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Home › NC › Forest City › Little RED School
319 S Broadway, Forest City NC 28043 · License #8155056 · Center · Child Care Center
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10A NCAC 09 .0902 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@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
Generated from this facility's specific inspection record
Data synced from North Carolina's child care licensing agency on Jul 9, 2026 · Report an error
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0302 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0509 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0803 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
G.S. 110-90 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
GS 110-91 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
GS110-91 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
NC GS 110-90 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/12/2026 Number Present: 33 Completed Date: 1/12/2026 Age: From 0 To 5 Total Minutes: 255 Time In: 09:15 AM Time Out: 01:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements for an annual compliance with rated license assessment, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. This program currently operates with a Five-star license issued on April 12, 2024. The permit restrictions include 1st shift, enhanced ratios, enhanced space, and 2 ½ yr olds in rooms with direct exits only. Your program was also monitored for compliance with implementing an approved curriculum as required for all four and five star licensed facilities where four-year -old children are enrolled. The last annual compliance visit was conducted on January 22, 2025. The most recent sanitation inspection for your facility was conducted on December 4, 2025 A superior sanitation classification was issued with eight demerits noted on the grade card. The most recent approved fire inspection for your facility was conducted on January 8, 2026 for daytime care only. The most recent monthly fire drill was conducted on December 11, 2025. The most recent quarterly lockdown/shelter-in-place drill was conducted on December 11, 2025. The most recent monthly playground inspection was completed on December 17, 2025. The center's compliance history was reviewed with the operator. The program’s compliance history was 96 percent as of December 31, 2025 The NC Secretary of State website was reviewed on December 31, 2025 and C.J. Hussey, Inc. was listed as current-active. The facilities contact information was reviewed and confirmed with you. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in free play activities indoors, large group activities, outdoor gross motor activities, handwashing routines, lunch, and rest time. Infants were engaged in tummy time and feeding. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. A checklist was used to note the requirements I monitored today. The analysis date for the most recent lead water test was June 28, 2024 Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated “enrollment started” for required asbestos and lead-based paint testing. You provided me with applicable program, staff, and children’s records for review. Files for one new staff, two existing staff, and applicable records for all staff were reviewed. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of six children’s records were reviewed. NC Pre-K requirements were monitored today. Rated License: Following the Technical Assistance visit conducted on October 27, 2025, you have chosen Pathway #1-Program Assessment. We reviewed the Application for Assessment for a Rated License for Centers document, including the linked forms for Family and Community Engagement Standards, Continuous Quality Improvement Plan (CQI) Facility, CQI and Professional Development (PD) Individual, Self Study Verification, Environment Rating Scale (ERS) Assessment Request, and the Staff Information and Education Worksheet. The application can be found on the DCDEE website under provider documents/forms. Program Standards: Your program uses the approved Creative Curriculum when four-year-olds are enrolled. Training and resources regarding the program assessment self-study can be found on the NC Rated License Assessment Project website www.ncrlap.org Additional information regarding the Environment Rated Scales Third Editions is also available on this website. You reported that you have been reading about the self study requirements and preparing to begin a self study. When you have completed your three month self study, please return the self study verification form, and the Environment Rated Scale Assessment Request form. Education Standards: Several staff members need to update their individual accounts on the DCDEE WORKS portal to request evaluation for a child care position and submit education verification. The link is the following: https://dcdee.works.nc.gov/ and scroll down to the DCDEE WORKS logon link. An updated DCDEE WORKS account is required for all staff to process the education standard for your program. Education will be evaluated for administrators and staff who provide direct care to children. Due to time constraints, violations observed today were discussed with you and documented in the handwritten Visit Summary left with you at the conclusion of this visit. The computer-generated Visit Summary was emailed to you. The following violations were observed: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In space #4, the activity plan posted was dated October 2025. GS 110-91(12); .0508(a) 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, four children one year of age had only the book center with twelve books accessible for play while one staff member was assisting children one at a time in an individual art project. 10A NCAC 09 .0509(2) 540 An individual written feeding plan was not provided by child's parent or health care provider or was not followed and posted. (omit posting for centers located in a residence) In space #1, two children thirteen months of age and two children fourteen months of age did not have feeding plans posted. In space #3, one child six months of age had a feeding plan that did not have the signature of the parent. 10A NCAC 09 .0902(a) 837 The EMC plan did not name the person responsible, and at least one alternate, for choosing and carrying out the plan of action to obtain appropriate medical care. The specific name and alternate name were not listed for persons in center responsible for giving first aid and CPR on the EMC plan. .0802(a)(1)(A-B); 847 Parent's medication authorization did not include required information. In space #4, a Destin diaper cream permission form for a two year old child did not include the date the authorization was to begin or to end. 10A NCAC 09 .0803(4)(6-9) 1044 Prior to the expiration date of the qualification letter, the child care provider did not complete and submit required forms to complete a criminal background check (a qualification letter is valid for a maximum of five years for the date of issuance). Juana Lazano had a qualifying letter that expired October 29, 2025. A new criminal background check application was initiated on December 10, 2025 and a new valid qualification letter dated December 15, 2025 was on file during today's visit. G.S. 110-90.2(b) & .2703(n)&(o) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had First Aid certification that expired May 2025 and completed new First Aid certification on December 29, 2025. One staff member employed October 23, 2017 had First Aid certification that expired November 17, 2025 and completed new First Aid certification on December 29, 2025. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member employed October 13, 2023 had CPR certification that expired May 2025 and completed new CPR certification on December 29, 2025. One staff member employed October 23, 2017 had CPR certification that expired November 17, 2025 and completed new CPR certification on December 29, 2025. .1102(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child two years of age who enrolled on September 8, 2025 did not have a medical exam on file. