Precious Moments Childcare Center

GS110-91 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: FARRAN RHYNE Operation Type: Center Case Number: Visit Date: 12/17/2025 Number Present: 16 Completed Date: 12/17/2025 Age: From 1 To 4 Total Minutes: 224 Time In: 09:30 AM Time Out: 10:34 AM Time In: 10:55 AM Time Out: 01:35 PM 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 program for compliance with all applicable child care requirements, including health and safety. The visit was conducted with you, Traci Ward, Administrator. This program currently operates with a five-star rated license issued on July 15, 2024. The permit restrictions include daytime care, second shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one per age group, and children under two and a half years old in rooms with direct exits only. You stated no children are currently enrolled on second shift. The last annual compliance visit was conducted on January 7, 2025. The program’s compliance history was reviewed with the administrator. The program’s compliance history was ninety-nine percent as of December 15, 2025. The North Carolina Secretary of State website was reviewed on December 15, 2025, and Precious Moments Childcare Center Inc. was listed as active/current. A checklist was used to note the requirements I monitored today. A walkthrough of the facility was completed. All indoor and outdoor spaces and transportation requirements 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, group-led activities, gross motor play outdoors, handwashing routines, lunch, and nap. The caregivers were interacting and meeting the developmental needs for each of the children. Inspections/Drills: The most recent approved fire inspection for your facility was conducted on August 6, 2025. The most recent sanitation inspection for your facility was conducted on August 4, 2025. A “superior” classification was issued with eight demerits noted on the grade card. The most recent monthly fire drill was conducted on November 12, 2025, at 9:50am. The most recent quarterly lockdown/shelter-in-place drill was a lockdown conducted on October 15, 2025, at 4:00pm. The most recent monthly playground inspection was completed on November 24, 2025, by Traci Ward. The facility’s EPR Plan was reviewed on February 27, 2025. Lead and Asbestos Testing: The analysis date for the most recent lead water test was March 15, 2024. Lead testing must be completed every three years. You may review your facilities results and enroll in the asbestos and lead-based paint testing by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated enrollment, and the risk assessment report was completed for required asbestos and lead-based paint testing. Files Reviewed: You provided me with applicable program, staff, and children’s records for review. The file for one existing staff, and applicable records for all staff were reviewed. No new staff have been hired since the last visit. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of four children’s records were reviewed. Violations observed today were discussed with you and documented in the Visit Summary left with you at the conclusion of this visit. The following violation was observed: Violation Number Comment Rule 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled on October 20, 2025, had a medical exam on file dated December 5, 2025. The medical exam was due by November 19, 2025. GS110-91(1) Technical Assistance was provided on the following: Children’s Records – Medical Exam: 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. I provided you with a copy of the children’s file checklist during the visit. This was corrected during the visit by a medical exam being on file and available for review. Reminders & Resources: Fire Inspections You must schedule and obtain a fire inspection within 12 months of your center's previous fire inspection and notify the local fire inspector when it is time for your center's annual fire inspection. You must submit the original of the approved annual fire inspection report to your Child Care Consultant within one week of the inspection visit on the form provided by the Division. Health & Safety Trainings All staff must complete on-going health and safety trainings every five years. Lead Water Testing Under rule 15A NCAC 18A .2816, child care centers are required to complete lead water testing every three (3) years. Automated Background Check Management System (ABCMS) 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. DCDEE Website 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. Compliance: 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. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-594-0003. Farran M. Rhyne, Child Care Consultant PO Box 92 Maiden, NC 28650 farran.m.rhyne@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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: FARRAN RHYNE Operation Type: Center Case Number: Visit Date: 12/17/2025 Number Present: 16 Completed Date: 12/17/2025 Age: From 1 To 4 Total Minutes: 224 Time In: 09:30 AM Time Out: 10:34 AM Time In: 10:55 AM Time Out: 01:35 PM 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 program for compliance with all applicable child care requirements, including health and safety. The visit was conducted with you, Traci Ward, Administrator. This program currently operates with a five-star rated license issued on July 15, 2024. The permit restrictions include daytime care, second shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one per age group, and children under two and a half years old in rooms with direct exits only. You stated no children are currently enrolled on second shift. The last annual compliance visit was conducted on January 7, 2025. The program’s compliance history was reviewed with the administrator. The program’s compliance history was ninety-nine percent as of December 15, 2025. The North Carolina Secretary of State website was reviewed on December 15, 2025, and Precious Moments Childcare Center Inc. was listed as active/current. A checklist was used to note the requirements I monitored today. A walkthrough of the facility was completed. All indoor and outdoor spaces and transportation requirements 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, group-led activities, gross motor play outdoors, handwashing routines, lunch, and nap. The caregivers were interacting and meeting the developmental needs for each of the children. Inspections/Drills: The most recent approved fire inspection for your facility was conducted on August 6, 2025. The most recent sanitation inspection for your facility was conducted on August 4, 2025. A “superior” classification was issued with eight demerits noted on the grade card. The most recent monthly fire drill was conducted on November 12, 2025, at 9:50am. The most recent quarterly lockdown/shelter-in-place drill was a lockdown conducted on October 15, 2025, at 4:00pm. The most recent monthly playground inspection was completed on November 24, 2025, by Traci Ward. The facility’s EPR Plan was reviewed on February 27, 2025. Lead and Asbestos Testing: The analysis date for the most recent lead water test was March 15, 2024. Lead testing must be completed every three years. You may review your facilities results and enroll in the asbestos and lead-based paint testing by visiting https://www.cleanwaterforuskids.org/en/carolina/. This website also indicated enrollment, and the risk assessment report was completed for required asbestos and lead-based paint testing. Files Reviewed: You provided me with applicable program, staff, and children’s records for review. The file for one existing staff, and applicable records for all staff were reviewed. No new staff have been hired since the last visit. All staff were listed on the ABCMS Provider Portal roster for this facility. A sample of four children’s records were reviewed. Violations observed today were discussed with you and documented in the Visit Summary left with you at the conclusion of this visit. The following violation was observed: Violation Number Comment Rule 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child enrolled on October 20, 2025, had a medical exam on file dated December 5, 2025. The medical exam was due by November 19, 2025. GS110-91(1) Technical Assistance was provided on the following: Children’s Records – Medical Exam: 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. I provided you with a copy of the children’s file checklist during the visit. This was corrected during the visit by a medical exam being on file and available for review. Reminders & Resources: Fire Inspections You must schedule and obtain a fire inspection within 12 months of your center's previous fire inspection and notify the local fire inspector when it is time for your center's annual fire inspection. You must submit the original of the approved annual fire inspection report to your Child Care Consultant within one week of the inspection visit on the form provided by the Division. Health & Safety Trainings All staff must complete on-going health and safety trainings every five years. Lead Water Testing Under rule 15A NCAC 18A .2816, child care centers are required to complete lead water testing every three (3) years. Automated Background Check Management System (ABCMS) 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. DCDEE Website 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. Compliance: 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. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-594-0003. Farran M. Rhyne, Child Care Consultant PO Box 92 Maiden, NC 28650 farran.m.rhyne@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .1102 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: FARRAN RHYNE Operation Type: Center Case Number: Visit Date: 1/7/2025 Number Present: 19 Completed Date: 1/7/2025 Age: From 1 To 5 Total Minutes: 435 Time In: 09:15 AM Time Out: 04:30 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 program for compliance with all applicable child care requirements, including health and safety requirements. Your last annual compliance visit was conducted on January 31, 2024. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. The North Carolina Secretary of State website was viewed on January 6, 2025, and Precious Moments Childcare Center Inc was listed as active and in good standing. If you decide to sell your business, then you must notify me, Farran Rhyne, at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Your program operates with a five (5) star rated license issued on July 15, 2024, earning six (6) points in staff education and seven (7) points in program standards. The license was posted, and the permit restrictions were in compliance including: 1st shift (daytime care), 2nd shift, meets enhanced ratios minus one per age group, meets enhanced space, meets enhanced space, and children under two and a half (2 ½) years old in rooms with direct exits only. You stated there are no children enrolled on 2nd shift. A walk-through was completed. All licensed indoor and outdoor spaces were monitored. The transportation vehicle was monitored. A checklist was used to note the requirements I monitored. Staff and children were observed during indoor free play, outdoor gross motor play, handwashing, lunch and naptime. Inspections/Drills: The last fire inspection was completed on July 18, 2024. The facility was approved for daytime and night time care. The last sanitation inspection was completed on July 30, 2024. A “superior” classification was issued with six (6) demerits noted on the grade card. The last monthly fire drill was completed on December 20, 2024, at 1:55pm. The last emergency drill was a shelter-in-place completed on October 30, 2024, at 3:55pm. The last playground inspection was completed on December 10, 2024. The Emergency Preparedness Plan on file was completed on February 28, 2024. Lead Testing: The last lead water test was completed on March 14, 2024. The lead-based paint test was completed on November 27, 2024. The asbestos test was completed on November 27, 2024. Files Reviewed: Children’s files, staff files, and program files were monitored. Four (4) children’s files were reviewed. One (1) new staff file was reviewed. One (1) existing staff file was reviewed. I discussed the Staff and Training Worksheet and the Children’s Record form with you. Both forms were completed and verified during the visit. The following violations were observed: Violation Number Comment Rule 1757 A valid qualification letter was not on file and available to review at the facility. One (1) staff member, C. Hall, employed on June 3, 2024, and one (1) staff member, C. Harris, employed on April 4, 2014, did not have a current criminal background check on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance: As a result of tropical storm Helene and a declared natural disaster in Western North Carolina, technical assistance was provided to assist the child care provider in achieving compliance. Criminal Background Checks: I discussed with you that child care providers must have a valid and current qualification letter on file and available for review. I checked the Criminal Background Unit Portal during today’s visit. The five (5) year Criminal Background re-check for staff member C. Hall, employed on June 3, 2024, shows the qualification expired October 9, 2024, and the re-check application has not been submitted. The five (5) year Criminal Background re-check shows in process for staff member, C. Harris, employed on April 14, 2014. Program Records: We discussed the barriers to maintaining staff records which include a current CPR/First Aid Certification. I discussed with you creating a plan for coming into compliance and maintaining program records. You stated you have registered one (1) staff member, employed on June 3, 2024, with an expired CPR/First Aid Certification to attend CPR/First Aid Training on January 18, 2025. Consultation: Lead Testing: I reviewed with you the child care rule for lead testing that went into effect on January 1, 2024. I also discussed with you that I had checked the Clean Water for Kids website and that your program is no longer listed. I suggested you contact Clean Water for Kids. You provided me with documentation to verify your lead water, lead-based paint, and asbestos tests have been completed. As a reminder, your next lead water test is due by March 14, 2027. Reminders & Resources: You must complete on-going health and safety trainings every five years. 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. For natural learning environment resources, consider using The Green Desk that is provided by the Natural Learning Initiative. The Green Desk contains numerous resources meant to improve outdoor learning environments and promote health, natural child development, physical activity, and nature-based learning. To access this page, go to www.naturalearning.org, hover on the link for ‘resources’, click on the link for ‘The Green Desk’. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Under rule 10A NCAC 09 .1102 (g), child care administrators and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. If you are having issues accessing Recognizing and Responding to Suspicions of Child Maltreatment Training, please utilize the below information: • This training does not use your NCID username and password • For this training providers must create a separate username and password for this course. • If you need further assistance, contact info@preventchildabusenc.org or call 919-829-8009. The link to access Recognizing and Responding to Suspicions of Child Maltreatment Training, is the following https://preventchildabusenc-lms.org/ Compliance History: The program’s compliance history was eighty-seven percent (87%) prior to today's visit. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4)(c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Compliance Letter: You must correct the violations found during today's visit immediately. Please send me a letter verifying compliance by January 21, 2025. Please include in that letter each item number and explain in detail how you corrected each violation and what plan will be implemented to prevent these violations from occurring again. Please sign the letter, include your facility name, ID number, visit date and mail the letter to my mailing address below or email the letter to me at farran.m.rhyne@dhhs.nc.gov Farran M. Rhyne PO Box 92 Maiden, NC 28650 Failure to correct the violations and send the written statement by the due date listed above will result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, 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. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-594-0300. Farran M. Rhyne, Child Care Consultant PO Box 92 Maiden, NC 28650 farran.m.rhyne@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. 110-90 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: FARRAN RHYNE Operation Type: Center Case Number: Visit Date: 1/7/2025 Number Present: 19 Completed Date: 1/7/2025 Age: From 1 To 5 Total Minutes: 435 Time In: 09:15 AM Time Out: 04:30 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 program for compliance with all applicable child care requirements, including health and safety requirements. Your last annual compliance visit was conducted on January 31, 2024. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. The North Carolina Secretary of State website was viewed on January 6, 2025, and Precious Moments Childcare Center Inc was listed as active and in good standing. If you decide to sell your business, then you must notify me, Farran Rhyne, at least thirty (30) days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. Your program operates with a five (5) star rated license issued on July 15, 2024, earning six (6) points in staff education and seven (7) points in program standards. The license was posted, and the permit restrictions were in compliance including: 1st shift (daytime care), 2nd shift, meets enhanced ratios minus one per age group, meets enhanced space, meets enhanced space, and children under two and a half (2 ½) years old in rooms with direct exits only. You stated there are no children enrolled on 2nd shift. A walk-through was completed. All licensed indoor and outdoor spaces were monitored. The transportation vehicle was monitored. A checklist was used to note the requirements I monitored. Staff and children were observed during indoor free play, outdoor gross motor play, handwashing, lunch and naptime. Inspections/Drills: The last fire inspection was completed on July 18, 2024. The facility was approved for daytime and night time care. The last sanitation inspection was completed on July 30, 2024. A “superior” classification was issued with six (6) demerits noted on the grade card. The last monthly fire drill was completed on December 20, 2024, at 1:55pm. The last emergency drill was a shelter-in-place completed on October 30, 2024, at 3:55pm. The last playground inspection was completed on December 10, 2024. The Emergency Preparedness Plan on file was completed on February 28, 2024. Lead Testing: The last lead water test was completed on March 14, 2024. The lead-based paint test was completed on November 27, 2024. The asbestos test was completed on November 27, 2024. Files Reviewed: Children’s files, staff files, and program files were monitored. Four (4) children’s files were reviewed. One (1) new staff file was reviewed. One (1) existing staff file was reviewed. I discussed the Staff and Training Worksheet and the Children’s Record form with you. Both forms were completed and verified during the visit. The following violations were observed: Violation Number Comment Rule 1757 A valid qualification letter was not on file and available to review at the facility. One (1) staff member, C. Hall, employed on June 3, 2024, and one (1) staff member, C. Harris, employed on April 4, 2014, did not have a current criminal background check on file. G.S. 110-90.2(b) & (d) & .2703(e) Technical Assistance: As a result of tropical storm Helene and a declared natural disaster in Western North Carolina, technical assistance was provided to assist the child care provider in achieving compliance. Criminal Background Checks: I discussed with you that child care providers must have a valid and current qualification letter on file and available for review. I checked the Criminal Background Unit Portal during today’s visit. The five (5) year Criminal Background re-check for staff member C. Hall, employed on June 3, 2024, shows the qualification expired October 9, 2024, and the re-check application has not been submitted. The five (5) year Criminal Background re-check shows in process for staff member, C. Harris, employed on April 14, 2014. Program Records: We discussed the barriers to maintaining staff records which include a current CPR/First Aid Certification. I discussed with you creating a plan for coming into compliance and maintaining program records. You stated you have registered one (1) staff member, employed on June 3, 2024, with an expired CPR/First Aid Certification to attend CPR/First Aid Training on January 18, 2025. Consultation: Lead Testing: I reviewed with you the child care rule for lead testing that went into effect on January 1, 2024. I also discussed with you that I had checked the Clean Water for Kids website and that your program is no longer listed. I suggested you contact Clean Water for Kids. You provided me with documentation to verify your lead water, lead-based paint, and asbestos tests have been completed. As a reminder, your next lead water test is due by March 14, 2027. Reminders & Resources: You must complete on-going health and safety trainings every five years. 