NC GS 110-90 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TANYA HERRING Operation Type: Center Case Number: Visit Date: 2/4/2025 Number Present: 35 Completed Date: 2/4/2025 Age: From 0 To 5 Total Minutes: 145 Time In: 12:35 PM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your routine unannounced visit. Upon my arrival, I was greeted by the owner/operator, F. Wilcox. Ms. Wilcox accompanied me as I conducted a general walk- through of the facility which consisted of four (4) classrooms, the outdoor play area, and the kitchen. A total of thirty-five (35) children were present during today’s visit. The children were observed resting during naptime. Today’s snack was in compliance with the Meal Pattern requirements. LICENSE STATUS: This facility currently operates with a five-star rated license issued on December 20, 2019. The NC Secretary of State website was reviewed on February 3, 2025, and First Steps Learning Center, Inc. was listed as current and active. REQUIRED INSPECTIONS/DRILLS: The last annual compliance visit was conducted on May 16, 2024. The last annual fire inspection was completed on May 28, 2024, and the last annual sanitation inspection was completed on December 10, 2024. The last documented monthly fire drill, the last documented quarterly lockdown/shelter-in-place drill, and the last documented playground inspection were all completed on January 31, 2025. During today’s visit, a partial assessment of the child care requirements was conducted. I observed all required postings, attendance logs, and safe sleep logs. I monitored the program records, equipment and furnishings, staff/child ratios & supervision, storage/administering of medication, and the outdoor area and equipment. This facility does not provide transportation. The following violation was observed and documented during today’s visit: Violation Number Comment Rule 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. Clorox, laundry detergent, bulk hand soap, and Fabulosa were stored in an unlocked closet. .2820(b) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 80%. A compliance letter is not required because the violation observed and documented was corrected during the visit. TECHNICAL ASSISTANCE/CONSULTATION: Child care programs are expected to achieve and maintain compliance at all times and are required by NC GS 110-90(4)(d) to achieve and maintain an eighteen-month compliance history score of at least seventy-five percent. Any violation(s) documented may impact the compliance history score. A compliance history score below seventy-five percent may result in an administrative action. STORAGE OF HAZARDOUS PRODUCTS: All storage closets and areas accessible to children must be free of potential safety hazards. All products dispensed from an aerosol dispenser, and substances which may be hazardous to a child if ingested, inhaled, or handled must be stored in a locked area when not in use. Locked areas or storage are those unlocked with a combination, electronic, or magnetic device, key, or equivalent locking device. You also must ensure that the keys are not left in the lock and are inaccessible to children. Thank you for your time today. If you have any questions, please contact me at tanya.herring@dhhs.nc.gov or at 910-624-4171. You may also contact Licensing Supervisor, Teraesa Leak at teraesa.leak@dhhs.nc.gov or by phone at 919-971-7765. 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.

GS 110-91 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 8/28/2024 Number Present: 35 Completed Date: 8/28/2024 Age: From 0 To 5 Total Minutes: 40 Time In: 09:50 AM Time Out: 10:30 AM Time In: Time Out: List to Use: Center Type Of Visit: Admin Action Follow-Up Lic Announced/Unannounced: Unannounced The purpose of today's visit was to assess compliance with applicable NC child care requirements following the issuance of a Written Warning issued to this facility on July 2, 2024. Upon my arrival, I was greeted by the administrator, F. Wilcox. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. The cover letter, Administrative Action, and CAP was also posted. I was accompanied by Ms. Wilcox as I completed a general walk-through of the indoor and outdoor environment. The children were observed during outdoor play, free play, circle time and completing routine tasks. During today’s visit, Ms. Wilcox submitted a sign in sheet containing signatures of the staff members that attended a staff meeting on August 24, 2024. The purpose of the meeting was to discuss the new policies and procedures regarding medication administration, handling and storage of medication and staff/child ratios. In addition, the staff received playground safety training. Prior to today’s visit, the 18-month compliance history was 81%. The following violations were documented during today's visit: Violation Number Comment Rule 428 A current activity plan was not posted for each group of children for reference. In the space designated for infants, the posted activity plan was dated for 8/19/2024 through 8/23/2024. GS 110-91(12); .0508(a) The violation was corrected during today’s visit; therefore no compliance letter is required in response. REVIEW OF ADMINISTRATIVE ACTION: Item #1: This item requires that the facility maintain compliance with applicable child care requirements including but not limited to medication administration and staff/child ratio and grouping requirements. A violation was documented today regarding activity plans. Item #2: This item requires that the Administrator contact me to arrange for a training regarding falsification. The facility is in compliance with this item. The falsification training occurred on August 1, 2024. Item #3: This item requires that you contact Ms. Turlington at the local Smart Start Partnership to request a training on children’s illnesses and administration of medication. The facility is in compliance with this item. The training occurred as scheduled on July 15, 2024. Item #4: This item requires that you review and revise your medication storage and administration polices and procedures within two weeks of the training in item #3. The facility is in compliance with this item. Policies and procedures were approved on August 23, 2024. Item #5: This item requires that