Gentle Gems Developmental Learning Center

10A NCAC 09 .0604 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SHARON WILLIAMS Operation Type: Center Case Number: Visit Date: 3/25/2026 Number Present: 28 Completed Date: 3/25/2026 Age: From 0 To 5 Total Minutes: 230 Time In: 10:00 AM Time Out: 01:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and to begin the rated license assessment process. A checklist was used to note the requirements I monitored today. The last annual compliance visit was conducted on 4/15/25. This facility currently operates with a Four-Star license issued on August 7, 2022. Ms. Katrina Melton, Administrator, assisted me during my visit today. I conducted a full assessment of the child care requirements and completed a walk-through of the indoor and outdoor spaces used by the children. Twenty-eight children were in attendance during today’s visit. I observed the children playing outside, engaged in free-choice activities, completing bathroom routines, and eating lunch. In the infant room, I observed two infants sitting in bouncy seats, one child being diapered, and one in a crib. A sample of children and staff files were reviewed. I reviewed the staff and training work sheets dated 4/15/25. You updated the worksheets today. The sanitation inspection was completed 10/16/25 with a “Superior” classification. An approved fire inspection was conducted on February 17, 2026. Monthly playground, fire drills, and emergency drills have been conducted, and documentation was available for review. The facility has an 18-month compliance history of 86%. The facility’s corporation status was verified as current and active on the NC Department of the Secretary of State today, 3/25/26. Two items of noncompliance with child care requirements were cited during today’s visit. Violation Number Comment Rule 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 the classroom for three year olds, the electrical outlets near the block area were uncovered and accessible to the children. This was corrected during the visit by administrator placing outlet covers. 10A NCAC 09 .0604(c) 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. One child did not have the asthma medical plan attached to application. .0801(b) Childcare programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violations documented must be corrected immediately. A signed and dated letter of compliance must be emailed to me at sharon.y.williams@dhhs.nc.gov on or before April 8, 2026 1. Facility Name 2. Facility ID 3. Date of the letter 4. The violation number. The date the violation was corrected. How the violation was corrected. 5. Signature of the person preparing the letter. If I do not receive your letter by April 8, 2026, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the violations have not been corrected or addressed. Pathways to the Stars We reviewed the updated rules in Section .3200 regarding the Standards for Two- through Five-Star Rated facilities (Pathway to Stars), and I demonstrated how to access the relevant information on the DCDEE website. A new rule rollout module is now available on the DCDEE e-learning Moodle platform. As discussed, the facility should carefully consider the available QRIS options and determine which pathway it plans to pursue for its rated license reassessment. While the reassessment process may begin at any time, the facility should be prepared to submit the Application for Assessment for a Rated License between April 1, 2026, and September 30, 2026. The following steps are how you can begin preparing for the Rated License process: Today you chose Pathway 1: Program Assessment Pathway • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, June 30, 2026. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, June 30, 2026. • Confirm all staff have active WORKS accounts. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, books. • Prepare for Environmental Rating Scale (ERS) assessments. • Access resources, trainings, and outreach via ncrlap.org. • Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-olds are enrolled, select and implement an approved curriculum. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If you have any questions or concerns, please feel free to contact me (336)-580-6239 or sharon.y.williams@dhhs.nc.gov. If there are additional concerns, please contact Meg Riddle, Licensing Supervisor at meg.riddle@dhhs.nc.gov Thank you for your time and cooperation during today’s visit. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

NC GS 110-90 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SHARON WILLIAMS Operation Type: Center Case Number: Visit Date: 3/25/2026 Number Present: 28 Completed Date: 3/25/2026 Age: From 0 To 5 Total Minutes: 230 Time In: 10:00 AM Time Out: 01:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp w/Rated Lic Assess Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor compliance during an annual compliance visit and to begin the rated license assessment process. A checklist was used to note the requirements I monitored today. The last annual compliance visit was conducted on 4/15/25. This facility currently operates with a Four-Star license issued on August 7, 2022. Ms. Katrina Melton, Administrator, assisted me during my visit today. I conducted a full assessment of the child care requirements and completed a walk-through of the indoor and outdoor spaces used by the children. Twenty-eight children were in attendance during today’s visit. I observed the children playing outside, engaged in free-choice activities, completing bathroom routines, and eating lunch. In the infant room, I observed two infants sitting in bouncy seats, one child being diapered, and one in a crib. A sample of children and staff files were reviewed. I reviewed the staff and training work sheets dated 4/15/25. You updated the worksheets today. The sanitation inspection was completed 10/16/25 with a “Superior” classification. An approved fire inspection was conducted on February 17, 2026. Monthly playground, fire drills, and emergency drills have been conducted, and documentation was available for review. The facility has an 18-month compliance history of 86%. The facility’s corporation status was verified as current and active on the NC Department of the Secretary of State today, 3/25/26. Two items of noncompliance with child care requirements were cited during today’s visit. Violation Number Comment Rule 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 the classroom for three year olds, the electrical outlets near the block area were uncovered and accessible to the children. This was corrected during the visit by administrator placing outlet covers. 10A NCAC 09 .0604(c) 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. One child did not have the asthma medical plan attached to application. .0801(b) Childcare programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4) (d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. The violations documented must be corrected immediately. A signed and dated letter of compliance must be emailed to me at sharon.y.williams@dhhs.nc.gov on or before April 8, 2026 1. Facility Name 2. Facility ID 3. Date of the letter 4. The violation number. The date the violation was corrected. How the violation was corrected. 