Little Lambs Childcare #2

10A NCAC 09 .1720 · Violation

Name of Operation: LITTLE LAMBS CHILDCARE #2 Facility ID: 18000467 Consultant: MERIA WILDER Operation Type: Family CC Home Case Number: Visit Date: 3/19/2025 Number Present: 5 Completed Date: 3/19/2025 Age: From 0 To 3 Total Minutes: 239 Time In: 10:01 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Lee Anna Flowers, Owner/Operator, assisted me with today’s visit. I observed all required posted in at the facility entrance including the following: four-star rated license, NC Summary of Child Care Law dated February 2025, Emergency Medical Care Plan, Emergency Phone Numbers, First Aid poster, tobacco free signage, daily schedule, current activity plan, and safe arrival and departure procedures. Your program currently operates with a four-star license, issued on December 27, 2019, earning seven (7) points in staff education, two (2) points in program standards and one (1) quality point. Your facility operates with the following permit restrictions: daytime care and overnight care, maximum of 5 preschool children in care at any time and serves no more than 2 infants under one (1) year old at any time. Your center's compliance history was 100% as of March 19, 2025, and was reviewed with you today. Your last annual compliance visit was conducted on July 24, 2024. I monitored all indoor spaces. I observed children in both the indoor learning environment. I observed children throughout the home participating in free play in activity areas, transitions, and personal care routines. I monitored for general safety, storage of hazardous products was monitored, appropriate discipline, storage of medication and medication administration were monitored. Program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan were monitored. Today, reviewed staff record files for four (4) existing staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training and completion of the Recognizing and Responding to Suspicions of Child Maltreatment training. There were no new staff members to monitor today. You sent me your current handbook by email and it included: written operational, administrative, and personnel policies and your parent participation plan in my office. You stated your written policies and procedures had not changed. Children were adequately supervised, appropriate discipline and permit restrictions were maintained during today’s visit. Today’s lunch was appropriate and contained all meal pattern guideline components. I monitored one (1) topical medication and one (1) medication permission to administer form. There were no Medical Action Plans to monitor. I monitored screen time logs, incident report logs and the current Emergency Preparedness and Response plan dated June 24, 2024. Your facility does provide transportation. Transportation requirements were monitored during the annual compliance visit. Your most recent fire drill was conducted on March 7, 2025, and has been completed monthly for the past twelve (12) months and your most recent shelter in place emergency drill was conducted March 7, 2025, and has been completed quarterly. I monitored for all health and safety requirements during today’s visit. The following violation was cited during today’s visit: Violation Number Comment Rule 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). There was one (1) medication permission to administer form for Aquafor healing ointment, did not list the date of expiration and was left blank. 10A NCAC 09 .1720(c)(4) TECHNICAL ASSISTANCE: • There was one (1) medication permission to administer form for Aquafor healing ointment, did not list the date of expiration and was left blank. This item was corrected during the visit by you updating the manufactures expiration date on the form as listed on manufacturers packaging. As discussed, the medication permission to administer form should include the directions for how to administer the medication is to be administered, medication expiration date, name of the child to receive the medication, amount of medication to apply, parent signature, date of signature, date the form was completed and the valid dates the medication may be administered. To maintain compliance with this child care requirement, I suggest you review all medication permission to administer forms when received from the parent and before the parent leaves the facility at the time of receiving the medication. CONSULTATION: • DCDEE Resources - Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. - Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License - Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development - Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings - Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy - DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New • Child Care facility’s now have until May 31, 2025, to enroll in the lead in water testing, lead based paint testing and Asbestos testing through Clean Water for US Kids. The following link will take you to the website to enroll https://www.cleanwaterforuskids.org/en/carolina/. • ABCMS SYSTEM: The process of notifying the Division of any new child care providers working who are hired or moved into the child care facility within five business days 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. 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 as stated in G.S. 110-90.2 & .2703(r) 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. • When reviewing Staff Files, Children’s Files, and Program Records, utilize the Staff Files Checklist, Children’s File Checklist, Volunteer Files Checklist and the Program Records File Checklist to ensure that you are maintaining compliance with all of the files that are monitored by DCDEE and that all of the documents within those files are current, accurate and relevant. These forms should be updated annually with staff files, children’s records and program record documents to ensure that all information stored in your facilities files are current and accurate prior to DCDEE monitoring visits. These file checklists can be found on the DCDEE website under provider documents. • Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. • Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. COMPLIANCE PLAN: • No compliance documentation is needed. All violations that were cited during today’s visit were corrected during the visit. In the visit summary, I documented the corrective actions taken today to correct the violation that was cited. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (980) 434-3877 or by email at meria.wilder@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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: LITTLE LAMBS CHILDCARE #2 Facility ID: 18000467 Consultant: MERIA WILDER Operation Type: Family CC Home Case Number: Visit Date: 3/19/2025 Number Present: 5 Completed Date: 3/19/2025 Age: From 0 To 3 Total Minutes: 239 Time In: 10:01 AM Time Out: 02:00 PM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements for a routine unannounced visit. You, Lee Anna Flowers, Owner/Operator, assisted me with today’s visit. I observed all required posted in at the facility entrance including the following: four-star rated license, NC Summary of Child Care Law dated February 2025, Emergency Medical Care Plan, Emergency Phone Numbers, First Aid poster, tobacco free signage, daily schedule, current activity plan, and safe arrival and departure procedures. Your program currently operates with a four-star license, issued on December 27, 2019, earning seven (7) points in staff education, two (2) points in program standards and one (1) quality point. Your facility operates with the following permit restrictions: daytime care and overnight care, maximum of 5 preschool children in care at any time and serves no more than 2 infants under one (1) year old at any time. Your center's compliance history was 100% as of March 19, 2025, and was reviewed with you today. Your last annual compliance visit was conducted on July 24, 2024. I monitored all indoor spaces. I observed children in both the indoor learning environment. I observed children throughout the home participating in free play in activity areas, transitions, and personal care routines. I monitored for general safety, storage of hazardous products was monitored, appropriate discipline, storage of medication and medication administration were monitored. Program records including emergency medical care plan, safe arrival and departure procedures, incident log, outdoor safety inspections, fire drills, emergency drills, and your Emergency Preparedness Response (EPR) Plan were monitored. Today, reviewed staff record files for four (4) existing staff members to verify current and valid Criminal Background Check qualification letters, valid CPR and First Aid training, valid ITS-SIDS training and completion of the Recognizing and Responding to Suspicions of Child Maltreatment training. There were no new staff members to monitor today. You sent me your current handbook by email and it included: written operational, administrative, and personnel policies and your parent participation plan in my office. You stated your written policies and procedures had not changed. Children were adequately supervised, appropriate discipline and permit restrictions were maintained during today’s visit. Today’s lunch was appropriate and contained all meal pattern guideline components. I monitored one (1) topical medication and one (1) medication permission to administer form. There were no Medical Action Plans to monitor. I monitored screen time logs, incident report logs and the current Emergency Preparedness and Response plan dated June 24, 2024. Your facility does provide transportation. Transportation requirements were monitored during the annual compliance visit. Your most recent fire drill was conducted on March 7, 2025, and has been completed monthly for the past twelve (12) months and your most recent shelter in place emergency drill was conducted March 7, 2025, and has been completed quarterly. I monitored for all health and safety requirements during today’s visit. The following violation was cited during today’s visit: Violation Number Comment Rule 1405 Authorization for up to 12 months to apply over-the-counter medications, topical ointment, topical teething ointment or gel, insect repellents, fluoridated toothpaste, lotions, creams, and powders; such as sunscreen, diapering creams, baby lotion, and baby powder, to a child, when needed, was not in writing and did not contain information required by rule .1720(b)(7). There was one (1) medication permission to administer form for Aquafor healing ointment, did not list the date of expiration and was left blank. 10A NCAC 09 .1720(c)(4) TECHNICAL ASSISTANCE: • There was one (1) medication permission to administer form for Aquafor healing ointment, did not list the date of expiration and was left blank. This item was corrected during the visit by you updating the manufactures expiration date on the form as listed on manufacturers packaging. As discussed, the medication permission to administer form should include the directions for how to administer the medication is to be administered, medication expiration date, name of the child to receive the medication, amount of medication to apply, parent signature, date of signature, date the form was completed and the valid dates the medication may be administered. To maintain compliance with this child care requirement, I suggest you review all medication permission to administer forms when received from the parent and before the parent leaves the facility at the time of receiving the medication. CONSULTATION: • DCDEE Resources - Stay updated with changes and new rule updates by visiting the DCDEE website at https://ncchildcare.ncdhhs.gov/. - Child Care Rules and Laws: https://ncchildcare.ncdhhs.gov/Services/Licensing/Getting-a-License - Training and Professional Development: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development - Required Health and Safety Training: https://ncchildcare.ncdhhs.gov/Provider/Training-and-Professional-Development/Health-and-Safety-Trainings - Care for Children Receiving Subsidy: https://ncchildcare.ncdhhs.gov/Provider/Providing-Child-Care/Subsidized-Child-Care/Care-for-Children-Receiving-Subsidy - DCDEE Updates, Current Projects, and information applicable to Child Care in NC: https://ncchildcare.ncdhhs.gov/Whats-New • Child Care facility’s now have until May 31, 2025, to enroll in the lead in water testing, lead based paint testing and Asbestos testing through Clean Water for US Kids. The following link will take you to the website to enroll https://www.cleanwaterforuskids.org/en/carolina/. • ABCMS SYSTEM: The process of notifying the Division of any new child care providers working who are hired or moved into the child care facility within five business days 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. 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 as stated in G.S. 110-90.2 & .2703(r) 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. • When reviewing Staff Files, Children’s Files, and Program Records, utilize the Staff Files Checklist, Children’s File Checklist, Volunteer Files Checklist and the Program Records File Checklist to ensure that you are maintaining compliance with all of the files that are monitored by DCDEE and that all of the documents within those files are current, accurate and relevant. These forms should be updated annually with staff files, children’s records and program record documents to ensure that all information stored in your facilities files are current and accurate prior to DCDEE monitoring visits. These file checklists can be found on the DCDEE website under provider documents. • Please continue to visit DCDEE’s website at https://ncchildcare.ncdhhs.gov/ to get the latest information for child care settings and child care updates including the most up to date documents and forms. • Visit NC Child Care Health and Safety Resource Center at http://healthychildcare.unc.edu to find the following resources: technical assistance, coaching support, resources, handwashing and diapering posters, monthly newsletters, and a list of approved in-service trainings including, but not limited to, ITS-SIDS training and Emergency Preparedness and Response in Child Care training. COMPLIANCE PLAN: • No compliance documentation is needed. All violations that were cited during today’s visit were corrected during the visit. In the visit summary, I documented the corrective actions taken today to correct the violation that was cited. At the completion of the visit, this visit summary was printed, reviewed, and a copy was left with you today. We appreciate all you and your staff do to serve the children and families in your community. If you have any questions, feel free to contact me by phone at (980) 434-3877 or by email at meria.wilder@dhhs.nc.gov or my supervisor, Erin Pickard, by email at erin.pickard@dhhs.nc.gov. Thank you for your time today. 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