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. For natural learning environment resources, consider using The Green Desk that is provided by the Natural Learning Initiative. The Green Desk contains numerous resources meant to improve outdoor learning environments and promote health, natural child development, physical activity, and nature-based learning. To access this page, go to www.naturalearning.org, hover on the link for ‘resources’, click on the link for ‘The Green Desk’. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. This information should be updated in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Under rule 10A NCAC 09 .1102 (g), child care administrators and all staff members shall complete Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. If you are having issues accessing Recognizing and Responding to Suspicions of Child Maltreatment Training, please utilize the below information: • This training does not use your NCID username and password • For this training providers must create a separate username and password for this course. • If you need further assistance, contact info@preventchildabusenc.org or call 919-829-8009. The link to access Recognizing and Responding to Suspicions of Child Maltreatment Training, is the following https://preventchildabusenc-lms.org/ Compliance History: The program’s compliance history was eighty-seven percent (87%) prior to today's visit. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4)(c). Please note any violations cited today and during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Compliance Letter: You must correct the violations found during today's visit immediately. Please send me a letter verifying compliance by January 21, 2025. Please include in that letter each item number and explain in detail how you corrected each violation and what plan will be implemented to prevent these violations from occurring again. Please sign the letter, include your facility name, ID number, visit date and mail the letter to my mailing address below or email the letter to me at farran.m.rhyne@dhhs.nc.gov Farran M. Rhyne PO Box 92 Maiden, NC 28650 Failure to correct the violations and send the written statement by the due date listed above will result in an unannounced follow-up visit being conducted or an administrative action may be recommended. Based on Child Care Rule 10A NCAC 09 Section .2200, 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. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-594-0300. Farran M. Rhyne, Child Care Consultant PO Box 92 Maiden, NC 28650 farran.m.rhyne@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0601 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 .0601 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 .0902 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 .1003 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 09.0508 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 09.1001 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 09.1003 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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. 110-91 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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 110-91 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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

GS110-91 · Violation

Name of Operation: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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: PRECIOUS MOMENTS CHILDCARE CENTER Facility ID: 36000435 Consultant: BETH ARCHER Operation Type: Center Case Number: Visit Date: 1/31/2024 Number Present: 26 Completed Date: 1/31/2024 Age: From 1 To 4 Total Minutes: 280 Time In: 09:30 AM Time Out: 02:10 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 annual compliance and rated license visit was to monitor your compliance with all applicable child care requirements, including health and safety. Upon arrival you, Traci Ward, Administrator, assisted me with the visit. Farran Rhyne, Child Care Consultant accompanied on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a five star license effective April 25, 2023. The permit restrictions were in compliance including 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, meets enhanced ratios minus one and children under 2 ½ years of age in rooms with direct exits only. The Secretary of State website was checked on January 30, 2024, and your business Precious Moments ChildCare Center, 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 found supervision and staff/child ratios in compliance. Children throughout the facility were participating in group art time, transitions, lunch time, rest time and outdoor gross motor time. The program currently does not have any 2nd shift children currently enrolled. The facility has an approved fire inspection for both day and night time care and would like to continue to have 2nd shift on the license for future use. The center's compliance history was at 93% 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 five children’s files were reviewed. One new staff file was reviewed. A sample of two existing staff files were reviewed. The last monthly fire drill was practiced on 1/30/24. The last shelter in place drill was practiced on 10/12/23. The last monthly playground inspection was completed on 1/4/24. The most recent sanitation inspection for your facility was conducted on January 31, 2024. A superior sanitation classification was issued with four demerits. The most recent fire inspection for your facility was conducted