Toddler Time Child Care Inc.

10A NCAC 09 .1102 · Violation

Name of Operation: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: FARRAN RHYNE Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 32 Completed Date: 12/17/2024 Age: From 1 To 5 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 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 16, 2024. Upon arrival you, Tammy Parker, owner, assisted me with the visit. Taylor Parker, Administrator also assisted with the visit. The North Carolina Secretary of State website was viewed on December 17, 2024, and Toddler Time Inc. was not listed. 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 four (4) star rated license issued on June 25, 2018, earning five (5) points in staff education and six (6) points in program standards. The permit restrictions were in compliance including: 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, Cap Bldg #1 – 39 and Cap Bldg #2 – 45. Staff and children were observed during teacher directed activities, outdoor gross motor play, toileting/diapering routine, handwashing routine, lunch, and naptime. A walk-through was completed, and all licensed indoor and outdoor spaces were monitored. A checklist was used to note the requirements I monitored. Inspections/Drills: The last fire inspection was completed on October 15, 2024. The last sanitation inspection was completed on May 1, 2024. A “superior” classification was issued with four (4) demerits noted on the grade card. The last monthly fire drill was completed on November 26, 2024, at 11:00am. The last emergency drill was a lockdown drill completed on November 26, 2024, at 11:30am. The last playground inspection was completed on November 26, 2024. Lead Testing: The last lead water test was completed on April 9, 2024. Your next lead water test is due by April 9, 2027. Files Reviewed: Children’s files, staff files, and program files were monitored. Ten (10) children’s files were reviewed. One (1) existing staff file and one (1) new staff file were 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 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) spray bottle of Black Ice Little Trees spray with the warning label “keep away from children” was observed in the transportation vehicle cupholder and accessible to children. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3a/b, one (1) prescription medication, EpiPenJr. (2pk), had an expiration date of August 2024. In space #4, one (1) prescription inhaler, Ventolin, had an expiration date of November 2024. .0803(12) 1757 A valid qualification letter was not on file and available to review at the facility. One (1) staff member, Ruby Davis, employed on February 17, 2011, did not have a current criminal background check on file. G.S. 110-90.2(b) & (d) & .2703(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #1b, one (1) child enrolled on February 5, 2024, did not have a Medical Action Plan – Asthma on file and available for review. In space 3a/b, one (1) child enrolled on August 29, 2022, did not have a Medical Action Plan – Asthma or a Medical Action Plan – Allergy and Anaphylaxis on file and available for review. In space #4, one (1) child enrolled on June 17, 2029, did not have a Medical Action Plan – Asthma on file and available for review. .0801(b) 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. Infant Feeding Plans: Infant feeding plans should be reviewed and updated regularly, and modifications made as needed. Any time a child’s nutritional needs change, it should be documented on the form and discussed with the child’s parent or health care provider. I suggested you review the requirements for the infant feeding plans for all staff members assigned to classrooms for infants. I discussed with you creating a plan for coming into compliance and maintaining program records. Medical Action Plans: For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan must be completed by the child’s parent or a health care professional, and on file for review. The medical action plan must be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. I provided you with a sample medical action plan which may also be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp 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, and the five (5) year Criminal Background re-check shows in process for staff member, Ruby Davis, employed on February 17, 2011. Storage of Hazardous Products: All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled must be stored in a locked storage room or cabinet. I suggested that you check all transportation vehicles at the beginning of the day and at the end of the day to ensure any hazardous products are removed and placed in locked storage. This was corrected during the visit by the director removing the hazardous item from the transportation vehicle and placing it in locked storage in the director’s office. Consultation: Lead Testing: I reviewed with you the new 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 has completed the lead water, lead-based paint and asbestos testing. 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’. 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/ 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. Compliance History: The program’s compliance history was eighty-four percent (84%) 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 December 31, 2024. 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: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: FARRAN RHYNE Operation Type: Center Case Number: Visit Date: 12/17/2024 Number Present: 32 Completed Date: 12/17/2024 Age: From 1 To 5 Total Minutes: 420 Time In: 09:45 AM Time Out: 04:45 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 16, 2024. Upon arrival you, Tammy Parker, owner, assisted me with the visit. Taylor Parker, Administrator also assisted with the visit. The North Carolina Secretary of State website was viewed on December 17, 2024, and Toddler Time Inc. was not listed. 