotional development, learning, and wellness with their success in Pre-K and elementary school classrooms. The utility of attending to social-emotional wellness and ranges of typical development is discussed, as well as the impact of trauma on students and how school staff can support children in concrete ways to promote their social-emotional learning (SEL). This course is approved by the Division of Child Development and Early Education for 3 contact hours. For more information about the course, please visit https://bhs.unc.edu/teaching-whole-child-supporting-social-emotional-wellness-preschool-and-elementary-school-aged. Darkness to Light Training Darkness to Light is a nonprofit organization with a mission to equip and empower adults to build safe environments that protect children from sexual abuse. Darkness to Light’s flagship program, Stewards of Children®, is a trauma and evidence-informed training that teaches adults to prevent, recognize, and react responsibly to child sexual abuse. More than 2.2 million adults have been trained using the program. To learn more about child sexual abuse prevention training or to enroll your organization in Darkness to Light’s “Partner in Prevention” program, please visit www.D2L.org/education/partner-in-prevention. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.L.reed@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: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/16/2024 Number Present: 18 Completed Date: 10/16/2024 Age: From 0 To 3 Total Minutes: 225 Time In: 01:30 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 16, 2024 and prior to today’s visit, the eighteen-month compliance history score was 86% which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed May 14, 2024. Fire Classification of Approved for Day Time Care Only was completed September 12, 2024. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free-choice activities. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. A prepared bottle of formula, labeled with the date of October 08, 2024, was stored in the refrigerator. Documentation of visual sleep checks was not available for review. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The children were observed building various structures with blocks. The teacher had to remind a few children not to walk on the blocks. To redirect the children who were not using the blocks correctly, the teacher said, “Make a building. Do you know how to make a building? Make a tall building.” A child responded by saying, “I’m going to make a tall castle.” Space #3 was not being used for child care, but it was monitored for general health and safety requirements. In Space #4, children were finishing their snack. Children had access to blocks, literacy, fine-motor, dramatic play, and creative art materials. When the children finished their snack, they lined up to walk to the bathroom, use the bathroom, and wash their hands. When the group returned to their classroom, they sat in a carpeted area and reviewed the names of shapes. In Space #5, children were observed eating their snack. Children had access to blocks, literacy, fine-motor, and literacy materials. Interactions were not observed. Routine care and handwashing practices were observed. Snack consisted of cheese crackers and milk. One recently hired staff member's file was reviewed. One staff member did not have a TB test or screening on file, indicating that they are free from active TB. One staff member did not have a signed acknowledgement on file, stating that the Shaken Baby Syndrome and Abusive Head Trauma Policy was reviewed prior to caring for children. Tiffany Armfield, Assistant Director, arrived at the facility at 4:15pm. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: 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. In Space #1, in the refrigerator, a bottle was labeled with the incorrect date (10/08/2024). 15A NCAC 18A .2804(d) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space #4, a bottle of hand sanitizer was stored on top of a shelf, below five feet from the finished floor. In Space #4, a pack of baby wipes labeled "keep out of reach of children" was stored on a shelf, below five feet from the finished floor. When brought to the teacher's attention, she immediately moved the items to a cabinet, above five feet from the finished floor. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In Space #1, documentation of visual sleep checks was not available for review. .0606(g) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member (F.W.) did not have a TB test or screening on file. .0701(a) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member (F.W.) did not have a signed Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement on file. The policy was explained and the acknowledgement was signed and placed in the staff's file during the visit. .0608(d)(1-4) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Nutrition Requirements A violation was cited today for a bottle not being labeled with the current date. According to child care sanitation rule 15A NCAC 18A .2804(d), breast milk, formula, and other bottled beverages, including beverages in sippy cups, sent from home shall be fully prepared, dated, and identified for the appropriate child at the child's home. All breast milk, formula, and other bottled beverages shall be returned to the child's home or discarded at the end of each day. Frozen breast milk shall be stored frozen for up to seven days. Frozen breast milk shall be labeled with the date received and date thawed for use. We discussed strategies for ensuring that unused bottles are sent back home with children at the end of each day. For example, a procedure can be developed for staff to check the refrigerator when preparing children to leave for the day, or a sign can be posted next to the classroom’s entrance door, asking parents to check if all bottles have been returned. Visual Sleep Checks A violation was cited today for not having documentation of visual sleep checks available for review. According to child care rule 10A NCAC 09 .0606(g), documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. We discussed ensuring that staff have access to safe sleep charts by printing enough out at the beginning of each week. Staff Medical Requirements A violation was cited today for a staff member not having a TB test or screening on file. According to child care rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a Tuberculin (TB) Test or screening, with the results indicating the individual is free of active tuberculosis. The TB test/screening shall be obtained on or before first day of work. The TB test/screening may be obtained within the 12 months prior to the date of employment. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #5. I encouraged T. Armfield to have the staff use mealtimes as learning opportunities. I suggested teachers continue to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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 .0701 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/16/2024 Number Present: 18 Completed Date: 10/16/2024 Age: From 0 To 3 Total Minutes: 225 Time In: 01:30 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 16, 2024 and prior to today’s visit, the eighteen-month compliance history score was 86% which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed May 14, 2024. Fire Classification of Approved for Day Time Care Only was completed September 12, 2024. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free-choice activities. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. A prepared bottle of formula, labeled with the date of October 08, 2024, was stored in the refrigerator. Documentation of visual sleep checks was not available for review. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The children were observed building various structures with blocks. The teacher had to remind a few children not to walk on the blocks. To redirect the children who were not using the blocks correctly, the teacher said, “Make a building. Do you know how to make a building? Make a tall building.” A child responded by saying, “I’m going to make a tall castle.” Space #3 was not being used for child care, but it was monitored for general health and safety requirements. In Space #4, children were finishing their snack. Children had access to blocks, literacy, fine-motor, dramatic play, and creative art materials. When the children finished their snack, they lined up to walk to the bathroom, use the bathroom, and wash their hands. When the group returned to their classroom, they sat in a carpeted area and reviewed the names of shapes. In Space #5, children were observed eating their snack. Children had access to blocks, literacy, fine-motor, and literacy materials. Interactions were not observed. Routine care and handwashing practices were observed. Snack consisted of cheese crackers and milk. One recently hired staff member's file was reviewed. One staff member did not have a TB test or screening on file, indicating that they are free from active TB. One staff member did not have a signed acknowledgement on file, stating that the Shaken Baby Syndrome and Abusive Head Trauma Policy was reviewed prior to caring for children. Tiffany Armfield, Assistant Director, arrived at the facility at 4:15pm. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: 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. In Space #1, in the refrigerator, a bottle was labeled with the incorrect date (10/08/2024). 15A NCAC 18A .2804(d) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space #4, a bottle of hand sanitizer was stored on top of a shelf, below five feet from the finished floor. In Space #4, a pack of baby wipes labeled "keep out of reach of children" was stored on a shelf, below five feet from the finished floor. When brought to the teacher's attention, she immediately moved the items to a cabinet, above five feet from the finished floor. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In Space #1, documentation of visual sleep checks was not available for review. .0606(g) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member (F.W.) did not have a TB test or screening on file. .0701(a) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member (F.W.) did not have a signed Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement on file. The policy was explained and the acknowledgement was signed and placed in the staff's file during the visit. .0608(d)(1-4) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Nutrition Requirements A violation was cited today for a bottle not being labeled with the current date. According to child care sanitation rule 15A NCAC 18A .2804(d), breast milk, formula, and other bottled beverages, including beverages in sippy cups, sent from home shall be fully prepared, dated, and identified for the appropriate child at the child's home. All breast milk, formula, and other bottled beverages shall be returned to the child's home or discarded at the end of each day. Frozen breast milk shall be stored frozen for up to seven days. Frozen breast milk shall be labeled with the date received and date thawed for use. We discussed strategies for ensuring that unused bottles are sent back home with children at the end of each day. For example, a procedure can be developed for staff to check the refrigerator when preparing children to leave for the day, or a sign can be posted next to the classroom’s entrance door, asking parents to check if all bottles have been returned. Visual Sleep Checks A violation was cited today for not having documentation of visual sleep checks available for review. According to child care rule 10A NCAC 09 .0606(g), documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. We discussed ensuring that staff have access to safe sleep charts by printing enough out at the beginning of each week. Staff Medical Requirements A violation was cited today for a staff member not having a TB test or screening on file. According to child care rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a Tuberculin (TB) Test or screening, with the results indicating the individual is free of active tuberculosis. The TB test/screening shall be obtained on or before first day of work. The TB test/screening may be obtained within the 12 months prior to the date of employment. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #5. I encouraged T. Armfield to have the staff use mealtimes as learning opportunities. I suggested teachers continue to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/16/2024 Number Present: 18 Completed Date: 10/16/2024 Age: From 0 To 3 Total Minutes: 225 Time In: 01:30 PM Time Out: 05:15 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a Routine Unannounced visit. The previous Annual Compliance visit was completed April 16, 2024 and prior to today’s visit, the eighteen-month compliance history score was 86% which is at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed May 14, 2024. Fire Classification of Approved for Day Time Care Only was completed September 12, 2024. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free-choice activities. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. A prepared bottle of formula, labeled with the date of October 08, 2024, was stored in the refrigerator. Documentation of visual sleep checks was not available for review. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The children were observed building various structures with blocks. The teacher had to remind a few children not to walk on the blocks. To redirect the children who were not using the blocks correctly, the teacher said, “Make a building. Do you know how to make a building? Make a tall building.” A child responded by saying, “I’m going to make a tall castle.” Space #3 was not being used for child care, but it was monitored for general health and safety requirements. In Space #4, children were finishing their snack. Children had access to blocks, literacy, fine-motor, dramatic play, and creative art materials. When the children finished their snack, they lined up to walk to the bathroom, use the bathroom, and wash their hands. When the group returned to their classroom, they sat in a carpeted area and reviewed the names of shapes. In Space #5, children were observed eating their snack. Children had access to blocks, literacy, fine-motor, and literacy materials. Interactions were not observed. Routine care and handwashing practices were observed. Snack consisted of cheese crackers and milk. One recently hired staff member's file was reviewed. One staff member did not have a TB test or screening on file, indicating that they are free from active TB. One staff member did not have a signed acknowledgement on file, stating that the Shaken Baby Syndrome and Abusive Head Trauma Policy was reviewed prior to caring for children. Tiffany Armfield, Assistant Director, arrived at the facility at 4:15pm. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: 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. In Space #1, in the refrigerator, a bottle was labeled with the incorrect date (10/08/2024). 15A NCAC 18A .2804(d) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In Space #4, a bottle of hand sanitizer was stored on top of a shelf, below five feet from the finished floor. In Space #4, a pack of baby wipes labeled "keep out of reach of children" was stored on a shelf, below five feet from the finished floor. When brought to the teacher's attention, she immediately moved the items to a cabinet, above five feet from the finished floor. .2820(b) 887 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of one month. In Space #1, documentation of visual sleep checks was not available for review. .0606(g) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. One staff member (F.W.) did not have a TB test or screening on file. .0701(a) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. One staff member (F.W.) did not have a signed Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy acknowledgement on file. The policy was explained and the acknowledgement was signed and placed in the staff's file during the visit. .0608(d)(1-4) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Technical Assistance: Nutrition Requirements A violation was cited today for a bottle not being labeled with the current date. According to child care sanitation rule 15A NCAC 18A .2804(d), breast milk, formula, and other bottled beverages, including beverages in sippy cups, sent from home shall be fully prepared, dated, and identified for the appropriate child at the child's home. All breast milk, formula, and other bottled beverages shall be returned to the child's home or discarded at the end of each day. Frozen breast milk shall be stored frozen for up to seven days. Frozen breast milk shall be labeled with the date received and date thawed for use. We discussed strategies for ensuring that unused bottles are sent back home with children at the end of each day. For example, a procedure can be developed for staff to check the refrigerator when preparing children to leave for the day, or a sign can be posted next to the classroom’s entrance door, asking parents to check if all bottles have been returned. Visual Sleep Checks A violation was cited today for not having documentation of visual sleep checks available for review. According to child care rule 10A NCAC 09 .0606(g), documents that verify staff member's compliance with visual checks on infants shall be maintained for a minimum of one month. We discussed ensuring that staff have access to safe sleep charts by printing enough out at the beginning of each week. Staff Medical Requirements A violation was cited today for a staff member not having a TB test or screening on file. According to child care rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a Tuberculin (TB) Test or screening, with the results indicating the individual is free of active tuberculosis. The TB test/screening shall be obtained on or before first day of work. The TB test/screening may be obtained within the 12 months prior to the date of employment. Infant/Toddler Classroom Observation I discussed with T. Armfield the results from observing the infant/toddler group in Space #5. Self-talk and Parallel talk were not observed. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk allows conversations to occur by talking out loud about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Classroom Observation I discussed with T. Armfield the results from observing the preschool-age group in Space #5. I encouraged T. Armfield to have the staff use mealtimes as learning opportunities. I suggested teachers continue to have meaningful conversations with children throughout the day and provide opportunities for parallel discussions between children and staff. I also recommended that teachers provide more open-ended questions, allowing the children to respond to what they think needs to happen, instead of giving directives to children. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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 .0604 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/16/2024 Number Present: 20 Completed Date: 4/16/2024 Age: From 0 To 4 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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 compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 25, 2023, and prior to today’s visit, the eighteen-month compliance history score was 88% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed on April 25, 2023. Fire Classification of Approved was completed on September 14, 2023. T. Armfield was present while I observed the indoor and outdoor areas. Twenty children were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms. Another group of children was observed in the outdoor play area, participating in sand play and exploring the stationary equipment. In Space #1, an unlabeled bottle with prepared formula and an expired gallon of whole milk were stored in the refrigerator. Joe Flood, Administrator, arrived at the facility after I completed the walkthrough. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. On a piece of stationary equipment in the infant/toddler playground area, the slide was observed separating from the platform of the equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. In the preschool playground area, several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. Routine care and handwashing practices were observed. Lunch consisted of fish sticks, mashed potatoes, mixed vegetables, diced peaches, and milk. Four children’s files were reviewed, and all documentation was in compliance with applicable child care rules. Four staff files were reviewed. One staff member did not have a medical report on file. One staff member did not have a valid TB test or screening with negative results on file. One staff member did not complete the required Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. One staff member did not complete the required health and safety training within one year of hire. Program files, including the EPR plan, were reviewed and all documentation was in compliance with applicable child care rules. This program does not provide transportation services. At the completion of the visit, the Visit Summary was reviewed with J. Flood and T. Armfield. The following violations were observed: 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. In Space #1, an unlabeled bottle was observed in the refrigerator. The teacher labeled the bottle with a child's name and today's date and placed it back in the refrigerator. 15A NCAC 18A .2804(d) 721 All equipment and furnishings were not in good repair. In Playground #2, a slide was observed separating from the platform of the stationary equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. Several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. G.S. 110-91(6); .0601(b) 856 The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. A staff member came to the facility, raked through the sand, and removed the debris. 10A NCAC 09 .0604(p) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A. Norfus, Teacher, did not have a medical report on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. M. McCuin, Teacher, did not have a TB test or screening with negative results on file. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in First Aid within 90 days of hire. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in CPR training within 90 days of hire. .1102(d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A. Norfus, Teacher, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. A. Norfus, Teacher, did not complete the required health and safety training within one year of employment (DOH: 4/03/2023). .1102(a) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Safe Outdoor Environment A violation was cited today for hazardous items on the playground. According to Child Care Rule 10A NCAC 09 .0604(p), once a day, prior to initial use, the indoor and outdoor premises shall be checked for debris, vandalism, and broken equipment. Debris shall be removed and disposed of. Providing a safe environment is important for children’s growth and development. We discussed the following strategies for achieving and maintaining compliance: review the rule section with staff at your next staff meeting and have staff report hazardous issues to administration staff immediately. Outdoor Equipment A violation was cited today for outdoor equipment not being in good repair. According to Child Care Rule 10A NCAC 09 .0601(b-d), all equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All equipment and furnishings not meeting the requirements shall be removed from the premises immediately or made inaccessible to the children. We discussed the following strategies for achieving and maintaining compliance: Having staff periodically inspect the playground equipment and making repairs as needed; having staff report broken items and hazardous issues to administration staff immediately. Children’s Records A violation was cited today for a child not having an immunization record on file. According to Child Care Rule 10A NCAC .0304(g), children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care shall be made available to the Division for review. Staff Medical Records A violation was cited today for a staff member not having a medical report on file. According to Child Care Rule 10A NCAC 09 .0701(a), child care providers and uncompensated providers who are not substitute providers or volunteers, shall obtain a medical report or a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. The medical report shall be obtained prior to employment. When submitted, the medical statement shall not be older than 12 months. A violation was cited today for a staff member not having a TB test or screening with negative results on file. According to Child Care Rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a tuberculin (TB) test or screening on or before first day of work. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. We discussed using the staff file checklist to periodically monitor the documentation that is required to be in the staff file, and each item’s due date and/or expiration date. A blank copy of the staff and file checklist was left with the assistant director. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 4/25/2024. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Challenging Behaviors Hotline: Do you have children who bite? Do children struggle to focus during circle time? Do challenging behaviors cause difficult transitions? Do you spend all day managing behavior? Are you at your wits' end? Help is available for these and other behavior challenges! The Challenging Behaviors Hotline has opened and is provided for Free. You may speak to a Behavior Support Advisor for advice and resources specific to challenging behaviors in your facility. Dial 1-888-600-1685 Option 1 or for more information go to www.childcareresourcesinc.org/challenging-behaviors-helpline. Natural Outdoor Learning Initiative The DCDEE has a new initiative – Natural Outdoor Learning Initiative. Through this initiative, we hope to: increase knowledge and confidence for everyone in developing and implementing best practices to support the creation, programming, and safe use of naturalized outdoor spaces in child care facilities. You can learn more by visiting the NLI website, where you will also find many resources, including an updated Toolkit designed to help you enhance your outdoor learning environment. The downloadable NLI Toolkit is available at: https://naturalearning.org/preschool-outdoor-toolkit Please feel free to contact me at tiffany.L.reed@dhhs.nc.gov or (910) 605-2367 if you have any questions, comments, or concerns. 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 .0601 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/16/2024 Number Present: 20 Completed Date: 4/16/2024 Age: From 0 To 4 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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 compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 25, 2023, and prior to today’s visit, the eighteen-month compliance history score was 88% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed on April 25, 2023. Fire Classification of Approved was completed on September 14, 2023. T. Armfield was present while I observed the indoor and outdoor areas. Twenty children were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms. Another group of children was observed in the outdoor play area, participating in sand play and exploring the stationary equipment. In Space #1, an unlabeled bottle with prepared formula and an expired gallon of whole milk were stored in the refrigerator. Joe Flood, Administrator, arrived at the facility after I completed the walkthrough. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. On a piece of stationary equipment in the infant/toddler playground area, the slide was observed separating from the platform of the equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. In the preschool playground area, several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. Routine care and handwashing practices were observed. Lunch consisted of fish sticks, mashed potatoes, mixed vegetables, diced peaches, and milk. Four children’s files were reviewed, and all documentation was in compliance with applicable child care rules. Four staff files were reviewed. One staff member did not have a medical report on file. One staff member did not have a valid TB test or screening with negative results on file. One staff member did not complete the required Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. One staff member did not complete the required health and safety training within one year of hire. Program files, including the EPR plan, were reviewed and all documentation was in compliance with applicable child care rules. This program does not provide transportation services. At the completion of the visit, the Visit Summary was reviewed with J. Flood and T. Armfield. The following violations were observed: 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. In Space #1, an unlabeled bottle was observed in the refrigerator. The teacher labeled the bottle with a child's name and today's date and placed it back in the refrigerator. 15A NCAC 18A .2804(d) 721 All equipment and furnishings were not in good repair. In Playground #2, a slide was observed separating from the platform of the stationary equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. Several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. G.S. 110-91(6); .0601(b) 856 The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. A staff member came to the facility, raked through the sand, and removed the debris. 10A NCAC 09 .0604(p) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A. Norfus, Teacher, did not have a medical report on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. M. McCuin, Teacher, did not have a TB test or screening with negative results on file. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in First Aid within 90 days of hire. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in CPR training within 90 days of hire. .1102(d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A. Norfus, Teacher, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. A. Norfus, Teacher, did not complete the required health and safety training within one year of employment (DOH: 4/03/2023). .1102(a) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Safe Outdoor Environment A violation was cited today for hazardous items on the playground. According to Child Care Rule 10A NCAC 09 .0604(p), once a day, prior to initial use, the indoor and outdoor premises shall be checked for debris, vandalism, and broken equipment. Debris shall be removed and disposed of. Providing a safe environment is important for children’s growth and development. We discussed the following strategies for achieving and maintaining compliance: review the rule section with staff at your next staff meeting and have staff report hazardous issues to administration staff immediately. Outdoor Equipment A violation was cited today for outdoor equipment not being in good repair. According to Child Care Rule 10A NCAC 09 .0601(b-d), all equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All equipment and furnishings not meeting the requirements shall be removed from the premises immediately or made inaccessible to the children. We discussed the following strategies for achieving and maintaining compliance: Having staff periodically inspect the playground equipment and making repairs as needed; having staff report broken items and hazardous issues to administration staff immediately. Children’s Records A violation was cited today for a child not having an immunization record on file. According to Child Care Rule 10A NCAC .0304(g), children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care shall be made available to the Division for review. Staff Medical Records A violation was cited today for a staff member not having a medical report on file. According to Child Care Rule 10A NCAC 09 .0701(a), child care providers and uncompensated providers who are not substitute providers or volunteers, shall obtain a medical report or a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. The medical report shall be obtained prior to employment. When submitted, the medical statement shall not be older than 12 months. A violation was cited today for a staff member not having a TB test or screening with negative results on file. According to Child Care Rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a tuberculin (TB) test or screening on or before first day of work. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. We discussed using the staff file checklist to periodically monitor the documentation that is required to be in the staff file, and each item’s due date and/or expiration date. A blank copy of the staff and file checklist was left with the assistant director. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 4/25/2024. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Challenging Behaviors Hotline: Do you have children who bite? Do children struggle to focus during circle time? Do challenging behaviors cause difficult transitions? Do you spend all day managing behavior? Are you at your wits' end? Help is available for these and other behavior challenges! The Challenging Behaviors Hotline has opened and is provided for Free. You may speak to a Behavior Support Advisor for advice and resources specific to challenging behaviors in your facility. Dial 1-888-600-1685 Option 1 or for more information go to www.childcareresourcesinc.org/challenging-behaviors-helpline. Natural Outdoor Learning Initiative The DCDEE has a new initiative – Natural Outdoor Learning Initiative. Through this initiative, we hope to: increase knowledge and confidence for everyone in developing and implementing best practices to support the creation, programming, and safe use of naturalized outdoor spaces in child care facilities. You can learn more by visiting the NLI website, where you will also find many resources, including an updated Toolkit designed to help you enhance your outdoor learning environment. The downloadable NLI Toolkit is available at: https://naturalearning.org/preschool-outdoor-toolkit Please feel free to contact me at tiffany.L.reed@dhhs.nc.gov or (910) 605-2367 if you have any questions, comments, or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0604 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/16/2024 Number Present: 20 Completed Date: 4/16/2024 Age: From 0 To 4 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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 compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 25, 2023, and prior to today’s visit, the eighteen-month compliance history score was 88% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed on April 25, 2023. Fire Classification of Approved was completed on September 14, 2023. T. Armfield was present while I observed the indoor and outdoor areas. Twenty children were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms. Another group of children was observed in the outdoor play area, participating in sand play and exploring the stationary equipment. In Space #1, an unlabeled bottle with prepared formula and an expired gallon of whole milk were stored in the refrigerator. Joe Flood, Administrator, arrived at the facility after I completed the walkthrough. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. On a piece of stationary equipment in the infant/toddler playground area, the slide was observed separating from the platform of the equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. In the preschool playground area, several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. Routine care and handwashing practices were observed. Lunch consisted of fish sticks, mashed potatoes, mixed vegetables, diced peaches, and milk. Four children’s files were reviewed, and all documentation was in compliance with applicable child care rules. Four staff files were reviewed. One staff member did not have a medical report on file. One staff member did not have a valid TB test or screening with negative results on file. One staff member did not complete the required Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. One staff member did not complete the required health and safety training within one year of hire. Program files, including the EPR plan, were reviewed and all documentation was in compliance with applicable child care rules. This program does not provide transportation services. At the completion of the visit, the Visit Summary was reviewed with J. Flood and T. Armfield. The following violations were observed: 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. In Space #1, an unlabeled bottle was observed in the refrigerator. The teacher labeled the bottle with a child's name and today's date and placed it back in the refrigerator. 15A NCAC 18A .2804(d) 721 All equipment and furnishings were not in good repair. In Playground #2, a slide was observed separating from the platform of the stationary equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. Several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. G.S. 110-91(6); .0601(b) 856 The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. A staff member came to the facility, raked through the sand, and removed the debris. 10A NCAC 09 .0604(p) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A. Norfus, Teacher, did not have a medical report on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. M. McCuin, Teacher, did not have a TB test or screening with negative results on file. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in First Aid within 90 days of hire. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in CPR training within 90 days of hire. .1102(d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A. Norfus, Teacher, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. A. Norfus, Teacher, did not complete the required health and safety training within one year of employment (DOH: 4/03/2023). .1102(a) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Safe Outdoor Environment A violation was cited today for hazardous items on the playground. According to Child Care Rule 10A NCAC 09 .0604(p), once a day, prior to initial use, the indoor and outdoor premises shall be checked for debris, vandalism, and broken equipment. Debris shall be removed and disposed of. Providing a safe environment is important for children’s growth and development. We discussed the following strategies for achieving and maintaining compliance: review the rule section with staff at your next staff meeting and have staff report hazardous issues to administration staff immediately. Outdoor Equipment A violation was cited today for outdoor equipment not being in good repair. According to Child Care Rule 10A NCAC 09 .0601(b-d), all equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All equipment and furnishings not meeting the requirements shall be removed from the premises immediately or made inaccessible to the children. We discussed the following strategies for achieving and maintaining compliance: Having staff periodically inspect the playground equipment and making repairs as needed; having staff report broken items and hazardous issues to administration staff immediately. Children’s Records A violation was cited today for a child not having an immunization record on file. According to Child Care Rule 10A NCAC .0304(g), children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care shall be made available to the Division for review. Staff Medical Records A violation was cited today for a staff member not having a medical report on file. According to Child Care Rule 10A NCAC 09 .0701(a), child care providers and uncompensated providers who are not substitute providers or volunteers, shall obtain a medical report or a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. The medical report shall be obtained prior to employment. When submitted, the medical statement shall not be older than 12 months. A violation was cited today for a staff member not having a TB test or screening with negative results on file. According to Child Care Rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a tuberculin (TB) test or screening on or before first day of work. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. We discussed using the staff file checklist to periodically monitor the documentation that is required to be in the staff file, and each item’s due date and/or expiration date. A blank copy of the staff and file checklist was left with the assistant director. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 4/25/2024. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Challenging Behaviors Hotline: Do you have children who bite? Do children struggle to focus during circle time? Do challenging behaviors cause difficult transitions? Do you spend all day managing behavior? Are you at your wits' end? Help is available for these and other behavior challenges! The Challenging Behaviors Hotline has opened and is provided for Free. You may speak to a Behavior Support Advisor for advice and resources specific to challenging behaviors in your facility. Dial 1-888-600-1685 Option 1 or for more information go to www.childcareresourcesinc.org/challenging-behaviors-helpline. Natural Outdoor Learning Initiative The DCDEE has a new initiative – Natural Outdoor Learning Initiative. Through this initiative, we hope to: increase knowledge and confidence for everyone in developing and implementing best practices to support the creation, programming, and safe use of naturalized outdoor spaces in child care facilities. You can learn more by visiting the NLI website, where you will also find many resources, including an updated Toolkit designed to help you enhance your outdoor learning environment. The downloadable NLI Toolkit is available at: https://naturalearning.org/preschool-outdoor-toolkit Please feel free to contact me at tiffany.L.reed@dhhs.nc.gov or (910) 605-2367 if you have any questions, comments, or concerns. 