5. Signature of the person preparing the letter. If I do not receive your letter by April 8, 2026, a return visit to your program will be made to monitor for compliance of violations and to obtain your compliance letter. Additional violations may be documented if the violations have not been corrected or addressed. Pathways to the Stars We reviewed the updated rules in Section .3200 regarding the Standards for Two- through Five-Star Rated facilities (Pathway to Stars), and I demonstrated how to access the relevant information on the DCDEE website. A new rule rollout module is now available on the DCDEE e-learning Moodle platform. As discussed, the facility should carefully consider the available QRIS options and determine which pathway it plans to pursue for its rated license reassessment. While the reassessment process may begin at any time, the facility should be prepared to submit the Application for Assessment for a Rated License between April 1, 2026, and September 30, 2026. The following steps are how you can begin preparing for the Rated License process: Today you chose Pathway 1: Program Assessment Pathway • Complete the “Application For Assessment for a Rated License for Centers” electronically and submit to your child care consultant no later than, June 30, 2026. • Complete the “Environmental Rating Scale (ERS) Assessment Request” form electronically and submit to your child care consultant no later than, June 30, 2026. • Confirm all staff have active WORKS accounts. • Complete the QRIS Staff Information and Education Worksheet electronically. • Begin planning for your three-month self-study using the applicable ITERS-3, ECERS-3, SACERS-U, books. • Prepare for Environmental Rating Scale (ERS) assessments. • Access resources, trainings, and outreach via ncrlap.org. • Work with CCR&R or Smart Start for support in preparation. • Identify CQI goals and begin planning for implementation. • Develop strategies for Family and Community Engagement. • If four-year-olds are enrolled, select and implement an approved curriculum. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ If you have any questions or concerns, please feel free to contact me (336)-580-6239 or sharon.y.williams@dhhs.nc.gov. If there are additional concerns, please contact Meg Riddle, Licensing Supervisor at meg.riddle@dhhs.nc.gov Thank you for your time and cooperation during today’s visit. 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: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SHARON WILLIAMS Operation Type: Center Case Number: Visit Date: 11/13/2025 Number Present: 31 Completed Date: 11/13/2025 Age: From 0 To 4 Total Minutes: 185 Time In: 10:40 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this unannounced routine visit was to evaluate the center’s compliance with applicable child care requirements. The facility currently operates under a Four-Star License, effective March 3, 2025. Upon arrival, I was greeted by Ms. Carla Johnson, floater. She contacted Ms. Katrina Melton, Administrator, by telephone. Ms. Melton arrived approximately twenty minutes after my arrival. A partial assessment of child care requirements was conducted. I completed a walkthrough of the indoor and outdoor areas utilized by the children. Thirty-one (31) children were present during the visit. Observations included children engaged in outdoor play, bathroom routines, lunch, and rest time. I reviewed two staff files and documentation for two vans used by the facility for transportation purposes. The facility’s corporate status was verified as current with the NC Department of the Secretary of State as of November 12, 2025. Violations of child care requirements were cited during today’s visit. A follow-up visit will be conducted. Violation Number Comment Rule 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. The required staff-to-child ratio for infants (ages 0–1) was not maintained. One staff member was observed supervising six children in this age group after the second staff member left the room. GS 110-91(7);.0713(a-d) 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. Electrical outlets not in use were observed without safety plugs in the infant room and the 1’s and 2’s classroom. During the visit, the administrator placed safety plugs in the outlets. 10A NCAC 09 .0604(c) 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. Leftover medication remained in the facility for one child after the course of treatment was completed and the authorization had expired. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was not completed for October 2025. This was corrected during the visit by the administrator completing a playground inspection. .0605(q) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The standing authorization on file for one child's diaper cream had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) The violations documented must be corrected immediately. A signed and dated letter of compliance must be emailed to me on or before November 27, 2025. The letter of compliance should contain the following information: 1. Facility Name 2. Facility ID 3. Date of the letter 4. The violation number. The date each violation was corrected. How the violation was corrected. 5. Signature of the person preparing the letter. If sufficient information is not received by the due date, a follow-up visit may be completed. Email the information to: sharon.y.williams@dhhs.nc.gov. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ You were provided with an opportunity to ask questions regarding interpretation and implementation of all child care requirements. Pathways to the Stars Today, we discussed the Pathway to Stars and I showed you how to access the relevant information on the DCDEE website. A new rule rollout module is now available on the DCDEE e-learning Moodle platform. We specifically went over the updated rules in Section .3200 regarding the Standards for Two through Five Star Rated facilities. I walked you through how to find this information on the DCDEE website, and we reviewed the forms for Pathway 2. You mentioned that you need more time to review the details to determine if Pathway 2 is the best fit for your facility. We also touched on staffing concerns, particularly the education requirements for lead teachers. ABCMS Child care administrators can access ABCMS, the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. Please complete the process for your facility as soon as possible. If you have any questions or need assistance, please contact me. Please remember that it is your responsibility to stay informed and comply with all child care rules and requirements. We truly appreciate everything you're doing to support the children and families of North Carolina. If you have any questions or need further assistance, don't hesitate to reach out to me. Thank you for your time and cooperation during today’s visit. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SHARON WILLIAMS Operation Type: Center Case Number: Visit Date: 11/13/2025 Number Present: 31 Completed Date: 11/13/2025 Age: From 0 To 4 Total Minutes: 185 Time In: 10:40 AM Time Out: 01:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of this unannounced routine visit was to evaluate the center’s compliance with applicable child care requirements. The facility currently operates under a Four-Star License, effective March 3, 2025. Upon arrival, I was greeted by Ms. Carla Johnson, floater. She contacted Ms. Katrina Melton, Administrator, by telephone. Ms. Melton arrived approximately twenty minutes after my arrival. A partial assessment of child care requirements was conducted. I completed a walkthrough of the indoor and outdoor areas utilized by the children. Thirty-one (31) children were present during the visit. Observations included children engaged in outdoor play, bathroom routines, lunch, and rest time. I reviewed two staff files and documentation for two vans used by the facility for transportation purposes. The facility’s corporate status was verified as current with the NC Department of the Secretary of State as of November 12, 2025. Violations of child care requirements were cited during today’s visit. A follow-up visit will be conducted. Violation Number Comment Rule 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. The required staff-to-child ratio for infants (ages 0–1) was not maintained. One staff member was observed supervising six children in this age group after the second staff member left the room. GS 110-91(7);.0713(a-d) 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. Electrical outlets not in use were observed without safety plugs in the infant room and the 1’s and 2’s classroom. During the visit, the administrator placed safety plugs in the outlets. 10A NCAC 09 .0604(c) 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. Leftover medication remained in the facility for one child after the course of treatment was completed and the authorization had expired. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. A playground inspection was not completed for October 2025. This was corrected during the visit by the administrator completing a playground inspection. .0605(q) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The standing authorization on file for one child's diaper cream had expired. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) The violations documented must be corrected immediately. A signed and dated letter of compliance must be emailed to me on or before November 27, 2025. The letter of compliance should contain the following information: 1. Facility Name 2. Facility ID 3. Date of the letter 4. The violation number. The date each violation was corrected. How the violation was corrected. 5. Signature of the person preparing the letter. If sufficient information is not received by the due date, a follow-up visit may be completed. Email the information to: sharon.y.williams@dhhs.nc.gov. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ You were provided with an opportunity to ask questions regarding interpretation and implementation of all child care requirements. Pathways to the Stars Today, we discussed the Pathway to Stars and I showed you how to access the relevant information on the DCDEE website. A new rule rollout module is now available on the DCDEE e-learning Moodle platform. We specifically went over the updated rules in Section .3200 regarding the Standards for Two through Five Star Rated facilities. I walked you through how to find this information on the DCDEE website, and we reviewed the forms for Pathway 2. You mentioned that you need more time to review the details to determine if Pathway 2 is the best fit for your facility. We also touched on staffing concerns, particularly the education requirements for lead teachers. ABCMS Child care administrators can access ABCMS, the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. Please complete the process for your facility as soon as possible. If you have any questions or need assistance, please contact me. Please remember that it is your responsibility to stay informed and comply with all child care rules and requirements. We truly appreciate everything you're doing to support the children and families of North Carolina. If you have any questions or need further assistance, don't hesitate to reach out to me. Thank you for your time and cooperation during today’s visit. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0509 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: CHERISSA ALSTON Operation Type: Center Case Number: Visit Date: 4/15/2025 Number Present: 46 Completed Date: 4/15/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance of child care rules during an annual compliance visit. The facility has an 18-month compliance history of 90%. The last annual compliance visit was documented on 4/18/24. The facility’s corporation status was verified current on the NC Department of the Secretary of State today, 4/15/25. Upon arrival, I was greeted by Mrs. Katrina Melton, Administrator. Mrs. Melton accompanied me on a walkthrough of the indoor and outdoor spaces. I noted attendance and monitored staff/child ratios. Mrs. Melton assisted me with required documentation and answered any questions I had. There were 46 children present today, ages 0-11 years old. Infants and toddlers were observed crawling and walking around playing with a variety of toys and receiving routine care. Other children were observed having group time, playing in centers of their choice and playing outside. School age children were observed playing games and interacting with one another at the table. Interactions observed were positive and nurturing in manner. Emergency medications, topical creams, and permissions were observed. There were two expired permission to admission forms and medical action plans. I monitored arrival and departure documentation, and safe sleep checks, both were current. Current activity plans were not posted in four of the five spaces during the walkthrough, they were posted before I finished the walkthrough. A current menu and allergy list was posted in the spaces and in the kitchen. Outdoor spaces were monitored and there were no hazards observed today. However, on the school age playground there were little to no items for play. Five randomly selected children’s file and staff files were monitored during today’s visit. I monitored health and safety training and other annual requirements. Training was complete except for new staff who are currently working on health and safety trainings and one staff member did not complete Maltreatment training. A satisfactory fire inspection was completed on 11/1/24 and the facility was approved for day and night time care. A sanitation inspection was completed on 9/5/24 and the facility received a Superior rating. Outdoor inspections were not available for review. Fire and emergency drills were documented and current. Required items were posted. There were ten items of non-compliance observed today and the corresponding violations were cited. Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Activity plans were not posted in four of the five licensed spaces during the walkthrough. They were posted by the end of the walkthrough. GS 110-91(12); .0508(a) 438 Developmentally appropriate equipment and materials were not provided for variety of outdoor activities for vigorous play and large muscle development. In the outdoor space for school age children there were no materials for vigorous play or large muscle development. 10A NCAC 09 .0509(4) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. There was a plastic store bag hanging in a cubby in reach of children ages 0-1. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Playground inspections were not made available for review. .0605(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. The 6 week portion of orientation was not completed for T. Carter. .1101(a) 1110 Vehicles used to transport children enrolled in the child care center did not comply with all applicable State and federal laws and regulations. The registration for the black passenger van expired in 2023. .1002(b) 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. Emergency medical care information was not updated annual. .0802(c) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. There were two medical action plans that were not updated annually, for T. Ellis and A. Squire. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The permission to administer form was not updated every six months for T. Ellis and A. Squire. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. M. Solan did nto complete Maltreatment course within 90 days of employment. .1102(g) Violation(s) documented above must be corrected immediately. A signed and dated letter of compliance must be emailed to me by 4/29/25, describing how and when the violation(s) were corrected and how compliance will be maintained in the future. Please remember your letter should include facility name, facility ID#, and original signature. The letter can be emailed to cherissa.alston@dhhs.nc.gov. RATED LICENSE UPDATE Hold harmless has been extended until the new QRIS (STAR rating) rules are implemented (SB 425). At this time assessments are optional and can be completed at your request. Please continue to work on preparing and ensuring staff education is current in WORKS. BACKGROUND CHECKS Child care administrators can access ABCMS, the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. Please complete the process for your facility as soon as possible. You were provided an opportunity to ask questions regarding interpretation and implementation of all child care requirements. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/. Thank you for your time today. If you have any questions or concerns, please feel free to contact me. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: CHERISSA ALSTON Operation Type: Center Case Number: Visit Date: 4/15/2025 Number Present: 46 Completed Date: 4/15/2025 Age: From 0 To 10 Total Minutes: 420 Time In: 09:30 AM Time Out: 04:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor for compliance of child care rules during an annual compliance visit. The facility has an 18-month compliance history of 90%. The last annual compliance visit was documented on 4/18/24. The facility’s corporation status was verified current on the NC Department of the Secretary of State today, 4/15/25. Upon arrival, I was greeted by Mrs. Katrina Melton, Administrator. Mrs. Melton accompanied me on a walkthrough of the indoor and outdoor spaces. I noted attendance and monitored staff/child ratios. Mrs. Melton assisted me with required documentation and answered any questions I had. There were 46 children present today, ages 0-11 years old. Infants and toddlers were observed crawling and walking around playing with a variety of toys and receiving routine care. Other children were observed having group time, playing in centers of their choice and playing outside. School age children were observed playing games and interacting with one another at the table. Interactions observed were positive and nurturing in manner. Emergency medications, topical creams, and permissions were observed. There were two expired permission to admission forms and medical action plans. I monitored arrival and departure documentation, and safe sleep checks, both were current. Current activity plans were not posted in four of the five spaces during the walkthrough, they were posted before I finished the walkthrough. A current menu and allergy list was posted in the spaces and in the kitchen. Outdoor spaces were monitored and there were no hazards observed today. However, on the school age playground there were little to no items for play. Five randomly selected children’s file and staff files were monitored during today’s visit. I monitored health and safety training and other annual requirements. Training was complete except for new staff who are currently working on health and safety trainings and one staff member did not complete Maltreatment training. A satisfactory fire inspection was completed on 11/1/24 and the facility was approved for day and night time care. A sanitation inspection was completed on 9/5/24 and the facility received a Superior rating. Outdoor inspections were not available for review. Fire and emergency drills were documented and current. Required items were posted. There were ten items of non-compliance observed today and the corresponding violations were cited. Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. Activity plans were not posted in four of the five licensed spaces during the walkthrough. They were posted by the end of the walkthrough. GS 110-91(12); .0508(a) 438 Developmentally appropriate equipment and materials were not provided for variety of outdoor activities for vigorous play and large muscle development. In the outdoor space for school age children there were no materials for vigorous play or large muscle development. 10A NCAC 09 .0509(4) 858 Plastic bags, materials that could be torn apart and toy parts small enough to be swallowed were accessible to children under three years of age. There was a plastic store bag hanging in a cubby in reach of children ages 0-1. .0604(q) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. Playground inspections were not made available for review. .0605(q) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. The 6 week portion of orientation was not completed for T. Carter. .1101(a) 1110 Vehicles used to transport children enrolled in the child care center did not comply with all applicable State and federal laws and regulations. The registration for the black passenger van expired in 2023. .1002(b) 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. Emergency medical care information was not updated annual. .0802(c) 1835 The medical action plan was not updated on an annual basis or when changes to the plan were made by the child's parent or health care professional. There were two medical action plans that were not updated annually, for T. Ellis and A. Squire. .0801(b) 1882 Medication authorization, giving the caregiver standing authorization did not meet the specifications in rule. The permission to administer form was not updated every six months for T. Ellis and A. Squire. .0803(6)(a-i); .0803(7)(a-g); .0803(8)(a-d) 1897 The child care administrator and all staff did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training within 90 days of employment. M. Solan did nto complete Maltreatment course within 90 days of employment. .1102(g) Violation(s) documented above must be corrected immediately. A signed and dated letter of compliance must be emailed to me by 4/29/25, describing how and when the violation(s) were corrected and how compliance will be maintained in the future. Please remember your letter should include facility name, facility ID#, and original signature. The letter can be emailed to cherissa.alston@dhhs.nc.gov. RATED LICENSE UPDATE Hold harmless has been extended until the new QRIS (STAR rating) rules are implemented (SB 425). At this time assessments are optional and can be completed at your request. Please continue to work on preparing and ensuring staff education is current in WORKS. BACKGROUND CHECKS Child care administrators can access ABCMS, the DCDEE’s criminal background check system. This access will allow providers to: • See the real-time background check status of staff members. • Run a printable report of the staff roster to assist with compliance visits. • See new background check applicants and add to staff roster. Access to the ABCMS requires the successful completion of a Moodle course consisting of a short video followed by a test. Please complete the process for your facility as soon as possible. You were provided an opportunity to ask questions regarding interpretation and implementation of all child care requirements. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/. Thank you for your time today. If you have any questions or concerns, please feel free to contact me. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0803 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SAMANTHA MCLEOD Operation Type: Center Case Number: Visit Date: 4/18/2024 Number Present: 74 Completed Date: 4/18/2024 Age: From 0 To 12 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor for compliance during an annual compliance visit. A checklist was used to note the requirements I monitored today. This facility currently operates with a Four Star license issued on March 2, 2022. Upon arrival to the facility, I was greeted by the administrator Mrs. Katrina Melton. Mrs. Melton assisted me during my visit today. A walk-thru of the indoor and outdoor spaces used by the children was conducted. During today’s visit, I observed the children during center time, outdoor time and small group activities. During today’s visit, I observed the children during center time, meal times, rest time, outdoor time and transition routines. Several infant feedings and diaper changes were observed in the space for infants. During my monitoring of the classroom spaces, I observed the space for infants out of staff/child ratio. When we arrived in the space, six children were present with one staff member and several of the children were observed crying. Mrs. Melton left immediately and was able to get two additional staff members to assist in the classroom. You stated you were not aware that the classroom was out of ratio and you were not sure why the extra teacher assigned to the classroom was not in the room as she was assigned. Seventy-four (74) children were present during today’s visit. A sanitation inspection was conducted on April 10, 2024. This facility received a superior rating with four (4) demerits. This facility received a satisfactory fire inspection on November 7, 2023. This facility was approved for daytime and overnight care. Monthly playground and fire drills have been conducted and documentation was available for review. Quarterly disaster drills have also been documented. This facility’s corporation status was verified current on the NC Department of the Secretary of State on April 15, 2024. Staff and children files were monitored during today’s visit. The staff and training worksheet was updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. The following violations of child care requirements were cited during today’s visit. Violation Number Comment Rule 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. In the space for infants six infants were observed in the classroom with one staff member. GS 110-91(7);.0713(a-d) 438 Developmentally appropriate equipment and materials were not provided for variety of outdoor activities for vigorous play and large muscle development. On the playground for preschool and school-age children there were not enough materials available for the children to use. 10A NCAC 09 .0509(4) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In the space for school age children sufficient materials were not observed as required. .0510(d)(1) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. A teacher was observed entering the space for infant children and did not wash her hands before feeding an infant. 15A NCAC 18A .2803(a) 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In the space for toddlers and preschool children the mats/cots were not places at least 18 inches apart. 15A NCAC 18A .2821(e) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In the space for toddler & preschool children over the counter medication (creams) did not have the children's name listed on the tube. 10A NCAC 09 .0803(4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member did not complete the Health & Safety training as required. .1102(a) Child Care facilities must maintain compliance with applicable childcare requirements at all times. In order to maintain compliance with North Carolina childcare laws and rules, the above violation must be corrected immediately. Please send a letter of compliance stating how the above violation was corrected and what you will do in the future to prevent this violation from being cited. Please email me this letter by May 2, 2024. A follow-up visit will also be conducted to verify compliance with staff/child ratio requirements. CONSULTATION AND RESOURCES Technical assistance regarding how to achieve and maintain compliance was offered. Health & Safety Requirements were also reviewed. MEDICATION: Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. Prevention is the key to prevent poisonings by making sure medications are inaccessible to children. Prescribed medications as well as over the counter (OTC) medicines, must be labeled properly when brought to the childcare facility by the parent/guardian. The medication must be in the original container (with a label that includes the child’s name, date filled, prescribing clinician’s name, pharmacy name and phone number, dosage/instructions, and relevant warnings). It is important that all medications properly contain the child’s first and last name on the medicine and the box (if applicable) to avoid a child receiving the wrong mediation (this also includes OTC medication). We discussed in detail options to assist you with monitoring on a more consistent basis for compliance with mediation requirements in your classrooms. I recommended that you keep a tracking log available for review that lists the mediations (prescribed/over the counter) in each classroom. The tracking log could include the medication, the date it expires and when to notify the parents. It is also recommended that you complete at least monthly checks of the classrooms to ensure all required forms, authorization and action plans are current and accessible. I also recommended that you reach out to your Child Care Health nurse to assist you with monitoring and updating medication information for your children. **ANNUAL REMINDERS: As discussed during today’s visit the following items must be completed/updated annually. --Staff Records: Emergency & Health Questionnaires, annual training, staff evaluations and development plan, fire safety training, aquatic policy, review of EPR Plan and Emergency Care Plan review. --Children Records: Updated emergency