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 four (4) star rated license issued on June 25, 2018, earning five (5) points in staff education and six (6) points in program standards. The permit restrictions were in compliance including: 1st shift, 2nd shift, meets enhanced ratios, meets enhanced space, Cap Bldg #1 – 39 and Cap Bldg #2 – 45. Staff and children were observed during teacher directed activities, outdoor gross motor play, toileting/diapering routine, handwashing routine, lunch, and naptime. A walk-through was completed, and all licensed indoor and outdoor spaces were monitored. A checklist was used to note the requirements I monitored. Inspections/Drills: The last fire inspection was completed on October 15, 2024. The last sanitation inspection was completed on May 1, 2024. A “superior” classification was issued with four (4) demerits noted on the grade card. The last monthly fire drill was completed on November 26, 2024, at 11:00am. The last emergency drill was a lockdown drill completed on November 26, 2024, at 11:30am. The last playground inspection was completed on November 26, 2024. Lead Testing: The last lead water test was completed on April 9, 2024. Your next lead water test is due by April 9, 2027. Files Reviewed: Children’s files, staff files, and program files were monitored. Ten (10) children’s files were reviewed. One (1) existing staff file and one (1) new staff file were 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 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. One (1) spray bottle of Black Ice Little Trees spray with the warning label “keep away from children” was observed in the transportation vehicle cupholder and accessible to children. .2820(b) 849 Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. In space #3a/b, one (1) prescription medication, EpiPenJr. (2pk), had an expiration date of August 2024. In space #4, one (1) prescription inhaler, Ventolin, had an expiration date of November 2024. .0803(12) 1757 A valid qualification letter was not on file and available to review at the facility. One (1) staff member, Ruby Davis, employed on February 17, 2011, did not have a current criminal background check on file. G.S. 110-90.2(b) & (d) & .2703(e) 1834 Application did not have a medical action plan attached for any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services. In space #1b, one (1) child enrolled on February 5, 2024, did not have a Medical Action Plan – Asthma on file and available for review. In space 3a/b, one (1) child enrolled on August 29, 2022, did not have a Medical Action Plan – Asthma or a Medical Action Plan – Allergy and Anaphylaxis on file and available for review. In space #4, one (1) child enrolled on June 17, 2029, did not have a Medical Action Plan – Asthma on file and available for review. .0801(b) 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. Infant Feeding Plans: Infant feeding plans should be reviewed and updated regularly, and modifications made as needed. Any time a child’s nutritional needs change, it should be documented on the form and discussed with the child’s parent or health care provider. I suggested you review the requirements for the infant feeding plans for all staff members assigned to classrooms for infants. I discussed with you creating a plan for coming into compliance and maintaining program records. Medical Action Plans: For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action plan must be completed by the child’s parent or a health care professional, and on file for review. The medical action plan must be updated on an annual basis and when changes to the plan are made by the child's parent or health care professional. I provided you with a sample medical action plan which may also be found on the Division's website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp 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, and the five (5) year Criminal Background re-check shows in process for staff member, Ruby Davis, employed on February 17, 2011. Storage of Hazardous Products: All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled must be stored in a locked storage room or cabinet. I suggested that you check all transportation vehicles at the beginning of the day and at the end of the day to ensure any hazardous products are removed and placed in locked storage. This was corrected during the visit by the director removing the hazardous item from the transportation vehicle and placing it in locked storage in the director’s office. Consultation: Lead Testing: I reviewed with you the new 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 has completed the lead water, lead-based paint and asbestos testing. 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’. 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/ 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. Compliance History: The program’s compliance history was eighty-four percent (84%) 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 December 31, 2024. 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 .0604 · Violation

Name of Operation: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 40 Completed Date: 1/16/2024 Age: From 0 To 5 Total Minutes: 187 Time In: 01:03 PM Time Out: 04:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety requirements. You, Tammy Parker, Owner, assisted me with today’s visit. Taylor Parker, Administrator, also assisted with the visit. Farran Rhyne, Child Care Consultant, accompanied me on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a four (4) star license issued June 25, 2018. The permit restrictions were in compliance including First Shift (daytime care), second shift, meets enhanced ratios, meets enhanced space, Cap Bldg#1-39, and Cap Bldg#2-45. The Secretary of State website was checked on January 16, 2024, and your business, Toddler Time Inc. was 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 at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. The last sanitation inspection was conducted on May 9, 2023. A “superior” classification was issued with zero (0) demerits noted on the grade card. The last approved fire inspection was conducted on October 2, 2023. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 542 The written feeding plan was not modified as the child's needs changed. Per the infant feeding plan, one (1) infant, thirteen (13) months of age enrolled in Space #1b, is to consume breast milk at the facility. Per teacher report, the infant consumes table food while at the facility. Per the infant feeding plan, one (1) infant, eleven (11) months of age enrolled in Space #1b, is to consume breast milk at the facility. Per teacher report, the infant consumes baby food while at the facility. Per the infant feeding plan, one (1) infant, seven (7) months of age enrolled in Space #1b, is to consume formula at the facility. Per teacher report, the infant consumes baby food while at the facility. 10 NCAC 09 .0902(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In Space #3a/b, two (2) outlets on a surge protector on top of the cubbies, and three (3) outlets on a surge protector on the teacher’s desk were not covered with safety plugs. 10A NCAC 09 .0604(c) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information on file for one (1) child, enrolled on May 5, 2022, was last updated on May 2, 2022. The emergency information on file for one (1) child, enrolled on April 10, 2019, was last updated on April 8, 2019. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One (1) child, enrolled on September 1, 2022, had a medical exam on file dated March 18, 2023. GS110-91(1) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by January 30, 2024. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 100%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance was provided on the following: 1. Infant feeding plans should be reviewed and updated regularly, and modifications made as needed. Any time a child’s nutritional needs change, it should be documented on the form and discussed with the child’s parent or health care provider. I suggested you review the requirements for the infant feeding plans for all staff members assigned to classrooms for infants. 2. Emergency medical care information must be on file for each child. That information must include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information must be on file in the center on the child's first day of attendance and must be updated as changes occur and at least annually. I suggested you create a schedule to have all families update emergency information regularly to ensure the information is updated at least annually. 3. All electrical outlets and power strips not in use must be kept covered with safety plugs at all times unless located behind furniture that cannot be moved by a child. I suggested you keep extra safety plugs in each classroom to ensure outlets and power strips are kept covered. All outlets were covered with safety plugs during the visit. You stated you will continue to keep extra safety plugs on site to ensure all outlets are kept covered when not in use. 4. 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. Consultation: The hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in cohort one. Beginning in July and throughout the next few months I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U, FCCERS-R] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Family child care home providers consider the FCCERS-R self-study process and timeline for completion since it must occur over a 3-month time period prior to your rated license reassessment • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time 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 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 40 Completed Date: 1/16/2024 Age: From 0 To 5 Total Minutes: 187 Time In: 01:03 PM Time Out: 04:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety requirements. You, Tammy Parker, Owner, assisted me with today’s visit. Taylor Parker, Administrator, also assisted with the visit. Farran Rhyne, Child Care Consultant, accompanied me on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a four (4) star license issued June 25, 2018. The permit restrictions were in compliance including First Shift (daytime care), second shift, meets enhanced ratios, meets enhanced space, Cap Bldg#1-39, and Cap Bldg#2-45. The Secretary of State website was checked on January 16, 2024, and your business, Toddler Time Inc. was 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 at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. The last sanitation inspection was conducted on May 9, 2023. A “superior” classification was issued with zero (0) demerits noted on the grade card. The last approved fire inspection was conducted on October 2, 2023. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 542 The written feeding plan was not modified as the child's needs changed. Per the infant feeding plan, one (1) infant, thirteen (13) months of age enrolled in Space #1b, is to consume breast milk at the facility. Per teacher report, the infant consumes table food while at the facility. Per the infant feeding plan, one (1) infant, eleven (11) months of age enrolled in Space #1b, is to consume breast milk at the facility. Per teacher report, the infant consumes baby food while at the facility. Per the infant feeding plan, one (1) infant, seven (7) months of age enrolled in Space #1b, is to consume formula at the facility. Per teacher report, the infant consumes baby food while at the facility. 10 NCAC 09 .0902(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In Space #3a/b, two (2) outlets on a surge protector on top of the cubbies, and three (3) outlets on a surge protector on the teacher’s desk were not covered with safety plugs. 10A NCAC 09 .0604(c) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information on file for one (1) child, enrolled on May 5, 2022, was last updated on May 2, 2022. The emergency information on file for one (1) child, enrolled on April 10, 2019, was last updated on April 8, 2019. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One (1) child, enrolled on September 1, 2022, had a medical exam on file dated March 18, 2023. GS110-91(1) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by January 30, 2024. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 100%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance was provided on the following: 1. Infant feeding plans should be reviewed and updated regularly, and modifications made as needed. Any time a child’s nutritional needs change, it should be documented on the form and discussed with the child’s parent or health care provider. I suggested you review the requirements for the infant feeding plans for all staff members assigned to classrooms for infants. 2. Emergency medical care information must be on file for each child. That information must include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information must be on file in the center on the child's first day of attendance and must be updated as changes occur and at least annually. I suggested you create a schedule to have all families update emergency information regularly to ensure the information is updated at least annually. 3. All electrical outlets and power strips not in use must be kept covered with safety plugs at all times unless located behind furniture that cannot be moved by a child. I suggested you keep extra safety plugs in each classroom to ensure outlets and power strips are kept covered. All outlets were covered with safety plugs during the visit. You stated you will continue to keep extra safety plugs on site to ensure all outlets are kept covered when not in use. 4. 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. Consultation: The hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in cohort one. Beginning in July and throughout the next few months I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U, FCCERS-R] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Family child care home providers consider the FCCERS-R self-study process and timeline for completion since it must occur over a 3-month time period prior to your rated license reassessment • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time 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 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: Visit Date: 1/16/2024 Number Present: 40 Completed Date: 1/16/2024 Age: From 0 To 5 Total Minutes: 187 Time In: 01:03 PM Time Out: 04:10 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced annual compliance visit was to monitor your compliance with all applicable child care requirements, including health and safety requirements. You, Tammy Parker, Owner, assisted me with today’s visit. Taylor Parker, Administrator, also assisted with the visit. Farran Rhyne, Child Care Consultant, accompanied me on the visit. A checklist was used to note the requirements I monitored today. Your program currently operates with a four (4) star license issued June 25, 2018. The permit restrictions were in compliance including First Shift (daytime care), second shift, meets enhanced ratios, meets enhanced space, Cap Bldg#1-39, and Cap Bldg#2-45. The Secretary of State website was checked on January 16, 2024, and your business, Toddler Time Inc. was 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 at least thirty days prior to any changes occurring. The license cannot be bought, sold, subleased, transferred to another person or location, or inherited. The last sanitation inspection was conducted on May 9, 2023. A “superior” classification was issued with zero (0) demerits noted on the grade card. The last approved fire inspection was conducted on October 2, 2023. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 542 The written feeding plan was not modified as the child's needs changed. Per the infant feeding plan, one (1) infant, thirteen (13) months of age enrolled in Space #1b, is to consume breast milk at the facility. Per teacher report, the infant consumes table food while at the facility. Per the infant feeding plan, one (1) infant, eleven (11) months of age enrolled in Space #1b, is to consume breast milk at the facility. Per teacher report, the infant consumes baby food while at the facility. Per the infant feeding plan, one (1) infant, seven (7) months of age enrolled in Space #1b, is to consume formula at the facility. Per teacher report, the infant consumes baby food while at the facility. 10 NCAC 09 .0902(a) 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. In Space #3a/b, two (2) outlets on a surge protector on top of the cubbies, and three (3) outlets on a surge protector on the teacher’s desk were not covered with safety plugs. 10A NCAC 09 .0604(c) 1311 Emergency medical care information was not on file in the center on the child's first day of attendance and/or was not updated as changes occurred or at least annually for each child. The emergency information on file for one (1) child, enrolled on May 5, 2022, was last updated on May 2, 2022. The emergency information on file for one (1) child, enrolled on April 10, 2019, was last updated on April 8, 2019. .0802(c) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One (1) child, enrolled on September 1, 2022, had a medical exam on file dated March 18, 2023. GS110-91(1) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by January 30, 2024. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 100%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical Assistance was provided on the following: 1. Infant feeding plans should be reviewed and updated regularly, and modifications made as needed. Any time a child’s nutritional needs change, it should be documented on the form and discussed with the child’s parent or health care provider. I suggested you review the requirements for the infant feeding plans for all staff members assigned to classrooms for infants. 2. Emergency medical care information must be on file for each child. That information must include: (1) the name, address, and telephone number of the parent or other person to be contacted in case of an emergency; (2) the responsible party's choice of health care professional; (3) any chronic illness and any medication taken for that illness; and (4) any other information that has a direct bearing on ensuring safe medical treatment for the child. This emergency medical care information must be on file in the center on the child's first day of attendance and must be updated as changes occur and at least annually. I suggested you create a schedule to have all families update emergency information regularly to ensure the information is updated at least annually. 