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child four months of age who enrolled on November 10, 2025 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1324 Signed and dated statement by parent that discipline policy received and explained at enrollment was not in child's file. In space #6, one child five years of age that enrolled in NC Pre K on August 11, 2025 did not have a signed and dated statement that the discipline policy was received and explained at the time of enrollment. .1804(c) 1769 The health assessment did not include a dental screening. In space #5, one child four years of age who enrolled in NC Pre K on August 13, 2025 did not have verification of a completed dental screening on file. .3005 (a)(5) 1793 Infants were served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. In space #3, one child seven months of age was served juice in a bottle without a prescription or written statement on file. .0902( c ) 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 annual review verification on file was dated January 18, 2024. .0607(e) 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. One staff member employed September 2, 2014 had verification on training for administering medication, prevention of shaken baby syndrome, abusive head trauma and child maltreatment and recognizing and reporting child abuse, child neglect and child maltreatment dated September 2020. .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. Any violation(s) documented may impact the compliance history score. The violation(s) documented must be corrected immediately. On or before January 26, 2026, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit will be conducted. Mail or email the information to: Beth Archer, Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov. If you email the compliance letter, it must be sent from the email address registered with the DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Technical Assistance was provided on the following: All centers must have a current schedule and activity plan for each group of children posted for reference by parents and by caregivers. For each group of children in care, the activity plan must include activities intended to stimulate the following developmental domains, in accordance with North Carolina Foundations for Early Learning and Development, available on the Division's website at http://ncchildcare.nc.gov/providers/pv_foundations.asp: emotional and social development; health and physical development; approaches to play and learning; language development and communication; and cognitive development. The activity plan must: identify activities that allow children to choose to participate with the whole group, part of the group, or independent of the group; reflect that the children have four different activities daily, at least one of which is outdoors, if weather conditions permit, art and other creative play; children's books; blocks and block building; manipulatives; family living and dramatic play; and include a daily gross motor activity that may occur indoors or outdoors. I suggested you assist teachers in developing their daily schedules and activity plans to ensure all requirements are met. I also suggested you remind teachers that an activity plan and schedule must be posted at all times. Additionally, I suggested you have staff members post the following weeks’ activity plan at the end of the day on the previous Friday to ensure a current activity plan is posted. The current weekly activity plan was posted during the walkthrough. This violation was corrected during the visit. Each classroom and outdoor play space must have sufficient materials and equipment 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. I suggested that when rotating materials for use and/or cleaning that you make sure that you have a variety of different materials for children to play. Two shelves of play materials were turned around and made accessible to the children in space #1. This violation was corrected during the visit. The parent or health care provider of each child under 15 months of age must provide the center an individual written feeding plan for the child. This plan must be followed at the center. This plan must include the child's name, be signed by the parent or health care provider, and be dated when received by the center. Each infant's plan is to be modified in consultation with the child's parent or health care provider to reflect changes in the child's needs as he or she develops. The feeding instructions for each infant must include the type and amount of milk, formula and food, the frequency of feedings and be posted for reference by the caregivers. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled and remind staff members that they should review all infant feeding plans with the parents to ensure information is recorded correctly and that the feeding plans are fully completed when received by the facility. The individual feeding plan must a posted in the classroom where the child is cared for until the child reaches 15 months of age. I suggested that you review this requirement with all staff members employed in classrooms where children under 15 months of age are enrolled. I also suggested that when children under 15 months change classrooms, the feeding plan is moved with the child and posted in space #1, where the children were in care. The feeding plans for the children thirteen and fourteen months of age were posted during the visit. This violation was corrected during the visit. Each child care center must have a written plan that sets forth the steps to follow in the event of a child medical emergency. The plan shall be reviewed with all staff annually and whenever the plan is revised. This plan shall give the procedures to be followed to ensure that any child who becomes ill or is injured and requires medical attention while in care at the center receives appropriate medical attention. The following information is to be included in the center's emergency medical care plan: (1) The name of the person and at least one alternate, responsible for carrying out that plan of action, ensuring that appropriate medical care is given, and determining which of the following is needed: (A) first aid given at the center for an injury or illness needing only minimal attention; and (B) calling 911 in accordance with CPR or First Aid training recommendations. (2) The name of the person and one alternate, at the center responsible for: (A) ensuring that the signed authorization described in Paragraph (d) of this Rule is taken with the ill or injured child to the medical facility; (B) accompanying the ill or injured child to the medical facility; (C) notifying a child's parents or emergency contact person about the illness or injury and where the child has been taken for treatment; (D) obtaining substitute staff, if needed, to maintain required staff/child ratio and adequate supervision of children who remain in the center; and (3) A statement giving the location of the telephone located on the premises available for use in case of emergency. A telephone located in an office in the center that is sometimes locked during the time the children are present shall not be designated for use in an emergency. I suggested you revise the form and add specific names for a person and an alternate on all required information on the form based on the facility’s emergency preparedness plan. You revised the Emergency Medical Care plan to include specific names for a person and alternate for administration of CPR/First Aid. This violation was corrected during the visit. Teachers should check Permission to Administer Medication Forms when brought into the facility and regularly thereafter to ensure they are filled out completely and properly. A parent may give standing authorization for up to 12 months to apply over-the-counter, topical ointments, topical teething ointment or gel, insect repellents, lotions, creams, fluoridated toothpaste, and powders, such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed. I suggested you assign a staff member to check all medications and Permission to Administer Medication Forms at least once a month to prevent further non-compliance regarding medication. Prior to the expiration date of the current qualifying letter, all staff members must complete and submit the required forms and information to complete a criminal background check. I suggested you set calendar reminders, or create a working document to track the expiration dates of the qualifying letters for all staff members to ensure all staff members maintain a current and valid qualifying letter. You may use the ABCMS Provider Portal to keep track of expiration dates of qualifying letters for all staff members. I also suggested you remind staff two (2) months prior to the expiration date of their qualifying letter to complete an application for an updated qualifying letter to begin the process. You corrected this violation during the visit by providing the current valid qualification letter. All staff members must maintain active CPR/First Aid certification. Verification on current certification must be on file for review. For existing staff, I suggested you schedule classes two to four months prior to the current certifications’ expiration to ensure certification does not expire. Both staff members with lapsed CPR and First Aid certifications had current