information and transportation forms --These documents will be monitored for compliance during each annual compliance visit. Sample forms can be found on the DCDEE website. RATED LICENSE UPDATE: The hold harmless legislation was extended and signed into law on Monday June 12, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each includes a preparation year and a reassessment year. Your facility is in Cohort Three, the preparation year for Cohort Three begins July 1, 2025 and the reassessment year will begin July 1, 2026. I will reach out to you prior to the beginning of the preparation year of your assigned cohort and will provide guidance to assist you as you begin the process. **I recommended you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2026, and June 30, 2027. --Have all staff update their WORKS account to reflect all currently completed coursework (DCDEE-WORKS) --Determine whether you wish to have the Environment Rating Scale (ERS) Assessment 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 NEW CRIMINAL BACKGROUND CHECK SYSTEM: The new Automated Background Check Management System (ABCMS) launched September 29, 2022 and can be found at https://ncabcms.nc.gov/DCDEE/Applicant/. The new Automated Background Check Management System (ABCMS) replaces the Criminal Background Check Portal as the site where applicants apply for their criminal background check to obtain a qualification letter to work in childcare. DCDEE has developed a user guide which is available at https://ncchildcare.ncdhhs.gov/Home/DCDEE-Sections/Criminal-Background-Check-Unit/Basic-Information. NEW CHILD CARE SANITATION RULES: The NC Children’s Environmental Health has re-adopted child care sanitation rules effective July 1, 2023. These rules can be found on the DCDEE website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/S/Section_2800_Sanitation_of_Child_Care_Centers.pdf. UPDATED RULES: Effective July 1, 2023, we have new rules posted on the DCDEE website. The changes are within the rules for: staff/child ratios and group sizes .0713, cooperative arrangements .2513, and enhanced space requirements .2809. Please refer to the website for more information. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ FINAL COMMENTS: You were provided an opportunity to ask questions regarding interpretation and implementation of all child care requirements. We appreciate all you are doing to serve the children and families of NC. If you have any further questions or concerns, please contact me at: Samantha R. McLeod Child Care Consultant (336) 580-5363 (336) 559-3513 (fax) samantha.mcleod@dhhs.nc.gov www.ncchildcare.nc.gov (DCDEE Website) Mailing Address: 2201 Mail Service Road Raleigh, NC 27699 If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

10A NCAC 09 .0509 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SAMANTHA MCLEOD Operation Type: Center Case Number: Visit Date: 4/18/2024 Number Present: 74 Completed Date: 4/18/2024 Age: From 0 To 12 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor for compliance during an annual compliance visit. A checklist was used to note the requirements I monitored today. This facility currently operates with a Four Star license issued on March 2, 2022. Upon arrival to the facility, I was greeted by the administrator Mrs. Katrina Melton. Mrs. Melton assisted me during my visit today. A walk-thru of the indoor and outdoor spaces used by the children was conducted. During today’s visit, I observed the children during center time, outdoor time and small group activities. During today’s visit, I observed the children during center time, meal times, rest time, outdoor time and transition routines. Several infant feedings and diaper changes were observed in the space for infants. During my monitoring of the classroom spaces, I observed the space for infants out of staff/child ratio. When we arrived in the space, six children were present with one staff member and several of the children were observed crying. Mrs. Melton left immediately and was able to get two additional staff members to assist in the classroom. You stated you were not aware that the classroom was out of ratio and you were not sure why the extra teacher assigned to the classroom was not in the room as she was assigned. Seventy-four (74) children were present during today’s visit. A sanitation inspection was conducted on April 10, 2024. This facility received a superior rating with four (4) demerits. This facility received a satisfactory fire inspection on November 7, 2023. This facility was approved for daytime and overnight care. Monthly playground and fire drills have been conducted and documentation was available for review. Quarterly disaster drills have also been documented. This facility’s corporation status was verified current on the NC Department of the Secretary of State on April 15, 2024. Staff and children files were monitored during today’s visit. The staff and training worksheet was updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. The following violations of child care requirements were cited during today’s visit. Violation Number Comment Rule 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. In the space for infants six infants were observed in the classroom with one staff member. GS 110-91(7);.0713(a-d) 438 Developmentally appropriate equipment and materials were not provided for variety of outdoor activities for vigorous play and large muscle development. On the playground for preschool and school-age children there were not enough materials available for the children to use. 10A NCAC 09 .0509(4) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In the space for school age children sufficient materials were not observed as required. .0510(d)(1) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. A teacher was observed entering the space for infant children and did not wash her hands before feeding an infant. 15A NCAC 18A .2803(a) 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In the space for toddlers and preschool children the mats/cots were not places at least 18 inches apart. 15A NCAC 18A .2821(e) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In the space for toddler & preschool children over the counter medication (creams) did not have the children's name listed on the tube. 10A NCAC 09 .0803(4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member did not complete the Health & Safety training as required. .1102(a) Child Care facilities must maintain compliance with applicable childcare requirements at all times. In order to maintain compliance with North Carolina childcare laws and rules, the above violation must be corrected immediately. Please send a letter of compliance stating how the above violation was corrected and what you will do in the future to prevent this violation from being cited. Please email me this letter by May 2, 2024. A follow-up visit will also be conducted to verify compliance with staff/child ratio requirements. CONSULTATION AND RESOURCES Technical assistance regarding how to achieve and maintain compliance was offered. Health & Safety Requirements were also reviewed. MEDICATION: Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. Prevention is the key to prevent poisonings by making sure medications are inaccessible to children. Prescribed medications as well