you develop a written plan for reviewing the approved policies and procedures in Item #4 with all new staff before they assume duties, and with all staff periodically. This plan is due within two weeks after the approval of the policies in Item #4. The facility is in compliance with this item. The written plan was also approved on August 23, 2024. Item #6: This item requires that you develop procedures that include a staffing pattern plan to ensure enhanced staff/child ratio requirements are being met. This plan is due within three weeks of receipt of the notice of administrative action. All bulleted items in the Corrective Action Plan must be included in this plan. The facility is in compliance with this item. The procedures were approved on August 23, 2024. Item #7: This item requires that you conduct a staff meeting to review the approved policies within one week of receiving approval. Following the staff meeting you will submit the documentation as outlined in the Corrective Action Plan. The facility is in compliance with this item. During today’s visit, Ms. Wilcox submitted documentation from the staff meeting that occurred on August 31, 2024. A second staff meeting is scheduled to take place on October 31, 2024. Additional monitoring visits will occur while the Administrative Action is in place. You will receive written verification once all items have been met. If you have any questions, please feel free to contact me at Teraesa.Leak@dhhs.nc.gov or by phone at 919-621-6968. 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: ratio. Open / not marked corrected.

10A NCAC 09 .0514 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/28/2024 Number Present: 36 Completed Date: 5/28/2024 Age: From 0 To 5 Total Minutes: 200 Time In: 10:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to conduct an annual compliance follow up visit after 16 violations were cited, including a violation for staff/child ratios. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival, we were greeted by staff members. The administrator, F. Wilcox, arrived a short time later. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We completed a general walk-through of the indoor learning environment, including the kitchen. Items that were documented during the annual compliance visit conducted on May 16, 2024, were monitored for compliance: Item # 108 – The operator has not submitted a compliance letter regarding how compliance will be maintained regarding falsification. An additional violation was not documented. Item # 115 - The summary of NC Child Care Law was posted in both English and Spanish. An additional violation was not documented. Item # 501 – 1% milk and whole milk was observed during today’s visit. An additional violation was not documented. Item # 526 – Posted menus were not current. An additional violation was documented. Item # 805 – A fire drill was conducted on May 21, 2024 and documented on the fire drill record. An additional violation was not documented. Item # 840 – This was corrected at the time of the visit. Item # 844 – Prescribed albuterol inhaler pumps for two enrolled students were not in the original, labeled containers. An additional violation was documented. Item #847- Medication authorization forms were updated and/or medications were returned to parents. An additional violation was not documented. Item # 849 - This was corrected at the time of the visit. Item # 859- Monthly playground inspections were not completed. An additional violation was documented. Item # 1301- This was corrected at the time of the visit. Item # 1321 – An enrolled student did not have a medical exam or health assessment record on file. An additional violation was documented. Item #1759- Enhanced staff/child ratios were maintained. An additional violation was not documented. Item # 1835 – Medical action plans were updated and/or completed. An additional violation was not documented. Item # 1908- A signed statement by a parent acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome/Abusive Head Trauma was not file for one child. An additional violation was documented. Item #9999-Bags of Cinnamon Toast Crunch cereal was not stored in an approved, clean, tightly covered, storage containers after the original package had been opened. This is a violation of 15A NCAC 18A .2806(a), therefore, an additional violation was documented. Staff files were also monitored during today’s visit. Any items not in compliance are listed in the violations section below. The following additional violations were cited during today’s visit: Violation Number Comment Rule 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for May 17-24, 2024. 10A NCAC 09 .0901(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In spaces 1 and 2, albuterol inhaler pumps for two (2) enrolled children were not in their original labeled containers. .0803(2)(a) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The facility has not completed a monthly outdoor inspection. .0605(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed annually for eight (8) employees. 10A NCAC 09 .0802(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. An employee with a hire date of 1/2/2024 did not receive at least 16 hours of orientation as required by the rule. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training an employee expired on June 17, 2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one employee expired on June 17, 2023. .1102(d) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. An employee with a start date of 1/2/2024 did not have documentation of six clock hours of training in required topic areas on file. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Eight employees did not have annual staff evaluations on file. 10A NCAC 09 .0514(f) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. One employee personnel file did not contain a signed and dated statement that they had received personnel and operational policies. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. An enrolled child did not have a medical exam or health assessment record on file. GS110-91(1) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. An annual review of the center's EPR plan was not conducted for eight (8) employees. .0607(f) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. An employee with a start date of 1/2/2024 did not have a signed acknowledgement on file as required by the rule. .0608(d)(1-4) 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. An employee with a hire date of 1/2/2024 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training as required by the rule. .1102(g) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One enrolled child did not have a signed statement by a parent on file, acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Bags of cereal were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a). COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By June 11, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 An additional sixteen (16) violations were documented during today's visit. As a result, a return visit will occur in the near future to monitor for ongoing compliance. In addition, the issuance of an Administrative Action may be recommended against the facility. TECHNICAL ASSISTANCE/CONSULTATION: OUTDOOR LEARNING ENVIRONMENT: During the annual compliance visit, Ms. Wilcox stated that due to the recent rain, the outdoor learning environment could not be used due to the number of fire ants. I explained that children are required to go outside each day, so that she would need to have someone come out to treat the areas so that the children could resume outdoor play time. On May 22, 2024, Hall’s Exterminating Plus came to the facility to treat the playground for the fire ants. I observed the invoice for the treatment during today’s visit. In addition, provided Ms. Wilcox with a resource from the Natural Learning Initiative for fire ant prevention and treatment. A monthly outdoor play inspection has not been completed since the annual compliance visit. You must come into compliance with this requirement immediately and maintain the inspections monthly. If you are not available to complete the inspections, another staff member must obtain the playground safety training so that they can complete the monthly inspections in your absence. You may contact the Harnett County Partnership for Children at https://harnettsmartstart.org/to obtain their current training calendar. You may also review the calendar to obtain additional trainings for those employees needing ongoing training hours. REQUIRED INSPECTIONS: In addition to the monthly outdoor playground inspections, monthly fire drills are also required as are the quarterly lockdown/shelter-in-place drills. These must be recorded on the log sheets available on the DCDEE website. During today’s visit, the fire Marshall was on site to complete the annual fire inspection. Due to issues with the exit sign lighting, the inspection report could not be completed. The inspection is due by Friday May 31, 2024. Please submit a copy of the report to me upon completion. ONGOING/REQUIRED TRAINING: Staff members are required to complete annual in-service hours each year. The number of hours for each staff member is based on education. Any training completed after the last annual compliance visit conducted on June 1, 2023, was counted towards completion. Remember that in order for training to count, in-service training slips are required. The training must be documented on the in-service training log, documentation of the completed training attached and maintained in their file. As a reminder, CPR and First Aid training is required for all staff and can no longer be used to meet the annual in-service training requirement. The training is good for two (2) years and the wallet cards along with the training certificate must be maintained in employee personnel files. CPR/First Aid training for one employee expired on June 17, 2023 and the training will expire for six (6) more employees on June 30, 2024. Recognizing and Responding to Suspicions of Child Maltreatment must be completed within ninety (90) days of hire. One employee with a hire date of January 2, 2024, did not have the completed training certificate on file. In order to meet the requirement, the training must be completed through Prevent Child Abuse NC at https://www.preventchildabusenc.org/. During today’s visit, we reviewed staff and training worksheets. As a reminder, completing and reviewing this document will help you identify due dates and prevent violations. Keeping it updated will let you see at a glance when items are due. Best practice is to update the worksheet quarterly or when staff changes or change positions. You may want to create a spreadsheet with due dates for criminal background checks, ITS-SIDS, and CPR/First Aid. Several employees have not completed their staff development plans, the annual medical care plan review or the EPR review. Please refer to the staff/training worksheets for additional information. STAFF/CHILD RATIOS: During today's visit, Ms. Wilcox and I had an extensive discussion regarding staff/child ratios. Currently, the facility is meeting the highest reduced staff/child ratios, including reduced ratios minus 1 based on the 7point level, and reduced space. I explained to Ms. Wilcox that she could reduce the points in program standards from 7 points to 6 points allowing her to meet the enhanced ratios and space, but she would no longer be required to reduce the ratios by 1. By removing the restriction, the facility would still maintain a 5 star rated license. Ms. Wilcox stated that she would like to have the restriction removed. Once all violations are corrected/brought into compliance, I will submit the request for the new license. All current permit restrictions must continue to be met until a new license is issued. As a reminder, retrain all staff on staff/child ratios. Direct each staff member to the classroom staff to child ratio sheet. Show each staff member what the program is required to meet based on your license type. When combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group. Children of all ages may be cared for together in groups at the beginning and end of the operating day provided the staff/child ratio for the youngest child in the group is maintained. Maintaining staff/child ratios ensures that caregivers can effectively supervise the entire group while engaging kids one-on-one as required to meet their needs. Thank you for your time today. For additional information or should you have any questions, please contact me at Teraesa.Leak@dhhs.nc.gov or 919-971-7765. 