certifications on file dated December 29, 2025. This violation was corrected at the visit. All children must have a medical exam on file within the first thirty (30) days of enrollment. The assessment shall be conducted by a licensed physician, 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, a certified nurse practitioner, or a public health nurse. I suggested you ask parents to provide the medical exam during the enrollment process to ensure the documentation is on file in a timely manner. I also suggested you use the children’s file checklist found on the DCDEE website under the “Provider” tab to ensure all required documentation is on file. All children must have an immunization record or valid exemption on file within the first thirty (30) days of enrollment. I suggested you ask parents to provide the immunization record or exemption during the enrollment process to ensure the documentation is on file in a timely manner. The staff member who conducts the enrollment conference must provide a written copy of and explain the center's discipline policies to each child's parents at the time of enrollment. The child care center must obtain from each parent, legal guardian, or full-time custodian a statement that attests that a copy of the center's written discipline policies was given to and discussed with him or her. That statement must include: the child's name; the date of enrollment; and if different, from the enrollment date the date the parent, legal guardian, or full-time custodian signed the statement. The signed, dated statement must be in the child's record. I suggested you create an enrollment packet and signature sheet for all required acknowledgements to have each parent complete during the enrollment process. A health assessment must be on file at the NC Pre-K site within 30 days after a child enters the NC Pre-K program and the assessment may be no more than 12 months old at the time of program entry. The health assessment must include the following: (1) physical examination; (2) updated immunizations; (3) vision screening; (4) hearing screening; and (5) dental screening. A dental screening may be completed on a separate form and must also be on file within 30 days after a child enters the NC Pre-K program. I suggested, if the health assessment form does not include dental screening information, that you obtain a dental screening from the parent during the enrollment process to ensure it is on file within the required timeframe. Infants may not be served juice in a bottle without a prescription or written statement on file from a health care professional or licensed dietitian/nutritionist. I suggested that if a parent requests a child be served juice from a bottle that you review the requirement and encourage them to obtain the required documentation. The staff member trained in Emergency Preparedness and Response must review and update the facility’s Emergency Preparedness and Response Plan annually, or when information in the plan changes, to ensure all information is current. I suggested you set a reminder in your calendar at least twice per year to review the Emergency Preparedness and Response Plan to ensure all of the information is up to date. The current EPR plan will need to be reviewed within the next two weeks. Health and safety training must be completed as part of on-going training so that every five years, all of the topic areas set forth in 10A NCAC 09 .1102(b) will have been covered. I suggested you use the Health and Safety Training Record to keep track of all health and safety trainings to ensure each topic area is completed at least once every five (5) years. I emailed you with a copy of this form. This form may also be found on the DCDEE website under the “Provider” tab. Consultation: The ABCMS provider portal facility roster should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time and assistance today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance , you may contact me at Beth.Archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .0803 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 7/16/2025 Number Present: 24 Completed Date: 7/16/2025 Age: From 0 To 5 Total Minutes: 164 Time In: 09:41 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. You provided me with applicable program and staff records for review. The NC Secretary of State website was viewed before the visit and C.J. Hussey, Inc. was current/active as of July 11, 2025. The facilities contact information was reviewed and confirmed with you. This program currently operates with a Five star rated license effective April 12, 2024. The permit restrictions were in compliance including 1st shift, meets enhanced ratios, meets enhanced space, and children under 2 ½ years of age in rooms with direct exits only. The program’s compliance history was 94 percent prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children and staff were participating in free play in activity areas, outdoor play, and rest time. Infants were engaged in feeding, tummy time activity, and rest. Three new staff have been hired since the annual compliance visit on January 22, 2025. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, and Special Training. Inspections/Drills: The last monthly fire drill was practiced on June 25, 2025. The last shelter-in-place drill was practiced on July 8, 2025. The last monthly playground inspection was completed on July 14, 2025. The most recent approved fire inspection for your facility was conducted on January 17, 2025. The most recent sanitation inspection for your facility was conducted on June 26, 2025. A superior sanitation classification was issued with 7 demerits noted on the grade card. The most recent lead water test results were completed on June 28, 2024. Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. As of May 31, 2025, in addition to the lead water testing all child care facilities were required to complete enrollment for both the asbestos and lead-based paint testing programs through the Clean Water for US Kids program. This website also indicated “no results” for required asbestos and lead paint testing. The following violation(s) were observed today: Violation Number Comment Rule 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, there was one aerosol can of Nutragena Ultra Sheer Sunscreen in a backpack on the shelf above the sink. .2820(b) 847 Parent's medication authorization did not include required information. In space #4, one child two years of age had a medication authorization that did not have the length of time that the authorization was valid listed on the form. 10A NCAC 09 .0803(4)(6-9) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. As of today’s visit, the child care program had not completed the requirements for establishing the child care provider portal roster and linking staff to the ABCMS system. G.S. 110-90.2 & .2703(r) The violation(s) documented must be corrected immediately. On or before July 30, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Please send the information to beth.archer@dhhs.nc.gov Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: Hazardous Products: We discussed that all aerosol products are required to be in locked storage. In space #4, the aerosol can of Nutragena Ultra Sheer Sunscreen was removed from the classroom during the visit. We discussed that since this classroom does not have a locked cabinet; you may consider putting a locked box in the room or having a discussion with the parent about using a sunscreen product that is not in an aerosol container. Medication Authorization: We discussed that medication authorization must include the length of time that the authorization is valid. You stated that you plan to talk with the parent to confirm that the authorization period that was intended and add the needed information to the form. I encouraged you to have a process for when medications/ointments are accepted to ensure that staff are reviewing the forms for all required information. ABCMS Provider Portal: I reviewed the ABCMS provider portal and no employees were listed on the facility roster. You reported that you are having difficulty with your personal NCID and have been unable to complete the Moodle training for next steps. We discussed that within the next 2 weeks, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119 . Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Consultation or other topics discussed today: We discussed requirements for activity plans for preschool-aged children and school-age children. Reminders and Resources: Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGallaird@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