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 .0701 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/16/2024 Number Present: 20 Completed Date: 4/16/2024 Age: From 0 To 4 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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 compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 25, 2023, and prior to today’s visit, the eighteen-month compliance history score was 88% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed on April 25, 2023. Fire Classification of Approved was completed on September 14, 2023. T. Armfield was present while I observed the indoor and outdoor areas. Twenty children were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms. Another group of children was observed in the outdoor play area, participating in sand play and exploring the stationary equipment. In Space #1, an unlabeled bottle with prepared formula and an expired gallon of whole milk were stored in the refrigerator. Joe Flood, Administrator, arrived at the facility after I completed the walkthrough. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. On a piece of stationary equipment in the infant/toddler playground area, the slide was observed separating from the platform of the equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. In the preschool playground area, several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. Routine care and handwashing practices were observed. Lunch consisted of fish sticks, mashed potatoes, mixed vegetables, diced peaches, and milk. Four children’s files were reviewed, and all documentation was in compliance with applicable child care rules. Four staff files were reviewed. One staff member did not have a medical report on file. One staff member did not have a valid TB test or screening with negative results on file. One staff member did not complete the required Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. One staff member did not complete the required health and safety training within one year of hire. Program files, including the EPR plan, were reviewed and all documentation was in compliance with applicable child care rules. This program does not provide transportation services. At the completion of the visit, the Visit Summary was reviewed with J. Flood and T. Armfield. The following violations were observed: 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. In Space #1, an unlabeled bottle was observed in the refrigerator. The teacher labeled the bottle with a child's name and today's date and placed it back in the refrigerator. 15A NCAC 18A .2804(d) 721 All equipment and furnishings were not in good repair. In Playground #2, a slide was observed separating from the platform of the stationary equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. Several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. G.S. 110-91(6); .0601(b) 856 The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. A staff member came to the facility, raked through the sand, and removed the debris. 10A NCAC 09 .0604(p) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A. Norfus, Teacher, did not have a medical report on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. M. McCuin, Teacher, did not have a TB test or screening with negative results on file. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in First Aid within 90 days of hire. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in CPR training within 90 days of hire. .1102(d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A. Norfus, Teacher, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. A. Norfus, Teacher, did not complete the required health and safety training within one year of employment (DOH: 4/03/2023). .1102(a) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Safe Outdoor Environment A violation was cited today for hazardous items on the playground. According to Child Care Rule 10A NCAC 09 .0604(p), once a day, prior to initial use, the indoor and outdoor premises shall be checked for debris, vandalism, and broken equipment. Debris shall be removed and disposed of. Providing a safe environment is important for children’s growth and development. We discussed the following strategies for achieving and maintaining compliance: review the rule section with staff at your next staff meeting and have staff report hazardous issues to administration staff immediately. Outdoor Equipment A violation was cited today for outdoor equipment not being in good repair. According to Child Care Rule 10A NCAC 09 .0601(b-d), all equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All equipment and furnishings not meeting the requirements shall be removed from the premises immediately or made inaccessible to the children. We discussed the following strategies for achieving and maintaining compliance: Having staff periodically inspect the playground equipment and making repairs as needed; having staff report broken items and hazardous issues to administration staff immediately. Children’s Records A violation was cited today for a child not having an immunization record on file. According to Child Care Rule 10A NCAC .0304(g), children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care shall be made available to the Division for review. Staff Medical Records A violation was cited today for a staff member not having a medical report on file. According to Child Care Rule 10A NCAC 09 .0701(a), child care providers and uncompensated providers who are not substitute providers or volunteers, shall obtain a medical report or a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. The medical report shall be obtained prior to employment. When submitted, the medical statement shall not be older than 12 months. A violation was cited today for a staff member not having a TB test or screening with negative results on file. According to Child Care Rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a tuberculin (TB) test or screening on or before first day of work. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. We discussed using the staff file checklist to periodically monitor the documentation that is required to be in the staff file, and each item’s due date and/or expiration date. A blank copy of the staff and file checklist was left with the assistant director. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 4/25/2024. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Challenging Behaviors Hotline: Do you have children who bite? Do children struggle to focus during circle time? Do challenging behaviors cause difficult transitions? Do you spend all day managing behavior? Are you at your wits' end? Help is available for these and other behavior challenges! The Challenging Behaviors Hotline has opened and is provided for Free. You may speak to a Behavior Support Advisor for advice and resources specific to challenging behaviors in your facility. Dial 1-888-600-1685 Option 1 or for more information go to www.childcareresourcesinc.org/challenging-behaviors-helpline. Natural Outdoor Learning Initiative The DCDEE has a new initiative – Natural Outdoor Learning Initiative. Through this initiative, we hope to: increase knowledge and confidence for everyone in developing and implementing best practices to support the creation, programming, and safe use of naturalized outdoor spaces in child care facilities. You can learn more by visiting the NLI website, where you will also find many resources, including an updated Toolkit designed to help you enhance your outdoor learning environment. The downloadable NLI Toolkit is available at: https://naturalearning.org/preschool-outdoor-toolkit Please feel free to contact me at tiffany.L.reed@dhhs.nc.gov or (910) 605-2367 if you have any questions, comments, or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/16/2024 Number Present: 20 Completed Date: 4/16/2024 Age: From 0 To 4 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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 compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 25, 2023, and prior to today’s visit, the eighteen-month compliance history score was 88% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed on April 25, 2023. Fire Classification of Approved was completed on September 14, 2023. T. Armfield was present while I observed the indoor and outdoor areas. Twenty children were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms. Another group of children was observed in the outdoor play area, participating in sand play and exploring the stationary equipment. In Space #1, an unlabeled bottle with prepared formula and an expired gallon of whole milk were stored in the refrigerator. Joe Flood, Administrator, arrived at the facility after I completed the walkthrough. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. On a piece of stationary equipment in the infant/toddler playground area, the slide was observed separating from the platform of the equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. In the preschool playground area, several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. Routine care and handwashing practices were observed. Lunch consisted of fish sticks, mashed potatoes, mixed vegetables, diced peaches, and milk. Four children’s files were reviewed, and all documentation was in compliance with applicable child care rules. Four staff files were reviewed. One staff member did not have a medical report on file. One staff member did not have a valid TB test or screening with negative results on file. One staff member did not complete the required Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. One staff member did not complete the required health and safety training within one year of hire. Program files, including the EPR plan, were reviewed and all documentation was in compliance with applicable child care rules. This program does not provide transportation services. At the completion of the visit, the Visit Summary was reviewed with J. Flood and T. Armfield. The following violations were observed: 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. In Space #1, an unlabeled bottle was observed in the refrigerator. The teacher labeled the bottle with a child's name and today's date and placed it back in the refrigerator. 15A NCAC 18A .2804(d) 721 All equipment and furnishings were not in good repair. In Playground #2, a slide was observed separating from the platform of the stationary equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. Several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. G.S. 110-91(6); .0601(b) 856 The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. A staff member came to the facility, raked through the sand, and removed the debris. 10A NCAC 09 .0604(p) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A. Norfus, Teacher, did not have a medical report on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. M. McCuin, Teacher, did not have a TB test or screening with negative results on file. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in First Aid within 90 days of hire. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in CPR training within 90 days of hire. .1102(d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A. Norfus, Teacher, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. A. Norfus, Teacher, did not complete the required health and safety training within one year of employment (DOH: 4/03/2023). .1102(a) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Safe Outdoor Environment A violation was cited today for hazardous items on the playground. According to Child Care Rule 10A NCAC 09 .0604(p), once a day, prior to initial use, the indoor and outdoor premises shall be checked for debris, vandalism, and broken equipment. Debris shall be removed and disposed of. Providing a safe environment is important for children’s growth and development. We discussed the following strategies for achieving and maintaining compliance: review the rule section with staff at your next staff meeting and have staff report hazardous issues to administration staff immediately. Outdoor Equipment A violation was cited today for outdoor equipment not being in good repair. According to Child Care Rule 10A NCAC 09 .0601(b-d), all equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All equipment and furnishings not meeting the requirements shall be removed from the premises immediately or made inaccessible to the children. We discussed the following strategies for achieving and maintaining compliance: Having staff periodically inspect the playground equipment and making repairs as needed; having staff report broken items and hazardous issues to administration staff immediately. Children’s Records A violation was cited today for a child not having an immunization record on file. According to Child Care Rule 10A NCAC .0304(g), children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care shall be made available to the Division for review. Staff Medical Records A violation was cited today for a staff member not having a medical report on file. According to Child Care Rule 10A NCAC 09 .0701(a), child care providers and uncompensated providers who are not substitute providers or volunteers, shall obtain a medical report or a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. The medical report shall be obtained prior to employment. When submitted, the medical statement shall not be older than 12 months. A violation was cited today for a staff member not having a TB test or screening with negative results on file. According to Child Care Rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a tuberculin (TB) test or screening on or before first day of work. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. We discussed using the staff file checklist to periodically monitor the documentation that is required to be in the staff file, and each item’s due date and/or expiration date. A blank copy of the staff and file checklist was left with the assistant director. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 4/25/2024. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Challenging Behaviors Hotline: Do you have children who bite? Do children struggle to focus during circle time? Do challenging behaviors cause difficult transitions? Do you spend all day managing behavior? Are you at your wits' end? Help is available for these and other behavior challenges! The Challenging Behaviors Hotline has opened and is provided for Free. You may speak to a Behavior Support Advisor for advice and resources specific to challenging behaviors in your facility. Dial 1-888-600-1685 Option 1 or for more information go to www.childcareresourcesinc.org/challenging-behaviors-helpline. Natural Outdoor Learning Initiative The DCDEE has a new initiative – Natural Outdoor Learning Initiative. Through this initiative, we hope to: increase knowledge and confidence for everyone in developing and implementing best practices to support the creation, programming, and safe use of naturalized outdoor spaces in child care facilities. You can learn more by visiting the NLI website, where you will also find many resources, including an updated Toolkit designed to help you enhance your outdoor learning environment. The downloadable NLI Toolkit is available at: https://naturalearning.org/preschool-outdoor-toolkit Please feel free to contact me at tiffany.L.reed@dhhs.nc.gov or (910) 605-2367 if you have any questions, comments, or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 4/16/2024 Number Present: 20 Completed Date: 4/16/2024 Age: From 0 To 4 Total Minutes: 405 Time In: 09:00 AM Time Out: 03:45 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 compliance with applicable child care requirements pertinent to an annual compliance visit, including Health and Safety Training. The previous Annual Compliance visit was completed on April 25, 2023, and prior to today’s visit, the eighteen-month compliance history score was 88% which is at or above 75%, as required by North Carolina General Statute 110-90(4)(c-d). This program currently operates with a Four-Star License issued January 07, 2020. The license was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet an educational option of having a child care administrator with at least 10 years of documented child care administration work experience in a licensed program. The information on record was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of Superior was completed on April 25, 2023. Fire Classification of Approved was completed on September 14, 2023. T. Armfield was present while I observed the indoor and outdoor areas. Twenty children were present upon my arrival. Groups of children were observed participating in free-choice activities in their classrooms. Another group of children was observed in the outdoor play area, participating in sand play and exploring the stationary equipment. In Space #1, an unlabeled bottle with prepared formula and an expired gallon of whole milk were stored in the refrigerator. Joe Flood, Administrator, arrived at the facility after I completed the walkthrough. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. On a piece of stationary equipment in the infant/toddler playground area, the slide was observed separating from the platform of the equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. In the preschool playground area, several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. Routine care and handwashing practices were observed. Lunch consisted of fish sticks, mashed potatoes, mixed vegetables, diced peaches, and milk. Four children’s files were reviewed, and all documentation was in compliance with applicable child care rules. Four staff files were reviewed. One staff member did not have a medical report on file. One staff member did not have a valid TB test or screening with negative results on file. One staff member did not complete the required Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. One staff member did not complete the required health and safety training within one year of hire. Program files, including the EPR plan, were reviewed and all documentation was in compliance with applicable child care rules. This program does not provide transportation services. At the completion of the visit, the Visit Summary was reviewed with J. Flood and T. Armfield. The following violations were observed: 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. In Space #1, an unlabeled bottle was observed in the refrigerator. The teacher labeled the bottle with a child's name and today's date and placed it back in the refrigerator. 15A NCAC 18A .2804(d) 721 All equipment and furnishings were not in good repair. In Playground #2, a slide was observed separating from the platform of the stationary equipment, creating pinch points and a falling hazard. A broken seat was observed on the see-saw bouncer, creating pinch points and a falling hazard. Several nails were observed sticking out from the base of the stationary school bus and playhouses, creating protrusions. G.S. 110-91(6); .0601(b) 856 The indoor and/or outdoor premises was not checked once a day, prior to initial use, ensuring debris, and broken equipment was removed and disposed of. Multiple pieces of broken glass were scattered throughout the sand in the outdoor play area. A staff member came to the facility, raked through the sand, and removed the debris. 10A NCAC 09 .0604(p) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A. Norfus, Teacher, did not have a medical report on file. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. M. McCuin, Teacher, did not have a TB test or screening with negative results on file. .0701(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in First Aid within 90 days of hire. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. A. Norfus, Teacher, did not complete certification in CPR training within 90 days of hire. .1102(d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. A. Norfus, Teacher, did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of hire. .1102(g) 1898 Staff did not complete the health and safety training within one year of employment. A. Norfus, Teacher, did not complete the required health and safety training within one year of employment (DOH: 4/03/2023). .1102(a) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on April 30, 2024, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Facility Specific TA Safe Outdoor Environment A violation was cited today for hazardous items on the playground. According to Child Care Rule 10A NCAC 09 .0604(p), once a day, prior to initial use, the indoor and outdoor premises shall be checked for debris, vandalism, and broken equipment. Debris shall be removed and disposed of. Providing a safe environment is important for children’s growth and development. We discussed the following strategies for achieving and maintaining compliance: review the rule section with staff at your next staff meeting and have staff report hazardous issues to administration staff immediately. Outdoor Equipment A violation was cited today for outdoor equipment not being in good repair. According to Child Care Rule 10A NCAC 09 .0601(b-d), all equipment and furnishings shall be in good repair. All commercially manufactured equipment and furnishings shall be assembled and installed according to procedures specified by the manufacturer. Equipment and furnishings shall be sturdy, stable, and free of hazards that may injure children including sharp edges, lead based or peeling paint, rust, loose nails, splinters, protrusions (excluding nuts and bolts on sides of fences), and pinch and crush points. All equipment and furnishings not meeting the requirements shall be removed from the premises immediately or made inaccessible to the children. We discussed the following strategies for achieving and maintaining compliance: Having staff periodically inspect the playground equipment and making repairs as needed; having staff report broken items and hazardous issues to administration staff immediately. Children’s Records A violation was cited today for a child not having an immunization record on file. According to Child Care Rule 10A NCAC .0304(g), children's records that include an application for enrollment, medical and immunization records, and permission to seek emergency medical care shall be made available to the Division for review. Staff Medical Records A violation was cited today for a staff member not having a medical report on file. According to Child Care Rule 10A NCAC 09 .0701(a), child care providers and uncompensated providers who are not substitute providers or volunteers, shall obtain a medical report or a statement signed by a health care professional that indicates that the person is emotionally and physically fit to care for children. The medical report shall be obtained prior to employment. When submitted, the medical statement shall not be older than 12 months. A violation was cited today for a staff member not having a TB test or screening with negative results on file. According to Child Care Rule 10A NCAC 09 .0701(a), all staff, including the director and individuals who volunteer more than once per week, shall obtain a tuberculin (TB) test or screening on or before first day of work. The results indicating the individual is free of active tuberculosis shall be obtained within the 12 months prior to the date of employment. We discussed using the staff file checklist to periodically monitor the documentation that is required to be in the staff file, and each item’s due date and/or expiration date. A blank copy of the staff and file checklist was left with the assistant director. Reminders Sanitation Inspection Your facility’s current sanitation inspection is due to expire on 4/25/2024. I encouraged the administrator to contact the Cumberland County Environmental Health Department at (910)433-3618 to schedule an updated inspection before the expiration date. Challenging Behaviors Hotline: Do you have children who bite? Do children struggle to focus during circle time? Do challenging behaviors cause difficult transitions? Do you spend all day managing behavior? Are you at your wits' end? Help is available for these and other behavior challenges! The Challenging Behaviors Hotline has opened and is provided for Free. You may speak to a Behavior Support Advisor for advice and resources specific to challenging behaviors in your facility. Dial 1-888-600-1685 Option 1 or for more information go to www.childcareresourcesinc.org/challenging-behaviors-helpline. Natural Outdoor Learning Initiative The DCDEE has a new initiative – Natural Outdoor Learning Initiative. Through this initiative, we hope to: increase knowledge and confidence for everyone in developing and implementing best practices to support the creation, programming, and safe use of naturalized outdoor spaces in child care facilities. You can learn more by visiting the NLI website, where you will also find many resources, including an updated Toolkit designed to help you enhance your outdoor learning environment. The downloadable NLI Toolkit is available at: https://naturalearning.org/preschool-outdoor-toolkit Please feel free to contact me at tiffany.L.reed@dhhs.nc.gov or (910) 605-2367 if you have any questions, comments, or concerns. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0901 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/11/2023 Number Present: 18 Completed Date: 10/11/2023 Age: From 0 To 3 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a routine unannounced visit. The previous Annual Compliance Visit was completed April 25, 2023 and prior to today’s visit, the eighteen-month compliance history score was 89% which at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Joseph Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Superior was completed April 25, 2023. Fire Classification of Approved for Day Time Care Only was completed September 14, 2023. J. Flood, Administrator, was present while I observed the indoor and outdoor areas. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free choice activities with music playing in the background. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. There were a limited amount of dramatic play materials (2 dolls) and a limited amount of literacy materials (7 books). A plastic bag was stored on top of a plastic drawer, below five feet from the finished floor. The teacher washed the children’s hands to prepare for lunch. The teacher gave the infants bottles of baby formula, which they were able to hold themselves, and gave the toddler a bottle of water before feeding him beefaroni and corn. The toddler was not served a fruit or milk. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The teacher and children transitioned to the playground for outdoor play. During outdoor play, the children from Space # 2 were observed participating in sand play, playing with balls, and exploring various pieces of stationary equipment. Children transitioned back inside, washed their hands, and sat at a table for lunch. Lunch consisted of beefaroni, corn, peaches, and milk. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. In Space #1, there were not a sufficient amount of materials to provide a variety of play experiences for children. The dramatic play materials consisted of two dolls. The literacy materials consisted of 7 books. One of the books was ripped. There were no blocks available for the children. 10A NCAC 09 .0509(2) 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. In Space #1, a toddler was served beefaroni, corn, and water for lunch. Fruit and milk were not served. 