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 .0802 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/28/2024 Number Present: 36 Completed Date: 5/28/2024 Age: From 0 To 5 Total Minutes: 200 Time In: 10:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to conduct an annual compliance follow up visit after 16 violations were cited, including a violation for staff/child ratios. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival, we were greeted by staff members. The administrator, F. Wilcox, arrived a short time later. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We completed a general walk-through of the indoor learning environment, including the kitchen. Items that were documented during the annual compliance visit conducted on May 16, 2024, were monitored for compliance: Item # 108 – The operator has not submitted a compliance letter regarding how compliance will be maintained regarding falsification. An additional violation was not documented. Item # 115 - The summary of NC Child Care Law was posted in both English and Spanish. An additional violation was not documented. Item # 501 – 1% milk and whole milk was observed during today’s visit. An additional violation was not documented. Item # 526 – Posted menus were not current. An additional violation was documented. Item # 805 – A fire drill was conducted on May 21, 2024 and documented on the fire drill record. An additional violation was not documented. Item # 840 – This was corrected at the time of the visit. Item # 844 – Prescribed albuterol inhaler pumps for two enrolled students were not in the original, labeled containers. An additional violation was documented. Item #847- Medication authorization forms were updated and/or medications were returned to parents. An additional violation was not documented. Item # 849 - This was corrected at the time of the visit. Item # 859- Monthly playground inspections were not completed. An additional violation was documented. Item # 1301- This was corrected at the time of the visit. Item # 1321 – An enrolled student did not have a medical exam or health assessment record on file. An additional violation was documented. Item #1759- Enhanced staff/child ratios were maintained. An additional violation was not documented. Item # 1835 – Medical action plans were updated and/or completed. An additional violation was not documented. Item # 1908- A signed statement by a parent acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome/Abusive Head Trauma was not file for one child. An additional violation was documented. Item #9999-Bags of Cinnamon Toast Crunch cereal was not stored in an approved, clean, tightly covered, storage containers after the original package had been opened. This is a violation of 15A NCAC 18A .2806(a), therefore, an additional violation was documented. Staff files were also monitored during today’s visit. Any items not in compliance are listed in the violations section below. The following additional violations were cited during today’s visit: Violation Number Comment Rule 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for May 17-24, 2024. 10A NCAC 09 .0901(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In spaces 1 and 2, albuterol inhaler pumps for two (2) enrolled children were not in their original labeled containers. .0803(2)(a) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The facility has not completed a monthly outdoor inspection. .0605(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed annually for eight (8) employees. 10A NCAC 09 .0802(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. An employee with a hire date of 1/2/2024 did not receive at least 16 hours of orientation as required by the rule. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training an employee expired on June 17, 2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one employee expired on June 17, 2023. .1102(d) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. An employee with a start date of 1/2/2024 did not have documentation of six clock hours of training in required topic areas on file. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Eight employees did not have annual staff evaluations on file. 10A NCAC 09 .0514(f) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. One employee personnel file did not contain a signed and dated statement that they had received personnel and operational policies. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. An enrolled child did not have a medical exam or health assessment record on file. GS110-91(1) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. An annual review of the center's EPR plan was not conducted for eight (8) employees. .0607(f) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. An employee with a start date of 1/2/2024 did not have a signed acknowledgement on file as required by the rule. .0608(d)(1-4) 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. An employee with a hire date of 1/2/2024 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training as required by the rule. .1102(g) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One enrolled child did not have a signed statement by a parent on file, acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Bags of cereal were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a). COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By June 11, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 An additional sixteen (16) violations were documented during today's visit. As a result, a return visit will occur in the near future to monitor for ongoing compliance. In addition, the issuance of an Administrative Action may be recommended against the facility. TECHNICAL ASSISTANCE/CONSULTATION: OUTDOOR LEARNING ENVIRONMENT: During the annual compliance visit, Ms. Wilcox stated that due to the recent rain, the outdoor learning environment could not be used due to the number of fire ants. I explained that children are required to go outside each day, so that she would need to have someone come out to treat the areas so that the