as over the counter (OTC) medicines, must be labeled properly when brought to the childcare facility by the parent/guardian. The medication must be in the original container (with a label that includes the child’s name, date filled, prescribing clinician’s name, pharmacy name and phone number, dosage/instructions, and relevant warnings). It is important that all medications properly contain the child’s first and last name on the medicine and the box (if applicable) to avoid a child receiving the wrong mediation (this also includes OTC medication). We discussed in detail options to assist you with monitoring on a more consistent basis for compliance with mediation requirements in your classrooms. I recommended that you keep a tracking log available for review that lists the mediations (prescribed/over the counter) in each classroom. The tracking log could include the medication, the date it expires and when to notify the parents. It is also recommended that you complete at least monthly checks of the classrooms to ensure all required forms, authorization and action plans are current and accessible. I also recommended that you reach out to your Child Care Health nurse to assist you with monitoring and updating medication information for your children. **ANNUAL REMINDERS: As discussed during today’s visit the following items must be completed/updated annually. --Staff Records: Emergency & Health Questionnaires, annual training, staff evaluations and development plan, fire safety training, aquatic policy, review of EPR Plan and Emergency Care Plan review. --Children Records: Updated emergency information and transportation forms --These documents will be monitored for compliance during each annual compliance visit. Sample forms can be found on the DCDEE website. RATED LICENSE UPDATE: The hold harmless legislation was extended and signed into law on Monday June 12, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each includes a preparation year and a reassessment year. Your facility is in Cohort Three, the preparation year for Cohort Three begins July 1, 2025 and the reassessment year will begin July 1, 2026. I will reach out to you prior to the beginning of the preparation year of your assigned cohort and will provide guidance to assist you as you begin the process. **I recommended you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2026, and June 30, 2027. --Have all staff update their WORKS account to reflect all currently completed coursework (DCDEE-WORKS) --Determine whether you wish to have the Environment Rating Scale (ERS) Assessment 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 NEW CRIMINAL BACKGROUND CHECK SYSTEM: The new Automated Background Check Management System (ABCMS) launched September 29, 2022 and can be found at https://ncabcms.nc.gov/DCDEE/Applicant/. The new Automated Background Check Management System (ABCMS) replaces the Criminal Background Check Portal as the site where applicants apply for their criminal background check to obtain a qualification letter to work in childcare. DCDEE has developed a user guide which is available at https://ncchildcare.ncdhhs.gov/Home/DCDEE-Sections/Criminal-Background-Check-Unit/Basic-Information. NEW CHILD CARE SANITATION RULES: The NC Children’s Environmental Health has re-adopted child care sanitation rules effective July 1, 2023. These rules can be found on the DCDEE website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/S/Section_2800_Sanitation_of_Child_Care_Centers.pdf. UPDATED RULES: Effective July 1, 2023, we have new rules posted on the DCDEE website. The changes are within the rules for: staff/child ratios and group sizes .0713, cooperative arrangements .2513, and enhanced space requirements .2809. Please refer to the website for more information. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ FINAL COMMENTS: You were provided an opportunity to ask questions regarding interpretation and implementation of all child care requirements. We appreciate all you are doing to serve the children and families of NC. If you have any further questions or concerns, please contact me at: Samantha R. McLeod Child Care Consultant (336) 580-5363 (336) 559-3513 (fax) samantha.mcleod@dhhs.nc.gov www.ncchildcare.nc.gov (DCDEE Website) Mailing Address: 2201 Mail Service Road Raleigh, NC 27699 If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS 110-91 · Violation

Name of Operation: GENTLE GEMS DEVELOPMENTAL LEARNING CENTER Facility ID: 41002403 Consultant: SAMANTHA MCLEOD Operation Type: Center Case Number: Visit Date: 4/18/2024 Number Present: 74 Completed Date: 4/18/2024 Age: From 0 To 12 Total Minutes: 360 Time In: 09:30 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor for compliance during an annual compliance visit. A checklist was used to note the requirements I monitored today. This facility currently operates with a Four Star license issued on March 2, 2022. Upon arrival to the facility, I was greeted by the administrator Mrs. Katrina Melton. Mrs. Melton assisted me during my visit today. A walk-thru of the indoor and outdoor spaces used by the children was conducted. During today’s visit, I observed the children during center time, outdoor time and small group activities. During today’s visit, I observed the children during center time, meal times, rest time, outdoor time and transition routines. Several infant feedings and diaper changes were observed in the space for infants. During my monitoring of the classroom spaces, I observed the space for infants out of staff/child ratio. When we arrived in the space, six children were present with one staff member and several of the children were observed crying. Mrs. Melton left immediately and was able to get two additional staff members to assist in the classroom. You stated you were not aware that the classroom was out of ratio and you were not sure why the extra teacher assigned to the classroom was not in the room as she was assigned. Seventy-four (74) children were present during today’s visit. A sanitation inspection was conducted on April 10, 2024. This facility received a superior rating with four (4) demerits. This facility received a satisfactory fire inspection on November 7, 2023. This facility was approved for daytime and overnight care. Monthly playground and fire drills have been conducted and documentation was available for review. Quarterly disaster drills have also been documented. This facility’s corporation status was verified current on the NC Department of the Secretary of State on April 15, 2024. Staff and children files were monitored during today’s visit. The staff and training worksheet was updated during today’s visit. Your signature on these forms serves as verification the information provided is accurate and complete. The following violations of child care requirements were cited during today’s visit. Violation Number Comment Rule 301 Minimum staff/child ratios and group sizes for the number and ages of children in care were not met. In the space for infants six infants were observed in the classroom with one staff member. GS 110-91(7);.0713(a-d) 438 Developmentally appropriate equipment and materials were not provided for variety of outdoor activities for vigorous play and large muscle development. On the playground for preschool and school-age children there were not enough materials available for the children to use. 10A NCAC 09 .0509(4) 468 When three year old children and older were in care, the materials and equipment in the activity area was not in sufficient quantity to allow at least three children to use the area regardless of whether the children choose the same or different activities. In the space for school age children sufficient materials were not observed as required. .0510(d)(1) 609 Staff did not wash their hands thoroughly before beginning work, before/after handling food, before bottle feeding or serving to other children, after toileting or handling body fluids, after diaper changing and after handling soiled items. A teacher was observed entering the space for infant children and did not wash her hands before feeding an infant. 