3. All electrical outlets and power strips not in use must be kept covered with safety plugs at all times unless located behind furniture that cannot be moved by a child. I suggested you keep extra safety plugs in each classroom to ensure outlets and power strips are kept covered. All outlets were covered with safety plugs during the visit. You stated you will continue to keep extra safety plugs on site to ensure all outlets are kept covered when not in use. 4. 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. Consultation: The hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in cohort one. Beginning in July and throughout the next few months I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U, FCCERS-R] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Family child care home providers consider the FCCERS-R self-study process and timeline for completion since it must occur over a 3-month time period prior to your rated license reassessment • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time 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 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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 .0713 · Violation

Name of Operation: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: 0823-188L Visit Date: 8/21/2023 Number Present: 32 Completed Date: 8/21/2023 Age: From 0 To 6 Total Minutes: 223 Time In: 08:42 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a report alleging violations of child care requirements regarding medication. You, Tammy Parker, Owner/Administrator, assisted with the visit. The Secretary of State website was reviewed and your business, Toddler Time Inc., is still 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 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. There are concerns that a medication was administered to a child at the incorrect time. A walkthrough of the facility was conducted. When I arrived at 8:42am, I observed twenty-one (21) children, one (1) to six (6) years of age eating breakfast in Space #1a with two (2) staff members. One (1) additional staff member arrived at 8:51am and took eight (8) children, three (3) to six (6) years of age to Space #2a. The second member who was in Space #1a when I arrived, then took five (5) children, one (1) to two (2) years of age into Space #2b. At that time, eight (8) children, three (3) to four (4) years of age remained in Space #1a with one (1) staff member. Per your facility’s permit restrictions, you meet enhanced rations and enhanced space. The maximum capacity of Space #1a is ten (10) children. I reviewed all Medication Administration Permission Forms for Chronic Illnesses and Medication Administration Records that were on site during today’s visit. Per the Medication Administration Records on site, all medication that had been administered were done so in accordance with the instructions on the Medication Administration Permission Forms and the Prescription Labels. Four (4) children’s files were reviewed during the visit. One (1) child’s file did not contain a Medication Administration Permission Form and/or a Medication Administration Record Log on file for a medication that was administered at the facility. The allegations were discussed with you and three (3) additional staff members during today’s visit. You and all staff members had an opportunity to ask questions, state perceptions of the situation and provide pertinent information in response to the allegation. You and staff interviewed stated that on June 28, 2023, one (1) child was given a medication, for which they were prescribed. You and staff interviewed stated the child had a current Medication Administration Permission Form for the medication on file which stated the medication was to be given “morning, afternoon, and evening”. You and staff interviewed stated the child was given the medication after breakfast on June 28, 2023, as the staff member responsible for the child was unaware that the parent had already given the child the morning dose of the medication prior to arrival at the facility. You and staff interviewed stated the Medication Administration Permission Form and Medication Administration Record for the medication were sent home with the parent when the medication was sent home and were no longer on file at the facility. Required documentation regarding medication was not on file for review during today’s visit. Based on file review, documentation review, and staff interviews, the allegations regarding medication was unconfirmed; therefore, unsubstantiated. One (1) violation related to the allegation was documented during the visit. Two (2) violations unrelated to the allegations were observed/documented during the visit. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. In Space #1a, two (2) staff members were caring for twenty-one (21) children, one (1) to six (6) years of age. 10A NCAC 09 .0713(a)(6) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The Medication Administration Permission Form and the Medication Administration Record for one (1) medication, last administered on June 28, 2023, was not on file. .0803(13)(a-e); .2318(3) 1245 For each child, there was not at least 30 sq. ft indoors and 75 sq. ft outdoors for one-third of the total number of the total licensed capacity, or at least 35 sq. ft. indoors and 75 sq. ft. outdoors for the total licensed capacity. Twenty-one (21) children were occupying Space #1a. Per the permit, the facility meets enhanced space requirements. The maximum capacity of Space #1a is ten (10) children. 10A NCAC 09 .2809(a) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by September 4, 2023. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 98%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Children between the ages of 12 months and 24 months may not be grouped with older children unless all children in the group are less than three years of age. Your facility meets enhanced ratios and space. The following staff/child ratios must be maintained at all times: Age of Children Voluntary Enhanced Ratio-Staff/Children (Voluntary Enhanced Maximum Group Size permitted) 0 to12 months-1/5 (10) 12 to 24 months-1/6(12) 2 to 3 years-1/9 (18) 3 to 4 years-1/10 (20) 4 to 5 years-1/13 (25) 5 to 6 years- 1/15 (25) 6 years and Older-1/20 (25) I suggested you create a staffing pattern to ensure proper staff/child rations and group sizes are able to be maintained at all times. 2. Your facility meets enhanced space requirements. Per enhanced space requirements, there must be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. The maximum capacity of Space #1a is ten (10) children. At any one time, there cannot be more than ten (10) children occupying Space #1a. 3. Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. If a parent requests the documentation for their records, I suggested you make a copy of the records for the parent, and keep the original copies of the documentation and place in the child’s file. Consultation: The hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in cohort one. Throughout the next few months I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U, FCCERS-R] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Family child care home providers consider the FCCERS-R self-study process and timeline for completion since it must occur over a 3-month time period prior to your rated license reassessment • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time 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 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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 .2809 · Violation

Name of Operation: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: 0823-188L Visit Date: 8/21/2023 Number Present: 32 Completed Date: 8/21/2023 Age: From 0 To 6 Total Minutes: 223 Time In: 08:42 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a report alleging violations of child care requirements regarding medication. You, Tammy Parker, Owner/Administrator, assisted with the visit. The Secretary of State website was reviewed and your business, Toddler Time Inc., is still 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 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. There are concerns that a medication was administered to a child at the incorrect time. A walkthrough of the facility was conducted. When I arrived at 8:42am, I observed twenty-one (21) children, one (1) to six (6) years of age eating breakfast in Space #1a with two (2) staff members. One (1) additional staff member arrived at 8:51am and took eight (8) children, three (3) to six (6) years of age to Space #2a. The second member who was in Space #1a when I arrived, then took five (5) children, one (1) to two (2) years of age into Space #2b. At that time, eight (8) children, three (3) to four (4) years of age remained in Space #1a with one (1) staff member. Per your facility’s permit restrictions, you meet enhanced rations and enhanced space. The maximum capacity of Space #1a is ten (10) children. I reviewed all Medication Administration Permission Forms for Chronic Illnesses and Medication Administration Records that were on site during today’s visit. Per the Medication Administration Records on site, all medication that had been administered were done so in accordance with the instructions on the Medication Administration Permission Forms and the Prescription Labels. Four (4) children’s files were reviewed during the visit. One (1) child’s file did not contain a Medication Administration Permission Form and/or a Medication Administration Record Log on file for a medication that was administered at the facility. The allegations were discussed with you and three (3) additional staff members during today’s visit. You and all staff members had an opportunity to ask questions, state perceptions of the situation and provide pertinent information in response to the allegation. You and staff interviewed stated that on June 28, 2023, one (1) child was given a medication, for which they were prescribed. You and staff interviewed stated the child had a current Medication Administration Permission Form for the medication on file which stated the medication was to be given “morning, afternoon, and evening”. You and staff interviewed stated the child was given the medication after breakfast on June 28, 2023, as the staff member responsible for the child was unaware that the parent had already given the child the morning dose of the medication prior to arrival at the facility. You and staff interviewed stated the Medication Administration Permission Form and Medication Administration Record for the medication were sent home with the parent when the medication was sent home and were no longer on file at the facility. Required documentation regarding medication was not on file for review during today’s visit. Based on file review, documentation review, and staff interviews, the allegations regarding medication was unconfirmed; therefore, unsubstantiated. One (1) violation related to the allegation was documented during the visit. Two (2) violations unrelated to the allegations were observed/documented during the visit. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. In Space #1a, two (2) staff members were caring for twenty-one (21) children, one (1) to six (6) years of age. 10A NCAC 09 .0713(a)(6) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The Medication Administration Permission Form and the Medication Administration Record for one (1) medication, last administered on June 28, 2023, was not on file. .0803(13)(a-e); .2318(3) 1245 For each child, there was not at least 30 sq. ft indoors and 75 sq. ft outdoors for one-third of the total number of the total licensed capacity, or at least 35 sq. ft. indoors and 75 sq. ft. outdoors for the total licensed capacity. Twenty-one (21) children were occupying Space #1a. Per the permit, the facility meets enhanced space requirements. The maximum capacity of Space #1a is ten (10) children. 