children could resume outdoor play time. On May 22, 2024, Hall’s Exterminating Plus came to the facility to treat the playground for the fire ants. I observed the invoice for the treatment during today’s visit. In addition, provided Ms. Wilcox with a resource from the Natural Learning Initiative for fire ant prevention and treatment. A monthly outdoor play inspection has not been completed since the annual compliance visit. You must come into compliance with this requirement immediately and maintain the inspections monthly. If you are not available to complete the inspections, another staff member must obtain the playground safety training so that they can complete the monthly inspections in your absence. You may contact the Harnett County Partnership for Children at https://harnettsmartstart.org/to obtain their current training calendar. You may also review the calendar to obtain additional trainings for those employees needing ongoing training hours. REQUIRED INSPECTIONS: In addition to the monthly outdoor playground inspections, monthly fire drills are also required as are the quarterly lockdown/shelter-in-place drills. These must be recorded on the log sheets available on the DCDEE website. During today’s visit, the fire Marshall was on site to complete the annual fire inspection. Due to issues with the exit sign lighting, the inspection report could not be completed. The inspection is due by Friday May 31, 2024. Please submit a copy of the report to me upon completion. ONGOING/REQUIRED TRAINING: Staff members are required to complete annual in-service hours each year. The number of hours for each staff member is based on education. Any training completed after the last annual compliance visit conducted on June 1, 2023, was counted towards completion. Remember that in order for training to count, in-service training slips are required. The training must be documented on the in-service training log, documentation of the completed training attached and maintained in their file. As a reminder, CPR and First Aid training is required for all staff and can no longer be used to meet the annual in-service training requirement. The training is good for two (2) years and the wallet cards along with the training certificate must be maintained in employee personnel files. CPR/First Aid training for one employee expired on June 17, 2023 and the training will expire for six (6) more employees on June 30, 2024. Recognizing and Responding to Suspicions of Child Maltreatment must be completed within ninety (90) days of hire. One employee with a hire date of January 2, 2024, did not have the completed training certificate on file. In order to meet the requirement, the training must be completed through Prevent Child Abuse NC at https://www.preventchildabusenc.org/. During today’s visit, we reviewed staff and training worksheets. As a reminder, completing and reviewing this document will help you identify due dates and prevent violations. Keeping it updated will let you see at a glance when items are due. Best practice is to update the worksheet quarterly or when staff changes or change positions. You may want to create a spreadsheet with due dates for criminal background checks, ITS-SIDS, and CPR/First Aid. Several employees have not completed their staff development plans, the annual medical care plan review or the EPR review. Please refer to the staff/training worksheets for additional information. STAFF/CHILD RATIOS: During today's visit, Ms. Wilcox and I had an extensive discussion regarding staff/child ratios. Currently, the facility is meeting the highest reduced staff/child ratios, including reduced ratios minus 1 based on the 7point level, and reduced space. I explained to Ms. Wilcox that she could reduce the points in program standards from 7 points to 6 points allowing her to meet the enhanced ratios and space, but she would no longer be required to reduce the ratios by 1. By removing the restriction, the facility would still maintain a 5 star rated license. Ms. Wilcox stated that she would like to have the restriction removed. Once all violations are corrected/brought into compliance, I will submit the request for the new license. All current permit restrictions must continue to be met until a new license is issued. As a reminder, retrain all staff on staff/child ratios. Direct each staff member to the classroom staff to child ratio sheet. Show each staff member what the program is required to meet based on your license type. When combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group. Children of all ages may be cared for together in groups at the beginning and end of the operating day provided the staff/child ratio for the youngest child in the group is maintained. Maintaining staff/child ratios ensures that caregivers can effectively supervise the entire group while engaging kids one-on-one as required to meet their needs. Thank you for your time today. For additional information or should you have any questions, please contact me at Teraesa.Leak@dhhs.nc.gov or 919-971-7765. 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 .0901 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/28/2024 Number Present: 36 Completed Date: 5/28/2024 Age: From 0 To 5 Total Minutes: 200 Time In: 10:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to conduct an annual compliance follow up visit after 16 violations were cited, including a violation for staff/child ratios. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival, we were greeted by staff members. The administrator, F. Wilcox, arrived a short time later. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We completed a general walk-through of the indoor learning environment, including the kitchen. Items that were documented during the annual compliance visit conducted on May 16, 2024, were monitored for compliance: Item # 108 – The operator has not submitted a compliance letter regarding how compliance will be maintained regarding falsification. An additional violation was not documented. Item # 115 - The summary of NC Child Care Law was posted in both English and Spanish. An additional violation was not documented. Item # 501 – 1% milk and whole milk was observed during today’s visit. An additional violation was not documented. Item # 526 – Posted menus were not current. An additional violation was documented. Item # 805 – A fire drill was conducted on May 21, 2024 and documented on the fire drill record. An additional violation was not documented. Item # 840 – This was corrected at the time of the visit. Item # 844 – Prescribed albuterol inhaler pumps for two enrolled students were not in the original, labeled containers. An additional violation was documented. Item #847- Medication authorization forms were updated and/or medications were returned to parents. An additional violation was not documented. Item # 849 - This was corrected at the time of the visit. Item # 859- Monthly playground inspections were not completed. An additional violation was documented. Item # 1301- This was corrected at the time of the visit. Item # 1321 – An enrolled student did not have a medical exam or health assessment record on file. An additional violation was documented. Item #1759- Enhanced staff/child ratios were maintained. An additional violation was not documented. Item # 1835 – Medical action plans were updated and/or completed. An additional violation was not documented. Item # 1908- A signed statement by a parent acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome/Abusive Head Trauma was not file for one child. An additional violation was documented. Item #9999-Bags of Cinnamon Toast Crunch cereal was not stored in an approved, clean, tightly covered, storage containers after the original package had been opened. This is a violation of 15A NCAC 18A .2806(a), therefore, an additional violation was documented. Staff files were also monitored during today’s visit. Any items not in compliance are listed in the violations section below. The following additional violations were cited during today’s visit: Violation Number Comment Rule 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for May 17-24, 2024. 10A NCAC 09 .0901(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In spaces 1 and 2, albuterol inhaler pumps for two (2) enrolled children were not in their original labeled containers. .0803(2)(a) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The facility has not completed a monthly outdoor inspection. .0605(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed annually for eight (8) employees. 10A NCAC 09 .0802(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. An employee with a hire date of 1/2/2024 did not receive at least 16 hours of orientation as required by the rule. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training an employee expired on June 17, 2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one employee expired on June 17, 2023. .1102(d) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. An employee with a start date of 1/2/2024 did not have documentation of six clock hours of training in required topic areas on file. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Eight employees did not have annual staff evaluations on file. 10A NCAC 09 .0514(f) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. One employee personnel file did not contain a signed and dated statement that they had received personnel and operational policies. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. An enrolled child did not have a medical exam or health assessment record on file. GS110-91(1) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. An annual review of the center's EPR plan was not conducted for eight (8) employees. .0607(f) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. An employee with a start date of 1/2/2024 did not have a signed acknowledgement on file as required by the rule. .0608(d)(1-4) 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. An employee with a hire date of 1/2/2024 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training as required by the rule. .1102(g) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One enrolled child did not have a signed statement by a parent on file, acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Bags of cereal were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a). COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By June 11, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 An additional sixteen (16) violations were documented during today's visit. As a result, a return visit will occur in the near future to monitor for ongoing compliance. In addition, the issuance of an Administrative Action may be recommended against the facility. TECHNICAL ASSISTANCE/CONSULTATION: OUTDOOR LEARNING ENVIRONMENT: During the annual compliance visit, Ms. Wilcox stated that due to the recent rain, the outdoor learning environment could not be used due to the number of fire ants. I explained that children are required to go outside each day, so that she would need to have someone come out to treat the areas so that the children could resume outdoor play time. On May 22, 2024, Hall’s Exterminating Plus came to the facility to treat the playground for the fire ants. I observed the invoice for the treatment during today’s visit. In addition, provided Ms. Wilcox with a resource from the Natural Learning Initiative for fire ant prevention and treatment. A monthly outdoor play inspection has not been completed since the annual compliance visit. You must come into compliance with this requirement immediately and maintain the inspections monthly. If you are not available to complete the inspections, another staff member must obtain the playground safety training so that they can complete the monthly inspections in your absence. You may contact the Harnett County Partnership for Children at https://harnettsmartstart.org/to obtain their current training calendar. You may also review the calendar to obtain additional trainings for those employees needing ongoing training hours. REQUIRED INSPECTIONS: In addition to the monthly outdoor playground inspections, monthly fire drills are also required as are the quarterly lockdown/shelter-in-place drills. These must be recorded on the log sheets available on the DCDEE website. During today’s visit, the fire Marshall was on site to complete the annual fire inspection. Due to issues with the exit sign lighting, the inspection report could not be completed. The