on July 21, 2023. The facility was approved for day time and night time care. Rated License Information: We discussed that you are interested in moving forward with a rated license reassessment. If you are ready to proceed with a preparatory year environment rating scale, please notify me to complete a rated license assessment request. Your current 5 Star license: Staff Education: 5 points, Program Standards: 7 points, Quality Point: 1 for a Total: 13 points Make sure that staff have WORKS accounts through Workforce Development that are updated. Education Points and Program Standards will be assessed once the Environment Rating Scale has been completed. We discussed the Rated License Assessment Request Review Form and the scheduling process for your Rating Scale Assessment. I observed, that you have four (4) classrooms: one (1) classroom for infants, one (1) classroom for toddlers, one (1) classroom for preschool age children and one (1) classroom for school age children. I recommended that you visit www.ncrlap.org for supplemental materials for preparing for the Environment Rating Scale Assessment. The following violation(s) were observed and discussed with you today: Violation Number Comment Rule 125 Daily records of arrival and departure times for children enrolled at the center were not maintained as children arrive and depart and/or were not made available for review. On 1/2/24, three children were not signed out of care. On 1/8/24, one child was not signed out of are. On 1/11/24, 2 children were not signed out of care. On 1/12/24, two children were not signed out of care. On 1/24/24, two children were not signed out of care. On 1/25/24, three children were not signed out of care. On 1/27/24, one child was not signed out of care. 10A NCAC 09 .0302(d)(4) 431 The activity plan did not provide at least 4 different activities daily listed in GS 110-91(12): art/creative play; books; blocks; manipulatives; and family living and dramatic play, including one of which is outdoors if weather conditions permit. In space #1 the activity plan listed free build for block activity. In space #2 the activity plan listed free choice for art, manipulatives, dramatic play and book activities. .0508(g)(2) 542 The written feeding plan was not modified as the child's needs changed. In space #3, there were three feeding plans that were not updated to reflect changes in the child's needs. 10 NCAC 09 .0902(a) 721 All equipment and furnishings were not in good repair. On the playground for preschool age children, there was a ride on toy with only 3 wheels and a cracked picnic table. On the playground for infants and toddlers, there was a cracked water table with sharp edges. G.S. 110-91(6); .0601(b) 807 A safe indoor and outdoor environment was not provided for the children. On the playground for preschool age children, there was a large hole in the ground next to the fence. 10A NCAC 09 .0601(a) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In space #1,one syringe of Diazepam rectal gel was not in the original container with the pharmacy label. .0803(2)(a) 847 Parent's medication authorization did not include required information. In space #1, there was one prescription Albuterol that the authorization expired 1/20/24. There were two prescription Ventalin inhalers that the authorization expired 12/19/23. 10A NCAC 09 .0803(4)(6-9) 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 #2, there were plastic bags in the cabinet under the changing table. In space #3, there were plastic bags in a drawer of the wooden cabinet, accessible to children under 3 years of age. .0604(q) 1106 Each adult and child was not restrained by appropriate individual belt/device. There were two expired booster seats used to transport children on the facility van. GS 110-91(13) 1124 Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form was not in the vehicle for each child being transported. There were no photographs for eighteen children that the facility provides transportation. 10A NCAC 09 .1003(d) 1125 Before children were transported, written permission from a parent was not obtained that included when and where the child was to be transported, expected time of departure and arrival, and the transportation provider. Five children had a written permission to transport form that did not include when and where the child was to be transported and the expected time of departure and arrival. .1003(i)(j) 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. Five children did not have verification that operational policies were discussed with parents on or before the child’s first day. 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. A parent participation plan was not posted in the center and there were five children without verification that the plan was discussed with parents on or before the first day of attendance. 10A NCAC 09 .0515(a) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. Two children: one enrolled 10/1/23 and one enrolled 12/13/23 did not have verification of a medical exam on file within 30 days of admission. GS110-91(1) 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 employed 12/19/23, had verification of the review of the Shaken Baby Abusive Head Trauma policy on 1/3/24. .0608(d)(1-4) The violation(s) documented must be corrected immediately. On or before February 14, 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: Activity Plan Components: I reviewed the activity plan with you and pointed out the issues of non-compliance. Free play is not a planned activity. Have staff submit their activity plans to you for review prior to the start date listed on the activity plan. 10A NCAC 09.0508(g)(2) Plastic Packaging: Plastic grocery bags may not be accessible to children under 3 years of age. Have staff complete daily safety checks before children arrive and remove any safety hazards such as plastic bags, plastic packaging, sponges, foam rubber, small toy parts and other possible choking hazards. 