G.S. 110-90 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 7/16/2025 Number Present: 24 Completed Date: 7/16/2025 Age: From 0 To 5 Total Minutes: 164 Time In: 09:41 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. You provided me with applicable program and staff records for review. The NC Secretary of State website was viewed before the visit and C.J. Hussey, Inc. was current/active as of July 11, 2025. The facilities contact information was reviewed and confirmed with you. This program currently operates with a Five star rated license effective April 12, 2024. The permit restrictions were in compliance including 1st shift, meets enhanced ratios, meets enhanced space, and children under 2 ½ years of age in rooms with direct exits only. The program’s compliance history was 94 percent prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children and staff were participating in free play in activity areas, outdoor play, and rest time. Infants were engaged in feeding, tummy time activity, and rest. Three new staff have been hired since the annual compliance visit on January 22, 2025. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, and Special Training. Inspections/Drills: The last monthly fire drill was practiced on June 25, 2025. The last shelter-in-place drill was practiced on July 8, 2025. The last monthly playground inspection was completed on July 14, 2025. The most recent approved fire inspection for your facility was conducted on January 17, 2025. The most recent sanitation inspection for your facility was conducted on June 26, 2025. A superior sanitation classification was issued with 7 demerits noted on the grade card. The most recent lead water test results were completed on June 28, 2024. Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. As of May 31, 2025, in addition to the lead water testing all child care facilities were required to complete enrollment for both the asbestos and lead-based paint testing programs through the Clean Water for US Kids program. This website also indicated “no results” for required asbestos and lead paint testing. The following violation(s) were observed today: Violation Number Comment Rule 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, there was one aerosol can of Nutragena Ultra Sheer Sunscreen in a backpack on the shelf above the sink. .2820(b) 847 Parent's medication authorization did not include required information. In space #4, one child two years of age had a medication authorization that did not have the length of time that the authorization was valid listed on the form. 10A NCAC 09 .0803(4)(6-9) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. As of today’s visit, the child care program had not completed the requirements for establishing the child care provider portal roster and linking staff to the ABCMS system. G.S. 110-90.2 & .2703(r) The violation(s) documented must be corrected immediately. On or before July 30, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Please send the information to beth.archer@dhhs.nc.gov Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: Hazardous Products: We discussed that all aerosol products are required to be in locked storage. In space #4, the aerosol can of Nutragena Ultra Sheer Sunscreen was removed from the classroom during the visit. We discussed that since this classroom does not have a locked cabinet; you may consider putting a locked box in the room or having a discussion with the parent about using a sunscreen product that is not in an aerosol container. Medication Authorization: We discussed that medication authorization must include the length of time that the authorization is valid. You stated that you plan to talk with the parent to confirm that the authorization period that was intended and add the needed information to the form. I encouraged you to have a process for when medications/ointments are accepted to ensure that staff are reviewing the forms for all required information. ABCMS Provider Portal: I reviewed the ABCMS provider portal and no employees were listed on the facility roster. You reported that you are having difficulty with your personal NCID and have been unable to complete the Moodle training for next steps. We discussed that within the next 2 weeks, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119 . Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Consultation or other topics discussed today: We discussed requirements for activity plans for preschool-aged children and school-age children. Reminders and Resources: Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGallaird@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 7/16/2025 Number Present: 24 Completed Date: 7/16/2025 Age: From 0 To 5 Total Minutes: 164 Time In: 09:41 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor your program for compliance with applicable child care requirements, including health and safety. The visit was conducted with you, Lori Delfosse, Administrator. You provided me with applicable program and staff records for review. The NC Secretary of State website was viewed before the visit and C.J. Hussey, Inc. was current/active as of July 11, 2025. The facilities contact information was reviewed and confirmed with you. This program currently operates with a Five star rated license effective April 12, 2024. The permit restrictions were in compliance including 1st shift, meets enhanced ratios, meets enhanced space, and children under 2 ½ years of age in rooms with direct exits only. The program’s compliance history was 94 percent prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios in compliance. Children and staff were participating in free play in activity areas, outdoor play, and rest time. Infants were engaged in feeding, tummy time activity, and rest. Three new staff have been hired since the annual compliance visit on January 22, 2025. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, EPR, Playground Safety, ITS-SIDS, and Special Training. Inspections/Drills: The last monthly fire drill was practiced on June 25, 2025. The last shelter-in-place drill was practiced on July 8, 2025. The last monthly playground inspection was completed on July 14, 2025. The most recent approved fire inspection for your facility was conducted on January 17, 2025. The most recent sanitation inspection for your facility was conducted on June 26, 2025. A superior sanitation classification was issued with 7 demerits noted on the grade card. The most recent lead water test results were completed on June 28, 2024. Lead testing must be completed every three years. You may review your facilities results by visiting https://www.cleanwaterforuskids.org/en/carolina/. As of May 31, 2025, in addition to the lead water testing all child care facilities were required to complete enrollment for both the asbestos and lead-based paint testing programs through the Clean Water for US Kids program. This website also indicated “no results” for required asbestos and lead paint testing. The following violation(s) were observed today: Violation Number Comment Rule 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, there was one aerosol can of Nutragena Ultra Sheer Sunscreen in a backpack on the shelf above the sink. .2820(b) 847 Parent's medication authorization did not include required information. In space #4, one child two years of age had a medication authorization that did not have the length of time that the authorization was valid listed on the form. 10A NCAC 09 .0803(4)(6-9) 1805 A child care operator did not notify the Division of any new child care providers, as defined in G.S. 110-90.2(a)(2), who were hired or moved into the child care facility within five business days. As of today’s visit, the child care program had not completed the requirements for establishing the child care provider portal roster and linking staff to the ABCMS system. G.S. 110-90.2 & .2703(r) The violation(s) documented must be corrected immediately. On or before July 30, 2025, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Please send the information to beth.archer@dhhs.nc.gov Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: Hazardous Products: We discussed that all aerosol products are required to be in locked storage. In space #4, the aerosol can of Nutragena Ultra Sheer Sunscreen was removed from the classroom during the visit. We discussed that since this classroom does not have a locked cabinet; you may consider putting a locked box in the room or having a discussion with the parent about using a sunscreen product that is not in an aerosol container. Medication Authorization: We discussed that medication authorization must include the length of time that the authorization is valid. You stated that you plan to talk with the parent to confirm that the authorization period that was intended and add the needed information to the form. I encouraged you to have a process for when medications/ointments are accepted to ensure that staff are reviewing the forms for all required information. ABCMS Provider Portal: I reviewed the ABCMS provider portal and no employees were listed on the facility roster. You reported that you are having difficulty with your personal NCID and have been unable to complete the Moodle training for next steps. We discussed that within the next 2 weeks, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119 . Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS on an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Consultation or other topics discussed today: We discussed requirements for activity plans for preschool-aged children and school-age children. Reminders and Resources: Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was given to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGallaird@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