10A NCAC 09 .2809(a) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by September 4, 2023. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 98%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Children between the ages of 12 months and 24 months may not be grouped with older children unless all children in the group are less than three years of age. Your facility meets enhanced ratios and space. The following staff/child ratios must be maintained at all times: Age of Children Voluntary Enhanced Ratio-Staff/Children (Voluntary Enhanced Maximum Group Size permitted) 0 to12 months-1/5 (10) 12 to 24 months-1/6(12) 2 to 3 years-1/9 (18) 3 to 4 years-1/10 (20) 4 to 5 years-1/13 (25) 5 to 6 years- 1/15 (25) 6 years and Older-1/20 (25) I suggested you create a staffing pattern to ensure proper staff/child rations and group sizes are able to be maintained at all times. 2. Your facility meets enhanced space requirements. Per enhanced space requirements, there must be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. The maximum capacity of Space #1a is ten (10) children. At any one time, there cannot be more than ten (10) children occupying Space #1a. 3. Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. If a parent requests the documentation for their records, I suggested you make a copy of the records for the parent, and keep the original copies of the documentation and place in the child’s file. Consultation: The hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in cohort one. Throughout the next few months I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U, FCCERS-R] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Family child care home providers consider the FCCERS-R self-study process and timeline for completion since it must occur over a 3-month time period prior to your rated license reassessment • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time 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 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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: TODDLER TIME CHILD CARE INC. Facility ID: 36000345 Consultant: CHRISTINE ROSINSKI Operation Type: Center Case Number: 0823-188L Visit Date: 8/21/2023 Number Present: 32 Completed Date: 8/21/2023 Age: From 0 To 6 Total Minutes: 223 Time In: 08:42 AM Time Out: 12:25 PM Time In: Time Out: List to Use: Center Type Of Visit: Complaint Visit Announced/Unannounced: Unannounced The purpose of today's unannounced visit was to investigate a report alleging violations of child care requirements regarding medication. You, Tammy Parker, Owner/Administrator, assisted with the visit. The Secretary of State website was reviewed and your business, Toddler Time Inc., is still 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 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. There are concerns that a medication was administered to a child at the incorrect time. A walkthrough of the facility was conducted. When I arrived at 8:42am, I observed twenty-one (21) children, one (1) to six (6) years of age eating breakfast in Space #1a with two (2) staff members. One (1) additional staff member arrived at 8:51am and took eight (8) children, three (3) to six (6) years of age to Space #2a. The second member who was in Space #1a when I arrived, then took five (5) children, one (1) to two (2) years of age into Space #2b. At that time, eight (8) children, three (3) to four (4) years of age remained in Space #1a with one (1) staff member. Per your facility’s permit restrictions, you meet enhanced rations and enhanced space. The maximum capacity of Space #1a is ten (10) children. I reviewed all Medication Administration Permission Forms for Chronic Illnesses and Medication Administration Records that were on site during today’s visit. Per the Medication Administration Records on site, all medication that had been administered were done so in accordance with the instructions on the Medication Administration Permission Forms and the Prescription Labels. Four (4) children’s files were reviewed during the visit. One (1) child’s file did not contain a Medication Administration Permission Form and/or a Medication Administration Record Log on file for a medication that was administered at the facility. The allegations were discussed with you and three (3) additional staff members during today’s visit. You and all staff members had an opportunity to ask questions, state perceptions of the situation and provide pertinent information in response to the allegation. You and staff interviewed stated that on June 28, 2023, one (1) child was given a medication, for which they were prescribed. You and staff interviewed stated the child had a current Medication Administration Permission Form for the medication on file which stated the medication was to be given “morning, afternoon, and evening”. You and staff interviewed stated the child was given the medication after breakfast on June 28, 2023, as the staff member responsible for the child was unaware that the parent had already given the child the morning dose of the medication prior to arrival at the facility. You and staff interviewed stated the Medication Administration Permission Form and Medication Administration Record for the medication were sent home with the parent when the medication was sent home and were no longer on file at the facility. Required documentation regarding medication was not on file for review during today’s visit. Based on file review, documentation review, and staff interviews, the allegations regarding medication was unconfirmed; therefore, unsubstantiated. One (1) violation related to the allegation was documented during the visit. Two (2) violations unrelated to the allegations were observed/documented during the visit. The following violations were observed/documented during today’s visit: Violation Number Comment Rule 318 Children between 12 and 24 months of age were grouped with children 3 years of age or older. In Space #1a, two (2) staff members were caring for twenty-one (21) children, one (1) to six (6) years of age. 10A NCAC 09 .0713(a)(6) 851 When medication was administered, documentation was not completed or maintained for 6 months and/or the documentation did not include the required information. The Medication Administration Permission Form and the Medication Administration Record for one (1) medication, last administered on June 28, 2023, was not on file. .0803(13)(a-e); .2318(3) 1245 For each child, there was not at least 30 sq. ft indoors and 75 sq. ft outdoors for one-third of the total number of the total licensed capacity, or at least 35 sq. ft. indoors and 75 sq. ft. outdoors for the total licensed capacity. Twenty-one (21) children were occupying Space #1a. Per the permit, the facility meets enhanced space requirements. The maximum capacity of Space #1a is ten (10) children. 