inspection is due by Friday May 31, 2024. Please submit a copy of the report to me upon completion. ONGOING/REQUIRED TRAINING: Staff members are required to complete annual in-service hours each year. The number of hours for each staff member is based on education. Any training completed after the last annual compliance visit conducted on June 1, 2023, was counted towards completion. Remember that in order for training to count, in-service training slips are required. The training must be documented on the in-service training log, documentation of the completed training attached and maintained in their file. As a reminder, CPR and First Aid training is required for all staff and can no longer be used to meet the annual in-service training requirement. The training is good for two (2) years and the wallet cards along with the training certificate must be maintained in employee personnel files. CPR/First Aid training for one employee expired on June 17, 2023 and the training will expire for six (6) more employees on June 30, 2024. Recognizing and Responding to Suspicions of Child Maltreatment must be completed within ninety (90) days of hire. One employee with a hire date of January 2, 2024, did not have the completed training certificate on file. In order to meet the requirement, the training must be completed through Prevent Child Abuse NC at https://www.preventchildabusenc.org/. During today’s visit, we reviewed staff and training worksheets. As a reminder, completing and reviewing this document will help you identify due dates and prevent violations. Keeping it updated will let you see at a glance when items are due. Best practice is to update the worksheet quarterly or when staff changes or change positions. You may want to create a spreadsheet with due dates for criminal background checks, ITS-SIDS, and CPR/First Aid. Several employees have not completed their staff development plans, the annual medical care plan review or the EPR review. Please refer to the staff/training worksheets for additional information. STAFF/CHILD RATIOS: During today's visit, Ms. Wilcox and I had an extensive discussion regarding staff/child ratios. Currently, the facility is meeting the highest reduced staff/child ratios, including reduced ratios minus 1 based on the 7point level, and reduced space. I explained to Ms. Wilcox that she could reduce the points in program standards from 7 points to 6 points allowing her to meet the enhanced ratios and space, but she would no longer be required to reduce the ratios by 1. By removing the restriction, the facility would still maintain a 5 star rated license. Ms. Wilcox stated that she would like to have the restriction removed. Once all violations are corrected/brought into compliance, I will submit the request for the new license. All current permit restrictions must continue to be met until a new license is issued. As a reminder, retrain all staff on staff/child ratios. Direct each staff member to the classroom staff to child ratio sheet. Show each staff member what the program is required to meet based on your license type. When combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group. Children of all ages may be cared for together in groups at the beginning and end of the operating day provided the staff/child ratio for the youngest child in the group is maintained. Maintaining staff/child ratios ensures that caregivers can effectively supervise the entire group while engaging kids one-on-one as required to meet their needs. Thank you for your time today. For additional information or should you have any questions, please contact me at Teraesa.Leak@dhhs.nc.gov or 919-971-7765. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/28/2024 Number Present: 36 Completed Date: 5/28/2024 Age: From 0 To 5 Total Minutes: 200 Time In: 10:15 AM Time Out: 01:35 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Compliance Follow-Up Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to conduct an annual compliance follow up visit after 16 violations were cited, including a violation for staff/child ratios. Tanya Herring, Licensing Consultant, accompanied me during today’s visit. Upon our arrival, we were greeted by staff members. The administrator, F. Wilcox, arrived a short time later. Limited monitoring of the child care requirements occurred during today’s visit. The license was posted. We completed a general walk-through of the indoor learning environment, including the kitchen. Items that were documented during the annual compliance visit conducted on May 16, 2024, were monitored for compliance: Item # 108 – The operator has not submitted a compliance letter regarding how compliance will be maintained regarding falsification. An additional violation was not documented. Item # 115 - The summary of NC Child Care Law was posted in both English and Spanish. An additional violation was not documented. Item # 501 – 1% milk and whole milk was observed during today’s visit. An additional violation was not documented. Item # 526 – Posted menus were not current. An additional violation was documented. Item # 805 – A fire drill was conducted on May 21, 2024 and documented on the fire drill record. An additional violation was not documented. Item # 840 – This was corrected at the time of the visit. Item # 844 – Prescribed albuterol inhaler pumps for two enrolled students were not in the original, labeled containers. An additional violation was documented. Item #847- Medication authorization forms were updated and/or medications were returned to parents. An additional violation was not documented. Item # 849 - This was corrected at the time of the visit. Item # 859- Monthly playground inspections were not completed. An additional violation was documented. Item # 1301- This was corrected at the time of the visit. Item # 1321 – An enrolled student did not have a medical exam or health assessment record on file. An additional violation was documented. Item #1759- Enhanced staff/child ratios were maintained. An additional violation was not documented. Item # 1835 – Medical action plans were updated and/or completed. An additional violation was not documented. Item # 1908- A signed statement by a parent acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome/Abusive Head Trauma was not file for one child. An additional violation was documented. Item #9999-Bags of Cinnamon Toast Crunch cereal was not stored in an approved, clean, tightly covered, storage containers after the original package had been opened. This is a violation of 15A NCAC 18A .2806(a), therefore, an additional violation was documented. Staff files were also monitored during today’s visit. Any items not in compliance are listed in the violations section below. The following additional violations were cited during today’s visit: Violation Number Comment Rule 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for May 17-24, 2024. 