GS110-91 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 .0801 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0302 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 .0514 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 .0515 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 .0609 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 .0801 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09 .0802 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 .0803 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 09.05015 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 09.0514 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 09.0608 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 09.0801 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09.0802 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
10A NCAC 09.0901 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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. 110-102 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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 110-102 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 2/8/2024 Number Present: 56 Completed Date: 2/8/2024 Age: From 0 To 5 Total Minutes: 249 Time In: 09:51 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Lori Delfosse, Administrator, assisted me with the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits only. The Secretary of State website was checked on February 7, 2024, and your business C.J.Hussey, Inc, is active and in good standing. If any changes to the corporation need to be made or you decide to sell your business, then you must notify me, your consultant at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and staff/child ratios in compliance. Children throughout the facility were participating in group music and art time, free play in activity areas, transitions and outdoor playtime. Infants were engaged in tummy time, feeding, and diapering routines. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history was at 84% prior to today’s visit. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A sample of seven children’s files were reviewed. Two new staff files were reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/29/24. The last lockdown drill was practiced on 1/12/24. The last monthly playground inspection was completed on 1/15/24. The most recent sanitation inspection for your facility was conducted on December 15, 2023. A superior sanitation classification was issued with eleven demerits. The most recent fire inspection for your facility was conducted on January 16, 2024. The facility was approved for day time care. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 114 A summary of the NC Child Care Law was not given to a parent of every child enrolled in the center. One child enrolled 2/7/24, did not have a signed summary of the law verification on file. GS 110-102 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/17/24 there were 4 children not signed out. On 1/18/24, there was one child not signed out. On 1/22/24, there were 3 children not signed out. On 1/23/24, there was one child not signed out. On 1/24/24, there was one child not signed out. On 1/25/24, there was 1 child not signed out. On 1/26/24, there were 2 children not signed out of care. 10A NCAC 09 .0302(d)(4) 303 Children were not adequately supervised at all times. Children were not adequately supervised at all times. In space #4, six children two years of age were transitioning from outdoors back into the classroom. One child, two years of age opened the interior classroom door leading to the hallway and went into the hallway unsupervised. The staff were unaware that the child left the classroom and went out into the hallway until the consultant made them aware of the situation. Two additional children, two years of age entered the bathroom located in the classroom and were playing in the toilet and rolling toilet paper onto the floor without staff acknowledgement. The staff were unaware that the two children were playing in the bathroom until the consultant made them aware of the situation. .1801(a)(1-5) 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 the refrigerator in space #3, there was one prepared bottle labeled 1/31/24, one prepared bottle labeled 2/1/24 and two prepared bottles labeled 2/6/24. 15A NCAC 18A .2804(d) 842 A drug or medication was administered without written authorization and/or instructions from a child's parent or authorized health professional. In space #4, a bottle of Vaseline, labeled for a 2 year old child, did not have a permission to administer form available for review. 10A NCAC 09 .0803(1)(a & b) 852 Incident reports were not completed each time a child was injured, it did not include all the information required in rule, it was not signed by the parent and/or it was not maintained in the child's file. An incident report dated 2/2/24, did not have the date/time the parent was contacted about the injury. .0802 (e) 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 #4, there was one package of Premium Baby wipes with suffocation hazard warnings in the cabinet beneath the sink and one package on the changing table, accessible to children under the age of three. .0604(q) 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. One staff member employed 1/2/24, had verification of a medical exam on file dated 1/8/24. 10A NCAC 09 .0701(a) 1052 Staff required to receive on-going training had not completed the required number of hours according to their education and experience. Staff required to receive on-going training had not completed the required number of hours according to their education and experience. One staff member employed 9/9/09 had completed 2 of 5 required hours of on-going training. One staff member employed 2/17/20, had completed 2 of 8 required hours of on-going training. .1103(a) 1203 Operational policies were not discussed with parents on or before the child's first day and/or they were not notified in writing of all changes. For one child enrolled 2/7/24, operational policies were not discussed with parents on or before the child’s first day of care. 10A NCAC 09 .0514(b) 1207 Parent participation plan was not discussed with parents on or before the child's first day of attendance and/or a copy was not given to them or posted in the center. The parent participation plan was not discussed with parents on or before the child’s first day for one child enrolled 2/7/24. 10A NCAC 09 .0515(a) 1302 Individual applications were not on file for each child. One child enrolled 2/7/24 did not have an application for enrollment on file. 10A NCAC 09 .0801(a) 1308 Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. Application did not include the names of individuals to whom the center may release the child, as authorized by the person who signs the application. One child enrolled 2/7/24, did not have on the application the names of the individuals to whom the center may release the child to. .0801(a)(7) 1313 Emergency information did not include name, address, and telephone number of parent or other emergency contact person. One child enrolled 2/7/24 had emergency information on file that did not include the address of the parent or other emergency contact person. .0802(c)(1) 1317 Authorization for emergency medical care information was not signed by child's parent. One child enrolled 2/7/24 did not have authorization to receive emergency medical care information on file. .0802(d) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have a medical exam on file. One child enrolled 3/9/22, had a medical exam on file dated 7/29/23. One child enrolled 1/24/22, had a medical exam on file dated 3/9/22. GS110-91(1) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. One child enrolled 1/2/24 did not have verification of immunizations on file. One child enrolled 1/24/22 had immunization verifications on file dated 3/9/22. One child enrolled 3/21/23 had immunization verification on file dated 11/21/23. 