10A NCAC 09 .2809(a) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by September 4, 2023. Please send your letter to christine.rosinski@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. You must maintain at least 75% Compliance History for each 18-month period as required by G.S. 110-90(4) (c). Prior to today's visit, your program maintained a compliance history of 98%. Please note any violations cited during future visits will negatively impact your compliance history. Repeated violations or violations left unresolved may lead to an administrative action. Technical assistance was provided on the following: 1. Children between the ages of 12 months and 24 months may not be grouped with older children unless all children in the group are less than three years of age. Your facility meets enhanced ratios and space. The following staff/child ratios must be maintained at all times: Age of Children Voluntary Enhanced Ratio-Staff/Children (Voluntary Enhanced Maximum Group Size permitted) 0 to12 months-1/5 (10) 12 to 24 months-1/6(12) 2 to 3 years-1/9 (18) 3 to 4 years-1/10 (20) 4 to 5 years-1/13 (25) 5 to 6 years- 1/15 (25) 6 years and Older-1/20 (25) I suggested you create a staffing pattern to ensure proper staff/child rations and group sizes are able to be maintained at all times. 2. Your facility meets enhanced space requirements. Per enhanced space requirements, there must be at least 30 square feet inside space per child per the total licensed capacity and 100 square feet outside space for each child using the outdoor learning environment at any one time. The maximum capacity of Space #1a is ten (10) children. At any one time, there cannot be more than ten (10) children occupying Space #1a. 3. Any time prescription or over-the-counter medication is administered by center personnel to children receiving care, the following information shall be recorded: (a) the child's name; (b) the date the medication was given; (c) the time the medication was given; (d) the amount and the type of medication given; and (e) the name and signature of the person administering the medication. This information shall be noted on a medication permission slip, or on a separate form developed by the provider which includes the required information. This information shall be available for review by a representative of the Division during the time period the medication is being administered and for six months after the medication is administered. If a parent requests the documentation for their records, I suggested you make a copy of the records for the parent, and keep the original copies of the documentation and place in the child’s file. Consultation: The hold harmless legislation was extended and signed into law on Monday June 12th, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024 and when reassessed it reduces the education evaluation requirements for lead teachers from 75% to 50% until June of 2026. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each include a preparation year and a reassessment year. While the first reassessment year will not begin until July 1, 2024, the preparation year for cohort one begins July 1, 2023. Your facility is in cohort one. Throughout the next few months I recommend you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2024 and June 30, 2025. If possible, we will align the reassessment with your annual compliance visit timeframe. • Have all staff update WORKS accounts to reflect all currently completed coursework (DCDEE-WORKS) • Determine whether you wish to have Environment Rating Scale (ERS) Assessments [ITERS-R, ECERS-R, SACERS-U, FCCERS-R] conducted • Request technical assistance with your child care consultant and local partners • Participate in local CCR&R and NCPC quality related training/workshops (CCRR Information) • Reach out to your local Community College to discuss educational opportunities • Review NCRLAP website ERS resources (www.NCRLAP.org). To help review ERS requirements and think carefully about the current characteristics and practices in your program and classrooms, check out the Thinking More worksheets. A worksheet is available for each subscale of each rating scale. • Family child care home providers consider the FCCERS-R self-study process and timeline for completion since it must occur over a 3-month time period prior to your rated license reassessment • Consider requesting an ERS assessment (free of charge) during the preparation year. Remember the scores can be used in a variety of ways o ERS assessments can be requested during the preparation year and scores can be used as guidance to enhance program quality o If desired, assessment scores can be used during the preparation year if the operator wants to move forward with a rated license reassessment o Assessment scores can be saved to use during the reassessment year o Facilities can request another ERS assessment (free of charge) in your reassessment year for any ERS assessment scoring less than a 5.0 Stay up to date with the Division of Child Development and Early Education by visiting www.ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time 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 704-579-4463. Christine Rosinski PO Box 927 Cornelius, NC 28031 Christine.rosinski@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