10A NCAC 09 .1724 · Violation

Name of Operation: FORNEY'S FUN HOUSE FAMILY CHILDCARE HOME Facility ID: 55000166 Consultant: KRISTEN R. MAUNEY Operation Type: Family CC Home Case Number: Visit Date: 8/27/2024 Number Present: 5 Completed Date: 8/27/2024 Age: From 0 To 3 Total Minutes: 157 Time In: 09:13 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements, including health and safety, for an annual compliance visit. The visit was conducted with you, Delouise Forney, Operator. Your program currently operates with a Five star rated license effective September 10, 2019. The program’s compliance history was 94 percent as of August 27, 2024. You stated your business is not incorporated. The FCCH and Centers Located in a Residence Operator’s Statements of Responsibility form and the Verification of Required Information for Operator and Additional Caregivers form was completed and signed during today’s visit. Your signature on these forms served as verification the information provided was accurate and complete. Your staff records were monitored during the visit. Five children were present today. I observed children engaged in free play activities indoors and gross motor activities outdoors. The caregiver was actively involved with the children. Five children, nine months to three years of age, were enrolled. The most recent outdoor inspection checklist was completed on August 1, 2024. The most recent fire drill was conducted on August 9, 2024. The most recent quarterly drill was conducted on June 11, 2024. Criminal Background Check Qualifying letters for you and household members were reviewed and were in compliance during today’s visit. The most recent lead water testing results were completed on August 16, 2023. You may check your results by visiting https://www.cleanwaterforuskids.org/en/carolina/. You also received lead water testing results from K&W Laboratories on February 7, 2024. The following violations of child care requirements were observed during today’s visit. The violations and technical assistance were thoroughly reviewed with you and documented in the Visit Summary given to you at the conclusion of the visit. Violation Number Comment Rule 714 Monthly check for hazards on the outdoor play area was not completed using a form supplied by the Division. The outdoor checklist for June 2024 was not completed in full. 10A NCAC .1721(e)(5)(A-F) 1718 The written plan of care was not given and explained to parents of children in care on or before the first day the child attended the home. Parents did not sign a statement acknowledging the receipt and explanation of the plan. Parents did not give written permission for their child to be transported by the operator for specific routine tasks that are included on the written schedule. The Written Plan of Care was not on file for review for one infant enrolled on 8/26/2024. .1712(e )(6) 1810 Operator did not retain the safe sleep acknowledgement in the child's records as long as the child was enrolled. The Safe Sleep Policy acknowledgement was not on file for review for one infant enrolled on 8/26/2024. 10A NCAC 09 .1724(c) 1821 Caregivers did not document compliance with visually checking on sleeping infants aged 12 months or younger and/or the documents were not maintained for a minimum of 30 days. The operator did not document sleep checks for one infant on 8/26/2024. .1724(a)(8)&(f) 1890 Biocontaminants were not stored in locked areas, or removed from the premises or otherwise inaccessible to children, or disposed of in a covered, plastic lined receptacle. Soiled diapers were observed in a trash can without a plastic liner and without a lid beside the handwashing sink. .1719(a)(8) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by September 10, 2024. Please send your letter to Kristen.Mauney@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical Assistance regarding the violation observed- Outdoor checklists- Monthly checks for hazards on the outdoor play area must be completed using a form supplied by the Division. The checklist on file available for review only included the date of the inspection, however, none of the information was marked to reflect the inspection was completed. I suggested that you mark the checklist while actively conducting the outdoor inspection. Written Plan of Care- I suggested that you utilize the Children’s File Checklist available of the DCDEE website under provider documents and forms to assist with ensuring all required documents are on file within the required timeframe. The written plan of care must be given and explained to parents of children in care on or before the first day the child attended the home. Parents must sign a statement acknowledging the receipt and explanation of the plan. Parents must give written permission for their child to be transported by the operator for specific routine tasks that are included on the written schedule. We discussed your Written Plan of Care and you confirmed you do not transport children. Safe Sleep Policy- I suggested that you utilize the Children’s File Checklist available of the DCDEE website under provider documents and forms to assist with ensuring all required documents are on file within the required timeframe. I also suggested creating an packet for enrollment specifically for infants to