10A NCAC 09 .0302(d)(2) 1792 Staff did not model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. In space #4, there was one half full can of Red Bull energy drink on the shelf in the classroom. .0901(i) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #2, there was no medical action plan for a three year old child with chronic eczema that requires daily medication. .0801(b) 1851 The operator did not notify the parent of each child enrolled in writing of the smoking and tobacco restriction. One child enrolled 2/7/24 did not have verification of receipt of the smoking and tobacco restriction in writing on file. .0604(j) 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 hired 1/2/24, did not review the Shaken Baby Abusive Head Trauma policy prior to providing care for children. .0608(d)(1-4) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. In space #2, the authorization for prescription Mupirocin 2% cream had an authorization from 3/6/23-3/6/24 for a non-chronic medical condition. The authorization for prescription Hydrocortisone Ointment USP 2.55 % was from 8/4/23-8/4/24 for a non-chronic medical condition. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One child enrolled 2/7/24, did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby and Abusive Head Trauma policy on file. .0608(b)(1-6) The violation(s) documented must be corrected immediately. On or before February 22, 2024, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@dhhs.nc.gov Technical assistance on violations was reviewed with you. Areas discussed included: Item # 303 Supervision: Children must be adequately supervised at all times. You must be able to see, hear and respond to the needs of the children. The lead teacher and I discussed techniques for staff positioning to allow for appropriate supervision. If staff are unable to provide adequate supervision when returning from outdoors, administration will need to offer additional staff assistance during transition times. 10A NCAC 09.1801 (a)(1-5) Item # 533 Labeled Bottles: We discussed having staff review labels on prepared bottles and sippy cups of formula, human milk, and juice brought from home to ensure they are labeled daily with the current date. 15A NCAC 18A .2804(d). Item #858 Plastic Packaging: In classrooms where children under three years of age are enrolled, plastic packaging must be stored out of reach of children and at least five feet from ground level. We discussed that wipes in plastic packaging have suffocation warning labels and must be kept out of the reach of children under the age of three. 10A NCAC 09 .0604(q) Item #1792 Model Appropriate Eating: I reminded you that staff must model appropriate eating behaviors by consuming food or beverages that meet the nutritional requirements specified in the Meal Patterns for Children in Child Care Programs in the presence of children in care. 10A NCAC 09.0901(j). I discussed this requirement with the lead teacher in space #4. Item # 842 Medication Permission: Each child with a medication or topical ointment must have specific instructions from the child’s parent, including a parent’s signature to administer the medication/topical ointment available for review. 10A NCAC 09 .0803(1)(b). You reported that a permission form had been completed for the bottle of Vaseline but the form was unable to be located during the visit. Item # 1882 Medication Permission: 10A NCAC 09 .0803 (6) A parent may give a caregiver standing authorization for up to six months to administer prescription or over-the-counter medication to a child, when needed, for chronic medical conditions. The permission forms on file for the prescription medications gave authorization for one year, which does not meet the requirement in rule. Both prescription medicines had authorizations that were greater than six months old. We discussed that new authorizations, valid for not greater than six months, will need to be completed with the parent for each prescription medication needed. Item # 1834 Medical Action Plan: For children with health care needs for a chronic condition, a medical action plan must be attached to the child’s application. 10A NCAC 09 .0801(b). We discussed that since the child with eczema is receiving daily on-going prescription medications for the condition, a medical action plan is needed. A sample general medical action plan is available on the Division’s website under provider document/forms. Item #125 Daily Records of Arrival and Departure: We discussed daily sign in and out documentation requirements. You need to develop a plan for ensuring daily sign in and out documentation is reviewed to confirm compliance. I suggested that each assigned classroom teacher be responsible for making sure these records are completed in their classroom. 10A NCAC 09 .0302(d)(4) Item #852 Incident Report: Incident reports must list all the information required in 10A NCAC 09 .0802(e). This includes the date/time the parent is notified of the incident. I suggested that you review all incident reports to ensure the incident report is being completed accurately. Complete training with staff on how to properly complete the Incident Report Form. Items #1321, #1323 Child Medical Exams and Immunizations: Each child must have a completed medical exam and immunization record on file for review within 30 days of enrollment. We discussed the importance of informing parents about the requirement to help them understand the need to get the required information turned in within 30 days. I recommended requiring medical exams and immunization records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Item #1302 Application: Each child in care must have an individual application for enrollment completed and signed by the child's parent. The completed, signed application must be on file in the center on the first day the child attends. 10A NCAC 09.0801(a). You reported that the parents of one child enrolled 2/7/24, have not met with staff to complete the admission orientation paperwork. You reported a plan to get the parents to complete an application for the child. Item #1308 Authorization to Release: The center must have the names of the individuals to whom the center may release the child as authorized by the person who signs the application before the child begins care. 10A NCAC 09.0801(a)(7) We discussed that staff should review the application with the parent to determine if all required information is complete. One of the children enrolled 2/7/24, had an application that was partially completed. The information about individuals that the center may release the child to was blank. I suggest that you have a meeting with the parents to complete all required information including this requirement. Item # 114 Summary of the Law: A summary of the NC Child Care Law must be given to a parent of every child enrolled in the center. G.S. 110-102. You reported that the parents of one of the children enrolled 2/7/24, has yet to meet with staff to review orientation information. I suggest that staff conduct a pre-enrollment orientation to complete all required paperwork before the child begins care. Item #1313 Emergency Information: Emergency information must include name, address and telephone number of parent or other emergency contact persons. 10A NCAC 09.0802 (c )(1) We discussed that staff should review the application that is completed by parents to ensure that all the required information is completed prior to the child’s first day of care. Item #1317 Emergency Medical Authorization: A parent must sign for a child to have emergency medical care. We discussed that this information should be discussed at the time of enrollment to ensure the needed information is on file from the first day that the child is in care. 10A NCAC 09 .0802(d) Item #1851 Smoking/Tobacco restriction: Parents must be notified in writing when each child is enrolled of the smoking and tobacco restriction at the facility. 10A NCAC 09 .0604(j). You reported that this information is discussed at admission orientation. You plan to review this information with the parents of the child enrolled on 2/7/24 when the parents come to complete the new enrollment paperwork. Item #1908 Shaken Baby Abusive Head-Child file: A child's file must have a statement with pare nt signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. 10A NCAC 09.0608(b)(1-6) You reported that one of the children enrolled 2/7/24 had not received a parent orientation meeting yet; therefore, this policy has not been reviewed or discussed. The policy will be signed when staff and parents meet. Item #1203 Operational policies: Operational policies must be discussed with parents on or before the child's first day. 10A NCAC 09.0514(b) You reported that this information is given to parents when children are enrolled. The parents of one child enrolled 2/7/24, have not met with staff to complete enrollment paperwork. We discussed that a meeting with parents needs to occur before the child begins care. Item #1207 Parent participation plan: The parent participation plan must be discussed with parents on or before the child's first day or a copy posted in the center. 