10A NCAC 09 .0604(q) Feeding Plans: Each infant's feeding plan must 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. 10A NCAC 09 .0902 Equipment in good repair: All equipment and furnishings shall be in good repair. We discussed that staff should view the playground area before the children go outside to ensure that any broken equipment or toys are removed from the play area. 10A NCAC 09 .0601(b) Outdoor Hazards: A safe outdoor area must be provided for children in care. Staff should complete a daily check for any hazards in the outdoor space. We discussed that the ground hole needs to be filled in order to prevent children from falling or being injured while playing. 10A NCAC 09 .0601(a) Safety Booster Seats: When children are transported, each child must be restrained in a child safety seat appropriate for the child’s age and weight according with the seat belt law. 10A NCAC 09.1001(a). We reviewed how to determine if a booster or car seat has expired. You reported that new booster seats will be purchased to replace the expired ones. Emergency Information Photos: Emergency and identifying information, including the child's name, photograph, emergency contact information and/or a copy of the emergency medical care information form must be in the vehicle for each child being transported. We discussed that a photograph is needed to complete emergency and identifying information requirement. 10A NCAC 09.1003(d) Shaken Baby and Abusive Head Trauma Policy: 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 required information must be maintained in the staff person’s file. 10A NCAC 09 .0609(d)(1-4) The verification of the policy review for the staff member, employed 12/19/23, is now on file. This violation was corrected at visit. Expired Medication Permission: 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, such as asthma, and for allergic reactions. The authorization must include the length of time the authorization is valid. We discussed that when the authorized time expires, a new form will need to be signed if the medication continues to be needed. 10A NCAC 09 .0803(6)(i) Prescribed medications: Prescriptions medications (a) shall be stored in the original containers in which they were dispensed with the pharmacy labels 10A NCAC 09 .0803(2)(a). We discussed that the parents will need to provide the original container with the pharmacy labels for the medication if the medication continues to be needed at the facility. Transportation Permission: Before children are transported, there must be written permission from a parent that includes when and where the child is to be transported, expected time of departure and arrival, and the transportation provider. 10A NCAC 09.1003(i)(j). We discussed that permission is needed for children that transportation is being provided with the specific place where the child is be transported to and from. Operational Policies: Operational policies must be discussed with parents on or before the child’s first day. 10A NCAC 09.0514(b). This information may be provided in a childcare handbook. We recommended that you keep a signed form that the policies were discussed as verification of this requirement. Parent Participation Plan: The Parent participation plan must be posted in the center or discussed or given to parents on or before the child's first day of attendance. This information may be provided in a childcare handbook. We recommended that you keep a signed form that the participation plan was discussed or given in the parent handbook as verification of this requirement. 10A NCAC 09.0515(a) Child Medical Exam: Each child must have a completed medical exam on file for review within thirty (30) days of enrollment. I recommended requiring medical exam records for children to be completed and turned in to you prior to enrollment when possible. GS 110-91(1). Arrival/Departure Records: Specific arrival and departure times are needed to ensure safe tracking of the children. I suggested that a designated staff person check sign in and out records at least twice daily for accuracy. 10A NCAC 09 .0302(d)(4) Consultation or other topics discussed today: 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 1 for resuming the star rated license reassessment. Your child care program’s prep year will begin on July 1, 2023, through June 30, 2024. Your child care program’s reassessment year will begin on July 1, 2024, through June 30, 2025. 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. At the completion of the visit, a handwritten visit summary was reviewed and a copy given to you. There was no one present that is a legal designee for the facility, so the visit summary was not signed. I emailed the handwritten summary, as well as the computer-generated visit summary for the owner’s signature on February 1, 2024. The visit summaries, both handwritten and computer generated, should be signed and returned to me as soon as possible. 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