ensure the paperwork required for an infant is obtained. A copy of the operator's safe sleep policy shall be given and explained to the parents of an infant aged 12 months or younger on or before the first day the infant attends the home. The parent shall sign a statement acknowledging the receipt and explanation of the policy. The acknowledgement shall contain: (1) the infant's name; (2) the date the infant first attended the home; (3) the date the operator's safe sleep policy was given and explained to the parent; and (4) the date the parent signed the acknowledgement. The operator shall retain the acknowledgement in the child's record as long as the child is enrolled at the home. Safe sleep checks- Caregivers must document compliance with visually checking on sleeping infants aged 12 months or younger and the documents must be maintained for a minimum of 30 days. The operator/caregiver shall visually check sleeping infants at least every 15 minutes. I suggested that you immediately implement safe sleep checks for the one infant that is currently enrolled. To assist with completing safe sleep checks every fifteen minutes, I suggested that you use a timer. Storage of biocontaminants- Biocontaminants must be stored in locked areas, removed from the premises or otherwise inaccessible to children, or disposed of in a covered, plastic lined receptacle. I reminded you to discard soiled diapers, soiled tissues, band-aids, etc. in a covered, plastic lined receptacle. You had a trash can with a lid and foot pedal in your bathroom. Consultation: -You may visit http://www.cleanwaterforuskids.org/carolina to check the results of asbestos and lead paint testing. The website states your facility is waiting for on-site visit results. -If you plan to utilize substitutes in the future, we discussed ensuring their files are current prior to allowing them to work. This includes criminal background checks. You stated you do not have additional caregivers at this time. -We discussed plastic wipe packaging and safety warnings listed on the package. You may either remove wipes from the plastic packaging and place in a hard, plastic container or keep wipe packages out of reach of children at a vertical distance of at least five feet from the floor. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-853-9196. Kristen Mauney, Child Care Consultant PO Box 674 Denver, NC 28037 Kristen.Mauney@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1725 · Violation

Name of Operation: FORNEY'S FUN HOUSE FAMILY CHILDCARE HOME Facility ID: 55000166 Consultant: KRISTEN R. MAUNEY Operation Type: Family CC Home Case Number: Visit Date: 9/21/2023 Number Present: 5 Completed Date: 9/21/2023 Age: From 1 To 3 Total Minutes: 137 Time In: 09:33 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements, including health and safety training, for an annual compliance visit. You, Delouise Forney, Operator, assisted me with the visit. Your program currently operates with a Five star rated license effective September 10, 2019. The program’s compliance history was 98 percent as of September 21, 2023. You stated your business is not incorporated. The FCCH and Centers Located in a Residence Operator’s Statements of Responsibility form and the Verification of Required Information for Operator and Additional Caregivers form was completed and signed during today’s visit. Your signature on these forms served as verification the information provided was accurate and complete. Your staff records were monitored during the visit. Five children were present today. I observed children engaged in free play activities indoors and gross motor activities outdoors. The caregiver was actively involved with the children. Five children, one through three years of age, were enrolled. The most recent outdoor inspection checklist was completed on September 1, 2023. The most recent fire drill was conducted on September 11, 2023. The most recent quarterly drill was conducted on September 11, 2023. Criminal Background Check Qualifying letters for you and household members were reviewed and were in compliance during today’s visit. The following violations of child care requirements were observed during today’s visit. The violations and technical assistance were thoroughly reviewed with you and documented on the Visit Summary sent to you at the conclusion of the visit. Violation Number Comment Rule 801 Bacteriological analysis indicating the water is free of bacteria had not been performed on a sample of water from each well used for the children's water supply every two years. Results were not kept on file in the home. The most recent well water analysis on file for review was dated 1/3/2020. 