10A NCAC 09.05015(a) You reported that this information is discussed in your parent orientation. We discussed that this orientation needs to occur before the child begins care. Item #1052 On-going Training: Staff are required annually to receive on-going training for the required number of hours needed according to their education and experience. 10A NCAC 09.1103(a). We discussed that annual trainings are reviewed at each annual compliance visit. Hours received prior to the last annual compliance visit would be credited to the previous year’s requirements. I encouraged you to use Moodle for Health and Safety training renewals as well as additional on-line training. The Health and Safety resource center also has virtual trainings available on their website. https://healthychildcare.unc.edu/ The needed trainings will be required to be completed within the next 2 weeks. Item #1032 Staff Medical Report: Staff must have a medical report on file prior to employment that was signed by a health care professional. 10A NCAC 09 .0701(a) The Staff File Checklist can be used as a guide and tool to ensure all documents are received within the required timeframes. The staff member employed 1/2/24 has a medical report on file dated 1/8/24. This violation was corrected at visit. Item #1874 Shaken Baby-employee: The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy must be reviewed with new staff prior to providing care for children. A signed acknowledgement with the required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4). The staff member employed 1/2/24 reviewed the policy and signed the acknowledgement during the visit. This violation was corrected at visit. Consultation or other topics discussed today: We discussed that you currently do not have any children enrolled on the 2nd shift. Your most recent fire inspection completed 1/16/24 is approved for day time care only. I reminded you that if you wanted 2nd shift to remain on the license, then an updated fire inspection would need to be completed to show approval for both day and night time care. You reported that the facility would like to remove 2nd shift from the license. I requested that you send me an email requesting that 2nd shift be removed from the license. As a reminder, you must submit the original of the approved annual fire inspection report to the Division within one week of the inspection visit on the form provided by the Division. 10A NCAC 09 .0304(a) Qualifying letters are now valid for five (5) years from the date of issue. Please begin the criminal background re-check at least two (2) months prior to the expiration of the current qualifying letter. Resuming Star Rated License Reassessment Information: As a reminder your facility is in cohort 2 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2024, through June 30, 2025. Your child care program’s reassessment year will begin on July 1, 2025, through June 30, 2026. For more information, please visit the DCDEE website under the providers tab. The link is https://ncchildcare.ncdhhs.gov/Provider/Licensing/Star-Rated-License/Resuming-StarRated-License We discussed information pertaining to COVID-19. Here is the link for the current resources and information regarding COVID-19. https://covid19.ncdhhs.gov/materials-and-resources/materials-about-covid-19-symptoms-and-treatment Moodle Support: The Division offers early childhood professionals a wide range of professional development opportunities through our online learning platform Moodle. As we continue expanding our training offerings, DCDEE has established a new email address and phone number for Moodle support. To get help with Moodle, email at DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. The Healthy Social Behavior Project is offering technical assistance with challenging behaviors to programs. Please see the link below for more information. Website Link: https://www.childcareresourcesinc.org/challenging-behaviors-helpline To speak to a Healthy Social Behavior Specialist, please contact the helpline at 1-888-600-1685 Option 1. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Due to time constraints, at the completion of the visit a handwritten visit summary was prepared, reviewed and a copy given to you. The computer generated visit summary was emailed to you for your records on February 9, 2024. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 (828)748-7893 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 8/9/2023 Number Present: 40 Completed Date: 8/9/2023 Age: From 0 To 6 Total Minutes: 167 Time In: 08:53 AM Time Out: 11:40 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced routine unannounced visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival, the purpose of today’s visit was reviewed with you, Lori Delfosse, Administrator. Dinah Brown, Child Care Consultant accompanied on the visit. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in group time, free play in activity areas and outdoor play time. Infants were engaged in tummy time and free play. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history prior to today’s visit was reviewed with the operator. The program’s compliance history was 87 percent as of August 1, 2023. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. One new staff member has been hired since the annual compliance visit on February 24, 2023. New staff file was reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. The most recent sanitation inspection for your facility was conducted on June 13, 2023. A supervisor sanitation classification was issued with six demerits. The most recent fire inspection for your facility was conducted on February 24, 2023. The following violation(s) were observed today: Violation Number Comment Rule 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, employed 6/7/23, had a TB test completed 7/27/23. .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. One staff member, employed 2/24/11, had a First Aid Certification that expired 4/2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member, employed 2/24/11, had a CPR Certification that expired 4/2023. .1102(d) The violation(s) documented must be corrected immediately. On or before August 22, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: TB Testing: Before the first day of work, all staff must provide results indicating they are free of active TB and/or provide a TB screening that is not older than 12 months. 10A NCAC 09 .0701(a). The employee hired 6/7/23 had a TB screening completed 7/27/23. This violation has been corrected. CPR/First Aid Training: All staff must complete a certification in CPR training appropriate to the age of the children in care. Verification of training from an approved training organization must be in the staff file. 10A NCAC 09 .1102(d). You reported that the employee whose certifications expired 4/2023 has completed the online portion of the trainings but is awaiting an in person class to complete the courses. We discussed that the certifications will need to be completed within the next 2 weeks. Consultation or other topics discussed today (the following items reviewed were in compliance today): We reviewed screen time rules including that screen time is prohibited for children less than 3 year of age. We reviewed the requirements for annual review of the Emergency Medical Care Plan and the Emergency Preparedness Response plan. Consider having staff to sign the updated plan to verify completion of this requirement. We discussed that facilities may begin to prepare for future rated license assessments by making sure that all staff have updated WORKS education evaluations and begin to monitor classrooms for appropriate materials. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was emailed to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
10A NCAC 09 .1102 · Violation