15A NCAC 18A .2803(a) 614 Bed, cribs, playpens, cots or mats were not placed at least 18" apart or separated by partitions when in use. In the space for toddlers and preschool children the mats/cots were not places at least 18 inches apart. 15A NCAC 18A .2821(e) 846 Over-the-counter medicines were not in their original containers or administered as authorized in writing by parent, physician or authorized health professional. In the space for toddler & preschool children over the counter medication (creams) did not have the children's name listed on the tube. 10A NCAC 09 .0803(4) 1898 Staff did not complete the health and safety training within one year of employment. One staff member did not complete the Health & Safety training as required. .1102(a) Child Care facilities must maintain compliance with applicable childcare requirements at all times. In order to maintain compliance with North Carolina childcare laws and rules, the above violation must be corrected immediately. Please send a letter of compliance stating how the above violation was corrected and what you will do in the future to prevent this violation from being cited. Please email me this letter by May 2, 2024. A follow-up visit will also be conducted to verify compliance with staff/child ratio requirements. CONSULTATION AND RESOURCES Technical assistance regarding how to achieve and maintain compliance was offered. Health & Safety Requirements were also reviewed. MEDICATION: Medicines can be crucial to the health and wellness of children. They can also be very dangerous if the wrong type or wrong amount is given to the wrong person or at the wrong time. Prevention is the key to prevent poisonings by making sure medications are inaccessible to children. Prescribed medications as well as over the counter (OTC) medicines, must be labeled properly when brought to the childcare facility by the parent/guardian. The medication must be in the original container (with a label that includes the child’s name, date filled, prescribing clinician’s name, pharmacy name and phone number, dosage/instructions, and relevant warnings). It is important that all medications properly contain the child’s first and last name on the medicine and the box (if applicable) to avoid a child receiving the wrong mediation (this also includes OTC medication). We discussed in detail options to assist you with monitoring on a more consistent basis for compliance with mediation requirements in your classrooms. I recommended that you keep a tracking log available for review that lists the mediations (prescribed/over the counter) in each classroom. The tracking log could include the medication, the date it expires and when to notify the parents. It is also recommended that you complete at least monthly checks of the classrooms to ensure all required forms, authorization and action plans are current and accessible. I also recommended that you reach out to your Child Care Health nurse to assist you with monitoring and updating medication information for your children. **ANNUAL REMINDERS: As discussed during today’s visit the following items must be completed/updated annually. --Staff Records: Emergency & Health Questionnaires, annual training, staff evaluations and development plan, fire safety training, aquatic policy, review of EPR Plan and Emergency Care Plan review. --Children Records: Updated emergency information and transportation forms --These documents will be monitored for compliance during each annual compliance visit. Sample forms can be found on the DCDEE website. RATED LICENSE UPDATE: The hold harmless legislation was extended and signed into law on Monday June 12, 2023. This legislation allows facilities to remain at their current star level without a reassessment until June 30, 2024. To prepare for the reassessment process, DCDEE has developed a cohort system. There are three cohorts, and each includes a preparation year and a reassessment year. Your facility is in Cohort Three, the preparation year for Cohort Three begins July 1, 2025 and the reassessment year will begin July 1, 2026. I will reach out to you prior to the beginning of the preparation year of your assigned cohort and will provide guidance to assist you as you begin the process. **I recommended you consider completing the following tasks and activities that will help prepare you for your reassessment year, which will be sometime between July 1, 2026, and June 30, 2027. --Have all staff update their WORKS account to reflect all currently completed coursework (DCDEE-WORKS) --Determine whether you wish to have the Environment Rating Scale (ERS) Assessment 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 NEW CRIMINAL BACKGROUND CHECK SYSTEM: The new Automated Background Check Management System (ABCMS) launched September 29, 2022 and can be found at https://ncabcms.nc.gov/DCDEE/Applicant/. The new Automated Background Check Management System (ABCMS) replaces the Criminal Background Check Portal as the site where applicants apply for their criminal background check to obtain a qualification letter to work in childcare. DCDEE has developed a user guide which is available at https://ncchildcare.ncdhhs.gov/Home/DCDEE-Sections/Criminal-Background-Check-Unit/Basic-Information. NEW CHILD CARE SANITATION RULES: The NC Children’s Environmental Health has re-adopted child care sanitation rules effective July 1, 2023. These rules can be found on the DCDEE website at https://ncchildcare.ncdhhs.gov/Portals/0/documents/pdf/S/Section_2800_Sanitation_of_Child_Care_Centers.pdf. UPDATED RULES: Effective July 1, 2023, we have new rules posted on the DCDEE website. The changes are within the rules for: staff/child ratios and group sizes .0713, cooperative arrangements .2513, and enhanced space requirements .2809. Please refer to the website for more information. For the latest information on childcare rules and regulations, please visit the Division of Child Development and Early Education's website at https://ncchildcare.ncdhhs.gov/ FINAL COMMENTS: You were provided an opportunity to ask questions regarding interpretation and implementation of all child care requirements. We appreciate all you are doing to serve the children and families of NC. If you have any further questions or concerns, please contact me at: Samantha R. McLeod Child Care Consultant (336) 580-5363 (336) 559-3513 (fax) samantha.mcleod@dhhs.nc.gov www.ncchildcare.nc.gov (DCDEE Website) Mailing Address: 2201 Mail Service Road Raleigh, NC 27699 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