10A NCAC 09 .1725(a)(1) 908 Health questionnaire was not completed annually. The most recent Health Questionnaire on file for review for the operator was dated 1/5/2022. .1703(a)(1) 1920 Indoor and outdoor area was not checked daily for debris, vandalism, broken equipment, and animal waste. On the playground, one red and blue plastic tricycle had two 3-inch cracks with sharp edges on both sides of the seat. .1719(a)(17) 2023 Operator and/or staff who work with children, did not complete health and safety training as part of on-going training so that every five years, all the topic areas were covered. Health and safety training was completed in 2017. The operator did not complete all required health and safety training within 5 years. The operator needs to complete Medication in Child Care training, last completed on 3/23/2017, to complete the five-year on-going health and training requirement. .1703(d)(2) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by October 5, 2023. Please send your letter to Kristen.Mauney@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical Assistance regarding the violation observed- Well water analysis- -Bacteriological analysis indicating the water is free of bacteria shall be performed on a sample of water from each well used for the children's water supply every two years. Results shall be kept on file in the home. Please schedule a well water analysis at your Family Child Care Home no later than October 5, 2023. Staff Health Questionnaire- -After receiving a license, the family child care home operator shall update the health questionnaire annually. The Division may request an evaluation of the operator's emotional and physical fitness to care for children when there is reason to believe that there has been a deterioration in the operator's emotional or physical fitness to care for children. This request may be based upon factors such as observations by staff, reports of concern from family, reports from law enforcement or reports from medical personnel. The Division may require the operator to obtain written proof that he or she is free of active tuberculosis when the Division determines that the operator was exposed to a person with active tuberculosis. Please complete an updated Health Questionnaire and keep it on file for review. I recommended that you update all annual documents at the same time each year. Safe Outdoor Environment- -The operator removed the tricycle from the playground during the visit. I reminded you to check the indoor and outdoor environment daily for debris, vandalism, broken equipment and animal waste. The operator shall keep all areas used by the children, indoors and outdoors, clean and orderly and free of items which are potentially hazardous to children. This includes the removal of items that a child can swallow and use of outdoor play equipment that is too hot to touch. In addition, loose nails or screws and splinters shall be removed on inside and outside equipment. Health and Safety Training- -The operator needs to complete Medication in Child Care training, last completed on 3/23/2017, to complete the five-year on-going health and training requirement. This training must be completed by 10/5/2023. I recommended that you utilize the Record of Health and Training Safety log available on the DCDEE website to assist you with tracking required health and safety trainings. Consultation: -We discussed child care rule 10A NCAC 09 .1706(a) regarding nutrition standards and meal patterns. Rice is considered a grain and not a vegetable. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-853-9196. Kristen Mauney, Child Care Consultant PO Box 674 Denver, NC 28037 Kristen.Mauney@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

Open Not marked corrected in the state record

Category: supervision. Open / not marked corrected.

10A NCAC 09 .1706 · Violation

Name of Operation: FORNEY'S FUN HOUSE FAMILY CHILDCARE HOME Facility ID: 55000166 Consultant: KRISTEN R. MAUNEY Operation Type: Family CC Home Case Number: Visit Date: 9/21/2023 Number Present: 5 Completed Date: 9/21/2023 Age: From 1 To 3 Total Minutes: 137 Time In: 09:33 AM Time Out: 11:50 AM Time In: Time Out: List to Use: Family CC Home Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s visit was to monitor your program for compliance with applicable child care requirements, including health and safety training, for an annual compliance visit. You, Delouise Forney, Operator, assisted me with the visit. Your program currently operates with a Five star rated license effective September 10, 2019. The program’s compliance history was 98 percent as of September 21, 2023. You stated your business is not incorporated. The FCCH and Centers Located in a Residence Operator’s Statements of Responsibility form and the Verification of Required Information for Operator and Additional Caregivers form was completed and signed during today’s visit. Your signature on these forms served as verification the information provided was accurate and complete. Your staff records were monitored during the visit. Five children were present today. I observed children engaged in free play activities indoors and gross motor activities outdoors. The caregiver was actively involved with the children. Five children, one through three years of age, were enrolled. The most recent outdoor inspection checklist was completed on September 1, 2023. The most recent fire drill was conducted on September 11, 2023. The most recent quarterly drill was conducted on September 11, 2023. Criminal Background Check Qualifying letters for you and household members were reviewed and were in compliance during today’s visit. The following violations of child care requirements were observed during today’s visit. The violations and technical assistance were thoroughly reviewed with you and documented on the Visit Summary sent to you at the conclusion of the visit. Violation Number Comment Rule 801 Bacteriological analysis indicating the water is free of bacteria had not been performed on a sample of water from each well used for the children's water supply every two years. Results were not kept on file in the home. The most recent well water analysis on file for review was dated 1/3/2020. 