Name of Operation: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 8/9/2023 Number Present: 40 Completed Date: 8/9/2023 Age: From 0 To 6 Total Minutes: 167 Time In: 08:53 AM Time Out: 11:40 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced routine unannounced visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival, the purpose of today’s visit was reviewed with you, Lori Delfosse, Administrator. Dinah Brown, Child Care Consultant accompanied on the visit. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in group time, free play in activity areas and outdoor play time. Infants were engaged in tummy time and free play. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history prior to today’s visit was reviewed with the operator. The program’s compliance history was 87 percent as of August 1, 2023. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. One new staff member has been hired since the annual compliance visit on February 24, 2023. New staff file was reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. The most recent sanitation inspection for your facility was conducted on June 13, 2023. A supervisor sanitation classification was issued with six demerits. The most recent fire inspection for your facility was conducted on February 24, 2023. The following violation(s) were observed today: Violation Number Comment Rule 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, employed 6/7/23, had a TB test completed 7/27/23. .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. One staff member, employed 2/24/11, had a First Aid Certification that expired 4/2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member, employed 2/24/11, had a CPR Certification that expired 4/2023. .1102(d) The violation(s) documented must be corrected immediately. On or before August 22, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: TB Testing: Before the first day of work, all staff must provide results indicating they are free of active TB and/or provide a TB screening that is not older than 12 months. 10A NCAC 09 .0701(a). The employee hired 6/7/23 had a TB screening completed 7/27/23. This violation has been corrected. CPR/First Aid Training: All staff must complete a certification in CPR training appropriate to the age of the children in care. Verification of training from an approved training organization must be in the staff file. 10A NCAC 09 .1102(d). You reported that the employee whose certifications expired 4/2023 has completed the online portion of the trainings but is awaiting an in person class to complete the courses. We discussed that the certifications will need to be completed within the next 2 weeks. Consultation or other topics discussed today (the following items reviewed were in compliance today): We reviewed screen time rules including that screen time is prohibited for children less than 3 year of age. We reviewed the requirements for annual review of the Emergency Medical Care Plan and the Emergency Preparedness Response plan. Consider having staff to sign the updated plan to verify completion of this requirement. We discussed that facilities may begin to prepare for future rated license assessments by making sure that all staff have updated WORKS education evaluations and begin to monitor classrooms for appropriate materials. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was emailed to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@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: LITTLE RED SCHOOL Facility ID: 8155056 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 8/9/2023 Number Present: 40 Completed Date: 8/9/2023 Age: From 0 To 6 Total Minutes: 167 Time In: 08:53 AM Time Out: 11:40 AM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced routine unannounced visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival, the purpose of today’s visit was reviewed with you, Lori Delfosse, Administrator. Dinah Brown, Child Care Consultant accompanied on the visit. Your program currently operates with a five star license effective July 19, 2019. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space and children under 2 ½ in rooms with direct exits. Your program was also monitored for compliance with implementing an approved curriculum as required for all four- and five-star licensed facilities where four-year-old children are enrolled. A walk-through of the facility was completed today, all indoor and outdoor areas were monitored. You conducted the walkthrough of the facility with me. I observed children in both the indoor and outdoor learning environments and found supervision and staff/child ratios to be in compliance. Children throughout the facility were participating in group time, free play in activity areas and outdoor play time. Infants were engaged in tummy time and free play. Sleep checks were completed, recorded, and maintained as required. The caregivers were interacting and meeting the developmental needs for each of the children. The center's compliance history prior to today’s visit was reviewed with the operator. The program’s compliance history was 87 percent as of August 1, 2023. Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. One new staff member has been hired since the annual compliance visit on February 24, 2023. New staff file was reviewed. Limited monitoring of staff files was conducted for the purpose of reviewing training regarding CPR/First Aid, ITS-SIDS, Special Training including Health and Safety Training and Criminal Background Checks. The most recent sanitation inspection for your facility was conducted on June 13, 2023. A supervisor sanitation classification was issued with six demerits. The most recent fire inspection for your facility was conducted on February 24, 2023. The following violation(s) were observed today: Violation Number Comment Rule 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, employed 6/7/23, had a TB test completed 7/27/23. .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. One staff member, employed 2/24/11, had a First Aid Certification that expired 4/2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. One staff member, employed 2/24/11, had a CPR Certification that expired 4/2023. .1102(d) The violation(s) documented must be corrected immediately. On or before August 22, 2023, I must receive a written, dated, and signed compliance letter that describes accurately and in detail, how and when the violations were corrected. Please be aware any information submitted by you is considered legal documentation. If it is determined the information provided in the letter is not true, this may be considered falsification of information. If sufficient information is not received by the due date, a follow-up visit may be completed. Mail or email the information to: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If you email the compliance letter, it must be sent from the email address on file with DCDEE (this serves as your signature) and the following information must be included: name, position, facility name, and facility ID number. An example is: Jane Doe, Administrator AAA Child Care ID # 12345678 Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical assistance on violations was reviewed with you. Areas discussed included: TB Testing: Before the first day of work, all staff must provide results indicating they are free of active TB and/or provide a TB screening that is not older than 12 months. 10A NCAC 09 .0701(a). The employee hired 6/7/23 had a TB screening completed 7/27/23. This violation has been corrected. CPR/First Aid Training: All staff must complete a certification in CPR training appropriate to the age of the children in care. Verification of training from an approved training organization must be in the staff file. 10A NCAC 09 .1102(d). You reported that the employee whose certifications expired 4/2023 has completed the online portion of the trainings but is awaiting an in person class to complete the courses. We discussed that the certifications will need to be completed within the next 2 weeks. Consultation or other topics discussed today (the following items reviewed were in compliance today): We reviewed screen time rules including that screen time is prohibited for children less than 3 year of age. We reviewed the requirements for annual review of the Emergency Medical Care Plan and the Emergency Preparedness Response plan. Consider having staff to sign the updated plan to verify completion of this requirement. We discussed that facilities may begin to prepare for future rated license assessments by making sure that all staff have updated WORKS education evaluations and begin to monitor classrooms for appropriate materials. For the latest information on child care rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ . This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. At the completion of the visit, this visit summary was reviewed and a copy was emailed to you for your records. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, Tammy.McGalliard@dhhs.nc.gov . If I can be of further assistance, you may contact me at: Beth Archer Child Care Consultant P.O. Box 64 Rutherfordton, NC 28139 beth.archer@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times
Open Not marked corrected in the state record
Category: supervision. Open / not marked corrected.
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