10A NCAC 09 .0901(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. In Space #1, a plastic bag containing diapers was stored on top of a plastic drawer, below five feet from the finished floor. .0604(q) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 25, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail on July 12, 2023. During today’s visit, I reviewed the progress of the correction action plan and monitored for supervision. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. Supervision and staff/child ratios were observed in compliance during today’s visit. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during a follow-up visit on August 30, 2023. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during a follow-up visit on August 30, 2023. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during the follow-up visit on August 30, 2023. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. TA/Consultation: Nutrition Requirements A violation was cited today for not following nutrition requirements. According to Child Care Rule .0901(a), meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. Safe Indoor Environment A violation was cited today for children under the age of three having access to a plastic bag. According to Child Care Rule .0604(q), plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. Classroom Materials A violation was cited today for not having a sufficient amount of materials in Space #1. According to Child Care Rule .0509(2), the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. Infant/Toddler Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #1. There were limited materials for literacy and dramatic play. Blocks were not available for the children. I encouraged J. Flood to order more materials for the infant/toddler classroom. The teacher was always aware of her surroundings. Self-talk and Parallel talk were not observed during today’s visit in Space #1. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk is important for the teacher to engage in conversations by talking about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #2. Children were engaged in classroom activities and were responsive to the teacher. There were ample materials in each interest center for children to use at their choice. The teacher was always aware of her surroundings. I encouraged J. Flood to have staff use mealtimes as learning opportunities. Mealtimes can offer opportunities to discuss where food comes from, how food is prepared, or connect concepts such as colors and letters to food. Reminders: July 2023 Child Care Rule Changes The DCDEE is excited to share information about the July 2023 child care rule changes. The NC Child Care Commission revised rules related to staff/child ratios for multi-age groups; cooperative arrangements; and enhanced space requirements. These rule changes may or may not impact your facility. The multi-age group staff/child ratio changes support a previous rule change submitted by Early Head Start and the new rule for defining cooperative arrangements provides clarification to a previous change in statute. July 2023 New Child Care Rule Rollout A New Rule Amendments Overview module has been added to the Child Care Rules Training on DCDEE Moodle. If you are unfamiliar with the Child Care Rule Rollout within Moodle, learn how to navigate Moodle. To access Moodle, 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, register for an individual NCID at https://ncid.nc.gov/ncidsspr/. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814- 6326. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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 .0509 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/11/2023 Number Present: 18 Completed Date: 10/11/2023 Age: From 0 To 3 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a routine unannounced visit. The previous Annual Compliance Visit was completed April 25, 2023 and prior to today’s visit, the eighteen-month compliance history score was 89% which at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Joseph Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Superior was completed April 25, 2023. Fire Classification of Approved for Day Time Care Only was completed September 14, 2023. J. Flood, Administrator, was present while I observed the indoor and outdoor areas. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free choice activities with music playing in the background. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. There were a limited amount of dramatic play materials (2 dolls) and a limited amount of literacy materials (7 books). A plastic bag was stored on top of a plastic drawer, below five feet from the finished floor. The teacher washed the children’s hands to prepare for lunch. The teacher gave the infants bottles of baby formula, which they were able to hold themselves, and gave the toddler a bottle of water before feeding him beefaroni and corn. The toddler was not served a fruit or milk. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The teacher and children transitioned to the playground for outdoor play. During outdoor play, the children from Space # 2 were observed participating in sand play, playing with balls, and exploring various pieces of stationary equipment. Children transitioned back inside, washed their hands, and sat at a table for lunch. Lunch consisted of beefaroni, corn, peaches, and milk. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. In Space #1, there were not a sufficient amount of materials to provide a variety of play experiences for children. The dramatic play materials consisted of two dolls. The literacy materials consisted of 7 books. One of the books was ripped. There were no blocks available for the children. 10A NCAC 09 .0509(2) 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. In Space #1, a toddler was served beefaroni, corn, and water for lunch. Fruit and milk were not served. 10A NCAC 09 .0901(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. In Space #1, a plastic bag containing diapers was stored on top of a plastic drawer, below five feet from the finished floor. .0604(q) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 25, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail on July 12, 2023. During today’s visit, I reviewed the progress of the correction action plan and monitored for supervision. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. Supervision and staff/child ratios were observed in compliance during today’s visit. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during a follow-up visit on August 30, 2023. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during a follow-up visit on August 30, 2023. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during the follow-up visit on August 30, 2023. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. TA/Consultation: Nutrition Requirements A violation was cited today for not following nutrition requirements. According to Child Care Rule .0901(a), meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. Safe Indoor Environment A violation was cited today for children under the age of three having access to a plastic bag. According to Child Care Rule .0604(q), plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. Classroom Materials A violation was cited today for not having a sufficient amount of materials in Space #1. According to Child Care Rule .0509(2), the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. Infant/Toddler Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #1. There were limited materials for literacy and dramatic play. Blocks were not available for the children. I encouraged J. Flood to order more materials for the infant/toddler classroom. The teacher was always aware of her surroundings. Self-talk and Parallel talk were not observed during today’s visit in Space #1. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk is important for the teacher to engage in conversations by talking about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #2. Children were engaged in classroom activities and were responsive to the teacher. There were ample materials in each interest center for children to use at their choice. The teacher was always aware of her surroundings. I encouraged J. Flood to have staff use mealtimes as learning opportunities. Mealtimes can offer opportunities to discuss where food comes from, how food is prepared, or connect concepts such as colors and letters to food. Reminders: July 2023 Child Care Rule Changes The DCDEE is excited to share information about the July 2023 child care rule changes. The NC Child Care Commission revised rules related to staff/child ratios for multi-age groups; cooperative arrangements; and enhanced space requirements. These rule changes may or may not impact your facility. The multi-age group staff/child ratio changes support a previous rule change submitted by Early Head Start and the new rule for defining cooperative arrangements provides clarification to a previous change in statute. July 2023 New Child Care Rule Rollout A New Rule Amendments Overview module has been added to the Child Care Rules Training on DCDEE Moodle. If you are unfamiliar with the Child Care Rule Rollout within Moodle, learn how to navigate Moodle. To access Moodle, 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, register for an individual NCID at https://ncid.nc.gov/ncidsspr/. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814- 6326. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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 .1801 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/11/2023 Number Present: 18 Completed Date: 10/11/2023 Age: From 0 To 3 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a routine unannounced visit. The previous Annual Compliance Visit was completed April 25, 2023 and prior to today’s visit, the eighteen-month compliance history score was 89% which at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Joseph Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Superior was completed April 25, 2023. Fire Classification of Approved for Day Time Care Only was completed September 14, 2023. J. Flood, Administrator, was present while I observed the indoor and outdoor areas. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free choice activities with music playing in the background. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. There were a limited amount of dramatic play materials (2 dolls) and a limited amount of literacy materials (7 books). A plastic bag was stored on top of a plastic drawer, below five feet from the finished floor. The teacher washed the children’s hands to prepare for lunch. The teacher gave the infants bottles of baby formula, which they were able to hold themselves, and gave the toddler a bottle of water before feeding him beefaroni and corn. The toddler was not served a fruit or milk. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The teacher and children transitioned to the playground for outdoor play. During outdoor play, the children from Space # 2 were observed participating in sand play, playing with balls, and exploring various pieces of stationary equipment. Children transitioned back inside, washed their hands, and sat at a table for lunch. Lunch consisted of beefaroni, corn, peaches, and milk. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. In Space #1, there were not a sufficient amount of materials to provide a variety of play experiences for children. The dramatic play materials consisted of two dolls. The literacy materials consisted of 7 books. One of the books was ripped. There were no blocks available for the children. 10A NCAC 09 .0509(2) 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. In Space #1, a toddler was served beefaroni, corn, and water for lunch. Fruit and milk were not served. 10A NCAC 09 .0901(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. In Space #1, a plastic bag containing diapers was stored on top of a plastic drawer, below five feet from the finished floor. .0604(q) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 25, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail on July 12, 2023. During today’s visit, I reviewed the progress of the correction action plan and monitored for supervision. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. Supervision and staff/child ratios were observed in compliance during today’s visit. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during a follow-up visit on August 30, 2023. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during a follow-up visit on August 30, 2023. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during the follow-up visit on August 30, 2023. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. TA/Consultation: Nutrition Requirements A violation was cited today for not following nutrition requirements. According to Child Care Rule .0901(a), meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. Safe Indoor Environment A violation was cited today for children under the age of three having access to a plastic bag. According to Child Care Rule .0604(q), plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. Classroom Materials A violation was cited today for not having a sufficient amount of materials in Space #1. According to Child Care Rule .0509(2), the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. Infant/Toddler Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #1. There were limited materials for literacy and dramatic play. Blocks were not available for the children. I encouraged J. Flood to order more materials for the infant/toddler classroom. The teacher was always aware of her surroundings. Self-talk and Parallel talk were not observed during today’s visit in Space #1. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk is important for the teacher to engage in conversations by talking about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #2. Children were engaged in classroom activities and were responsive to the teacher. There were ample materials in each interest center for children to use at their choice. The teacher was always aware of her surroundings. I encouraged J. Flood to have staff use mealtimes as learning opportunities. Mealtimes can offer opportunities to discuss where food comes from, how food is prepared, or connect concepts such as colors and letters to food. Reminders: July 2023 Child Care Rule Changes The DCDEE is excited to share information about the July 2023 child care rule changes. The NC Child Care Commission revised rules related to staff/child ratios for multi-age groups; cooperative arrangements; and enhanced space requirements. These rule changes may or may not impact your facility. The multi-age group staff/child ratio changes support a previous rule change submitted by Early Head Start and the new rule for defining cooperative arrangements provides clarification to a previous change in statute. July 2023 New Child Care Rule Rollout A New Rule Amendments Overview module has been added to the Child Care Rules Training on DCDEE Moodle. If you are unfamiliar with the Child Care Rule Rollout within Moodle, learn how to navigate Moodle. To access Moodle, 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, register for an individual NCID at https://ncid.nc.gov/ncidsspr/. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814- 6326. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 10/11/2023 Number Present: 18 Completed Date: 10/11/2023 Age: From 0 To 3 Total Minutes: 240 Time In: 09:30 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to a routine unannounced visit. The previous Annual Compliance Visit was completed April 25, 2023 and prior to today’s visit, the eighteen-month compliance history score was 89% which at or above 75%, as required by North Carolina General Statute 110-90(4) (c-d). This program currently operates with a Four-Star License issued January 07, 2020. The License was based on the program earning 6 points in education standards, 5 points in program standards, and one quality point by choosing to meet the educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Joseph Flood, Administrator. Current Inspections are as follows: Sanitation Classification of Superior was completed April 25, 2023. Fire Classification of Approved for Day Time Care Only was completed September 14, 2023. J. Flood, Administrator, was present while I observed the indoor and outdoor areas. Upon my arrival, eighteen (18) children and four (4) teachers were present. In Space #1, infants and toddlers were observed participating in free choice activities with music playing in the background. Children had access to music materials, fine motor materials, dramatic play materials, and literacy materials. There were a limited amount of dramatic play materials (2 dolls) and a limited amount of literacy materials (7 books). A plastic bag was stored on top of a plastic drawer, below five feet from the finished floor. The teacher washed the children’s hands to prepare for lunch. The teacher gave the infants bottles of baby formula, which they were able to hold themselves, and gave the toddler a bottle of water before feeding him beefaroni and corn. The toddler was not served a fruit or milk. In Space #2, children were observed participating in free-choice activities. Children had access to dramatic-play materials, blocks, science materials, creative art materials, fine motor materials, and literacy materials. The teacher and children transitioned to the playground for outdoor play. During outdoor play, the children from Space # 2 were observed participating in sand play, playing with balls, and exploring various pieces of stationary equipment. Children transitioned back inside, washed their hands, and sat at a table for lunch. Lunch consisted of beefaroni, corn, peaches, and milk. At the completion of the visit, the Visit Summary was reviewed with J. Flood. The following violations were observed: Violation Number Comment Rule 434 The materials and equipment indoors and outdoors were not sufficient to provide a variety of play experiences to promote the children's emotional and social development, health and physical development, approaches to play and learning, language and communication development, and cognitive development. In Space #1, there were not a sufficient amount of materials to provide a variety of play experiences for children. The dramatic play materials consisted of two dolls. The literacy materials consisted of 7 books. One of the books was ripped. There were no blocks available for the children. 10A NCAC 09 .0509(2) 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. In Space #1, a toddler was served beefaroni, corn, and water for lunch. Fruit and milk were not served. 10A NCAC 09 .0901(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. In Space #1, a plastic bag containing diapers was stored on top of a plastic drawer, below five feet from the finished floor. .0604(q) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on October 25, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail on July 12, 2023. During today’s visit, I reviewed the progress of the correction action plan and monitored for supervision. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. Supervision and staff/child ratios were observed in compliance during today’s visit. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during a follow-up visit on August 30, 2023. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during a follow-up visit on August 30, 2023. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during the follow-up visit on August 30, 2023. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. TA/Consultation: Nutrition Requirements A violation was cited today for not following nutrition requirements. According to Child Care Rule .0901(a), meals and snacks served to children in a child care center shall comply with the Meal Patterns for Children in Child Care Programs from the United States Department of Agriculture (USDA) which are based on the recommended nutrient intake judged by the National Research Council to be adequate for maintaining good nutrition. The types of food, number and size of servings shall be appropriate for the ages and developmental levels of the children in care. The Meal Patterns for Children in Child Care Programs are incorporated by reference and include subsequent amendments. A copy of the Meal Patterns for Children in Child Care Programs is available online at https://www.fns.usda.gov/cacfp/meals-and-snacks. Safe Indoor Environment A violation was cited today for children under the age of three having access to a plastic bag. According to Child Care Rule .0604(q), plastic bags, toys, toy parts small enough to be swallowed, and materials that can be torn apart, such as foam rubber and styrofoam, shall not be accessible to children under three years of age. Classroom Materials A violation was cited today for not having a sufficient amount of materials in Space #1. According to Child Care Rule .0509(2), the materials and equipment indoors and outdoors shall be sufficient to provide a variety of play experiences that promote the children's emotional and social development, health and physical development, approaches to play and learning, language development, and communication and cognitive development. Infant/Toddler Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #1. There were limited materials for literacy and dramatic play. Blocks were not available for the children. I encouraged J. Flood to order more materials for the infant/toddler classroom. The teacher was always aware of her surroundings. Self-talk and Parallel talk were not observed during today’s visit in Space #1. We discussed how self-talk offers an opportunity to allow conversation to occur in a silent classroom. For example, the teacher can talk out loud about what he/she is doing, seeing, hearing, or feeling. Parallel talk is important for the teacher to engage in conversations by talking about what the child is doing, seeing, hearing, or feeling. I encouraged staff to implement these methods of classroom interactions. Preschool Observation I discussed with J. Flood the results from observing the infant/toddler group in Space #2. Children were engaged in classroom activities and were responsive to the teacher. There were ample materials in each interest center for children to use at their choice. The teacher was always aware of her surroundings. I encouraged J. Flood to have staff use mealtimes as learning opportunities. Mealtimes can offer opportunities to discuss where food comes from, how food is prepared, or connect concepts such as colors and letters to food. Reminders: July 2023 Child Care Rule Changes The DCDEE is excited to share information about the July 2023 child care rule changes. The NC Child Care Commission revised rules related to staff/child ratios for multi-age groups; cooperative arrangements; and enhanced space requirements. These rule changes may or may not impact your facility. The multi-age group staff/child ratio changes support a previous rule change submitted by Early Head Start and the new rule for defining cooperative arrangements provides clarification to a previous change in statute. July 2023 New Child Care Rule Rollout A New Rule Amendments Overview module has been added to the Child Care Rules Training on DCDEE Moodle. If you are unfamiliar with the Child Care Rule Rollout within Moodle, learn how to navigate Moodle. To access Moodle, 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, register for an individual NCID at https://ncid.nc.gov/ncidsspr/. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814- 6326. DCDEE Website/ Child Care Consultant Contact Information Please visit DCDEE’s website for the latest childcare updates visit https://ncchildcare.ncdhhs.gov/. If you have questions, please contact me at: 910-605-2367 or tiffany.l.reed@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 .0304 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 8/30/2023 Number Present: 22 Completed Date: 8/30/2023 Age: From 0 To 5 Total Minutes: 180 Time In: 01:45 PM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to an Administrative Action Follow-Up visit. The previous annual compliance visit was conducted on April 25, 2023. The eighteen-month compliance history score prior to today’s visit was 90%. This program currently operates with a four (4) Star License issued January 07, 2020. The License was based on the program earning six (6) points in education standards, five (5) points in program standards, and one quality point by choosing to meet an educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of superior completed April 25, 2023. Fire Classification of approved for daytime care only completed August 25, 2022. T. Armfield, Assistant Director, was present and accompanied me when observing the indoor and outdoor areas. Upon my arrival, twenty-two (22) children and four (4) teachers were present. Children were observed resting on individualized cots and cribs. In Space #2, two school-aged children were grouped with three-year-old children and four-year-old children. Children transitioned from rest time to snack time. Snack consisted of tiger bite graham crackers and milk. When children finished their snack, they were observed participating in free-choice activities. Children had access to literacy, fine-motor, dramatic-play, blocks, art and music materials. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The operator did not schedule and obtain a fire inspection within 12 months of the previous inspection. The previous fire inspection was completed on August 25, 2022. 10A NCAC 09 .0304(a) 1750 Except for special events or activities, children ages three and older were grouped with school age children. In Space #2, two school-aged children were grouped with three-year-old and four-year-old children during nap time, snack, and free-choice activities. 10 NCAC 09 .2904(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on September 13, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail. T. Armfield stated the certified letter was delivered by the USPS on July 12, 2023. During today’s visit, I monitored the progress of the correction action plan. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The Administrative Action- Written Warning must remain available for review by parents and DCDEE Representatives throughout the effective time period of three (3) months. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during today’s visit. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during today’s visit. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during today’s visit. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. Facility Specific TA/Reminders: Program Requirements A violation was cited today for grouping three-year-old and four-year-old children with school-aged children. According to Child Care Rule .2904(b), preschool children aged three and older shall not be grouped with school aged children except for special events or activities such as birthday, holiday, or cultural celebrations and special presentations such as puppet or magic shows, a special story teller, or a discussion of safety practices by a fireman or nurse. Fire Inspection A violation was cited today for not obtaining an updated fire inspection within 12 months of the previous inspection. According to your records, your fire inspection expired on August 25, 2023. According to Child Care Rule .0304(a), each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. When the updated fire inspection has been completed, please send the inspection report to Tiffany Reed, Child Care Consultant, within 7 days of the inspection visit. QRIS Modernization (Two–Five Star Rated Licenses) The North Carolina Child Care Commission and the NCDHHS Division of Child Development and Early Education (DCDEE) are collaborating to modernize North Carolina's Quality Rating and Improvement System (QRIS) commonly known as the Star Rated License. DCDEE is developing a plan that will be reviewed by the legislature in Spring 2024. During the next few months, we are collecting information from parents, teachers, administrators, operators, and partners to consider in the plan. You are invited to participate in opportunities for Commission members and Division staff to listen and learn about your experiences and challenges within our Star Rated License system. An email with upcoming community outreach meetings and/or webinar dates will be sent in an email from DCDEE. Feel free to share this information with ECE colleagues and parents. If you have questions, please contact me at: (910) 605-2367 or tiffany.L.reed@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 .1801 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 8/30/2023 Number Present: 22 Completed Date: 8/30/2023 Age: From 0 To 5 Total Minutes: 180 Time In: 01:45 PM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to an Administrative Action Follow-Up visit. The previous annual compliance visit was conducted on April 25, 2023. The eighteen-month compliance history score prior to today’s visit was 90%. This program currently operates with a four (4) Star License issued January 07, 2020. The License was based on the program earning six (6) points in education standards, five (5) points in program standards, and one quality point by choosing to meet an educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of superior completed April 25, 2023. Fire Classification of approved for daytime care only completed August 25, 2022. T. Armfield, Assistant Director, was present and accompanied me when observing the indoor and outdoor areas. Upon my arrival, twenty-two (22) children and four (4) teachers were present. Children were observed resting on individualized cots and cribs. In Space #2, two school-aged children were grouped with three-year-old children and four-year-old children. Children transitioned from rest time to snack time. Snack consisted of tiger bite graham crackers and milk. When children finished their snack, they were observed participating in free-choice activities. Children had access to literacy, fine-motor, dramatic-play, blocks, art and music materials. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The operator did not schedule and obtain a fire inspection within 12 months of the previous inspection. The previous fire inspection was completed on August 25, 2022. 10A NCAC 09 .0304(a) 1750 Except for special events or activities, children ages three and older were grouped with school age children. In Space #2, two school-aged children were grouped with three-year-old and four-year-old children during nap time, snack, and free-choice activities. 10 NCAC 09 .2904(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on September 13, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail. T. Armfield stated the certified letter was delivered by the USPS on July 12, 2023. During today’s visit, I monitored the progress of the correction action plan. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The Administrative Action- Written Warning must remain available for review by parents and DCDEE Representatives throughout the effective time period of three (3) months. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during today’s visit. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during today’s visit. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during today’s visit. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. Facility Specific TA/Reminders: Program Requirements A violation was cited today for grouping three-year-old and four-year-old children with school-aged children. According to Child Care Rule .2904(b), preschool children aged three and older shall not be grouped with school aged children except for special events or activities such as birthday, holiday, or cultural celebrations and special presentations such as puppet or magic shows, a special story teller, or a discussion of safety practices by a fireman or nurse. Fire Inspection A violation was cited today for not obtaining an updated fire inspection within 12 months of the previous inspection. According to your records, your fire inspection expired on August 25, 2023. According to Child Care Rule .0304(a), each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. When the updated fire inspection has been completed, please send the inspection report to Tiffany Reed, Child Care Consultant, within 7 days of the inspection visit. QRIS Modernization (Two–Five Star Rated Licenses) The North Carolina Child Care Commission and the NCDHHS Division of Child Development and Early Education (DCDEE) are collaborating to modernize North Carolina's Quality Rating and Improvement System (QRIS) commonly known as the Star Rated License. DCDEE is developing a plan that will be reviewed by the legislature in Spring 2024. During the next few months, we are collecting information from parents, teachers, administrators, operators, and partners to consider in the plan. You are invited to participate in opportunities for Commission members and Division staff to listen and learn about your experiences and challenges within our Star Rated License system. An email with upcoming community outreach meetings and/or webinar dates will be sent in an email from DCDEE. Feel free to share this information with ECE colleagues and parents. If you have questions, please contact me at: (910) 605-2367 or tiffany.L.reed@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

NC GS 110-90 · Violation

Name of Operation: CREATIVE ENHANCEMENT DAY CARE Facility ID: 26000709 Consultant: TIFFANY REED Operation Type: Center Case Number: Visit Date: 8/30/2023 Number Present: 22 Completed Date: 8/30/2023 Age: From 0 To 5 Total Minutes: 180 Time In: 01:45 PM Time Out: 04:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today's visit was to monitor compliance with applicable child care requirements pertinent to an Administrative Action Follow-Up visit. The previous annual compliance visit was conducted on April 25, 2023. The eighteen-month compliance history score prior to today’s visit was 90%. This program currently operates with a four (4) Star License issued January 07, 2020. The License was based on the program earning six (6) points in education standards, five (5) points in program standards, and one quality point by choosing to meet an educational option: The child care administrator has at least 10 years of documented child care administrative work experience in a licensed program that can be verified by the Division. The information on record with DCDEE was verified as correct by Tiffany Armfield, Assistant Director. Current Inspections are as follows: Sanitation Classification of superior completed April 25, 2023. Fire Classification of approved for daytime care only completed August 25, 2022. T. Armfield, Assistant Director, was present and accompanied me when observing the indoor and outdoor areas. Upon my arrival, twenty-two (22) children and four (4) teachers were present. Children were observed resting on individualized cots and cribs. In Space #2, two school-aged children were grouped with three-year-old children and four-year-old children. Children transitioned from rest time to snack time. Snack consisted of tiger bite graham crackers and milk. When children finished their snack, they were observed participating in free-choice activities. Children had access to literacy, fine-motor, dramatic-play, blocks, art and music materials. At the completion of the visit, the Visit Summary was reviewed with T. Armfield. The following violations were observed: Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The operator did not schedule and obtain a fire inspection within 12 months of the previous inspection. The previous fire inspection was completed on August 25, 2022. 10A NCAC 09 .0304(a) 1750 Except for special events or activities, children ages three and older were grouped with school age children. In Space #2, two school-aged children were grouped with three-year-old and four-year-old children during nap time, snack, and free-choice activities. 10 NCAC 09 .2904(b) 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. Violations observed and documented today may impact the compliance history score. The violations observed and documented today must be corrected immediately. Additionally, by 5:00pm on September 13, 2023, you must submit a written, dated, and signed statement to me. The statement must describe accurately and in detail, how and when the violations were corrected. If the letter states that corrections have been made when they have not, 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: Tiffany Reed Child Care Consultant P.O. Box 9939 Fayetteville, NC 28311 tiffany.L.reed@dhhs.nc.gov If you email the compliance letter, you must include a signature block, which contains your name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Childcare ID# 12345678 Administrative Action Type: Written Warning The facility was issued an Administrative Action - Written Warning dated July 10, 2023 and was delivered by mail. T. Armfield stated the certified letter was delivered by the USPS on July 12, 2023. During today’s visit, I monitored the progress of the correction action plan. The Administrative Action was posted on the Parent Information Board in the hallway of the facility. The Administrative Action- Written Warning must remain available for review by parents and DCDEE Representatives throughout the effective time period of three (3) months. The following stipulations were monitored: Corrective Action Plan: 1. The child care operator shall maintain compliance at all times with all applicable child care requirements including, but not limited to, Child Care Rule 10A NCAC 09 .1801(a)(1-5), regarding supervision in child care centers. 2. Within two (2) weeks after this Notice is received Joseph Flood, administrator, shall develop or revise current policies and procedures regarding supervision. The written policies and procedures shall include a method for ensuring children are adequately supervised at all times. The written policies and procedures shall include, but not be limited to: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick • Procedures for checking on the well-being and needs of staff Revised supervision policies and procedures were sent to Tiffany Reed, Child Care Consultant, via email on July 24, 2023. The Child Care Consultant reviewed and approved the updated supervision policies and procedures on July 31, 2023. A copy of the approved policies and procedures were maintained in facility files and was available for my review during today’s visit. 3. Within one (1) month after this Notice is received Mr. Flood shall conduct a mandatory staff meeting with all staff members to review the following topics: • Procedures to follow when staff need bathroom breaks • Procedures to follow when staff are not feeling well • Procedures to follow when staff need to take medication • Procedures to follow when staff need to call out sick • Procedures for ensuring staff/child ratios are maintained when staff call out sick A staff meeting was conducted on August 02, 2023 to discuss the updated supervision policies and procedures. A roster with signatures of attendees was provided to me during today’s visit. Acknowledgements, signed by staff, stating that staff reviewed the updated supervision policies, were provided to me during today’s visit. Unannounced visits will be made by a representative of the Division of Child Development and Early Education to verify compliance with the Written Warning. Documentation to support compliance with the Written Warning is required. Failure to comply with the terms of the Written Warning may result in the issuance of a more stringent administrative action and/or the assessment of a civil penalty. Please let me know if you have any questions or concerns regarding what is required of you for the Administrative Action – Written Warning. Facility Specific TA/Reminders: Program Requirements A violation was cited today for grouping three-year-old and four-year-old children with school-aged children. According to Child Care Rule .2904(b), preschool children aged three and older shall not be grouped with school aged children except for special events or activities such as birthday, holiday, or cultural celebrations and special presentations such as puppet or magic shows, a special story teller, or a discussion of safety practices by a fireman or nurse. Fire Inspection A violation was cited today for not obtaining an updated fire inspection within 12 months of the previous inspection. According to your records, your fire inspection expired on August 25, 2023. According to Child Care Rule .0304(a), each operator shall schedule and obtain a fire inspection within 12 months of the center's previous fire inspection. The operator shall notify the local fire inspector when it is time for the center's annual fire inspection. The operator shall submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. When the updated fire inspection has been completed, please send the inspection report to Tiffany Reed, Child Care Consultant, within 7 days of the inspection visit. QRIS Modernization (Two–Five Star Rated Licenses) The North Carolina Child Care Commission and the NCDHHS Division of Child Development and Early Education (DCDEE) are collaborating to modernize North Carolina's Quality Rating and Improvement System (QRIS) commonly known as the Star Rated License. DCDEE is developing a plan that will be reviewed by the legislature in Spring 2024. During the next few months, we are collecting information from parents, teachers, administrators, operators, and partners to consider in the plan. You are invited to participate in opportunities for Commission members and Division staff to listen and learn about your experiences and challenges within our Star Rated License system. An email with upcoming community outreach meetings and/or webinar dates will be sent in an email from DCDEE. Feel free to share this information with ECE colleagues and parents. If you have questions, please contact me at: (910) 605-2367 or tiffany.L.reed@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