10A NCAC 09 .1725(a)(1) 908 Health questionnaire was not completed annually. The most recent Health Questionnaire on file for review for the operator was dated 1/5/2022. .1703(a)(1) 1920 Indoor and outdoor area was not checked daily for debris, vandalism, broken equipment, and animal waste. On the playground, one red and blue plastic tricycle had two 3-inch cracks with sharp edges on both sides of the seat. .1719(a)(17) 2023 Operator and/or staff who work with children, did not complete health and safety training as part of on-going training so that every five years, all the topic areas were covered. Health and safety training was completed in 2017. The operator did not complete all required health and safety training within 5 years. The operator needs to complete Medication in Child Care training, last completed on 3/23/2017, to complete the five-year on-going health and training requirement. .1703(d)(2) The violations documented above must be corrected immediately. Send me a letter of compliance describing in detail specifically how each violation was corrected and how compliance will be maintained in the future. Include the violation item number, statement of compliance, date of the visit and license ID number in the letter. I must receive your compliance statement by October 5, 2023. Please send your letter to Kristen.Mauney@dhhs.nc.gov. Failure to correct the violations and send the written statement by the due date may result in an unannounced follow-up visit being conducted or an administrative action may be recommended. The Division of Child Development may take administrative action against the license and/or impose civil penalties based on the failure of the operator to correct any documented violations within the established time period. Technical Assistance regarding the violation observed- Well water analysis- -Bacteriological analysis indicating the water is free of bacteria shall be performed on a sample of water from each well used for the children's water supply every two years. Results shall be kept on file in the home. Please schedule a well water analysis at your Family Child Care Home no later than October 5, 2023. Staff Health Questionnaire- -After receiving a license, the family child care home operator shall update the health questionnaire annually. The Division may request an evaluation of the operator's emotional and physical fitness to care for children when there is reason to believe that there has been a deterioration in the operator's emotional or physical fitness to care for children. This request may be based upon factors such as observations by staff, reports of concern from family, reports from law enforcement or reports from medical personnel. The Division may require the operator to obtain written proof that he or she is free of active tuberculosis when the Division determines that the operator was exposed to a person with active tuberculosis. Please complete an updated Health Questionnaire and keep it on file for review. I recommended that you update all annual documents at the same time each year. Safe Outdoor Environment- -The operator removed the tricycle from the playground during the visit. I reminded you to check the indoor and outdoor environment daily for debris, vandalism, broken equipment and animal waste. The operator shall keep all areas used by the children, indoors and outdoors, clean and orderly and free of items which are potentially hazardous to children. This includes the removal of items that a child can swallow and use of outdoor play equipment that is too hot to touch. In addition, loose nails or screws and splinters shall be removed on inside and outside equipment. Health and Safety Training- -The operator needs to complete Medication in Child Care training, last completed on 3/23/2017, to complete the five-year on-going health and training requirement. This training must be completed by 10/5/2023. I recommended that you utilize the Record of Health and Training Safety log available on the DCDEE website to assist you with tracking required health and safety trainings. Consultation: -We discussed child care rule 10A NCAC 09 .1706(a) regarding nutrition standards and meal patterns. Rice is considered a grain and not a vegetable. Stay up to date with the Division of Child Development and Early Education by visiting https://ncchildcare.ncdhhs.gov. This website enables you to view the entire Law and Child Care Requirements for North Carolina as well as download required forms. I encourage you to click on the "What's New" tab for important updates impacting child care in North Carolina. Thank you for your time today. If you have any questions about today’s visit, please contact me or my supervisor, Tammy McGalliard, at Tammy.McGalliard@dhhs.nc.gov. If I can be of further assistance, you may contact me at 704-853-9196. Kristen Mauney, Child Care Consultant PO Box 674 Denver, NC 28037 Kristen.Mauney@dhhs.nc.gov If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times