10A NCAC 09 .0901(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. In spaces 1 and 2, albuterol inhaler pumps for two (2) enrolled children were not in their original labeled containers. .0803(2)(a) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The facility has not completed a monthly outdoor inspection. .0605(q) 862 The EMC plan was not reviewed with all staff annually and whenever the plan was revised. The EMC plan was not reviewed annually for eight (8) employees. 10A NCAC 09 .0802(a) 1045 New staff, who had contact with children, did not receive at least 16 hrs. orientation within first 6 weeks. An employee with a hire date of 1/2/2024 did not receive at least 16 hours of orientation as required by the rule. .1101(a) 1048 All staff did not successfully complete certification in First Aid appropriate to the age of children in care. Verification of staff completion of First Aid training from an approved training organization was not in the staff file. First Aid training an employee expired on June 17, 2023. .1102(c) 1049 All staff did not successfully complete certification in CPR training appropriate to the age of the children in care. Verification of staff completion of the CPR course from an approved training organization was not in the staff file. CPR training for one employee expired on June 17, 2023. .1102(d) 1067 Each new employee did not complete, within the first two weeks of employment, six clock hours of training in required topic areas. An employee with a start date of 1/2/2024 did not have documentation of six clock hours of training in required topic areas on file. .1101(a)(b) 1232 Each employee's personnel file did not contain an annual staff evaluation and a staff development plan. Eight employees did not have annual staff evaluations on file. 10A NCAC 09 .0514(f) 1233 Each employee's personnel file did not contain a signed and dated statement that they received a job description and that they have received personnel and operational policies. One employee personnel file did not contain a signed and dated statement that they had received personnel and operational policies. 10A NCAC 09 .0514(g) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. An enrolled child did not have a medical exam or health assessment record on file. GS110-91(1) 1825 All staff did not review the center's EPR Plan during orientation and/or on an annual basis with the trained staff. Documentation of the review was not maintained on file. An annual review of the center's EPR plan was not conducted for eight (8) employees. .0607(f) 1874 The Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy was not reviewed with new staff prior to providing care with children and/or a signed acknowledgement with all the required information was not maintained in the staff person's file. An employee with a start date of 1/2/2024 did not have a signed acknowledgement on file as required by the rule. .0608(d)(1-4) 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. An employee with a hire date of 1/2/2024 did not complete the Recognizing and Responding to Suspicions of Child Maltreatment training as required by the rule. .1102(g) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. One enrolled child did not have a signed statement by a parent on file, acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Bags of cereal were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a). COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By June 11, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 An additional sixteen (16) violations were documented during today's visit. As a result, a return visit will occur in the near future to monitor for ongoing compliance. In addition, the issuance of an Administrative Action may be recommended against the facility. TECHNICAL ASSISTANCE/CONSULTATION: OUTDOOR LEARNING ENVIRONMENT: During the annual compliance visit, Ms. Wilcox stated that due to the recent rain, the outdoor learning environment could not be used due to the number of fire ants. I explained that children are required to go outside each day, so that she would need to have someone come out to treat the areas so that the children could resume outdoor play time. On May 22, 2024, Hall’s Exterminating Plus came to the facility to treat the playground for the fire ants. I observed the invoice for the treatment during today’s visit. In addition, provided Ms. Wilcox with a resource from the Natural Learning Initiative for fire ant prevention and treatment. A monthly outdoor play inspection has not been completed since the annual compliance visit. You must come into compliance with this requirement immediately and maintain the inspections monthly. If you are not available to complete the inspections, another staff member must obtain the playground safety training so that they can complete the monthly inspections in your absence. You may contact the Harnett County Partnership for Children at https://harnettsmartstart.org/to obtain their current training calendar. You may also review the calendar to obtain additional trainings for those employees needing ongoing training hours. REQUIRED INSPECTIONS: In addition to the monthly outdoor playground inspections, monthly fire drills are also required as are the quarterly lockdown/shelter-in-place drills. These must be recorded on the log sheets available on the DCDEE website. During today’s visit, the fire Marshall was on site to complete the annual fire inspection. Due to issues with the exit sign lighting, the inspection report could not be completed. The inspection is due by Friday May 31, 2024. Please submit a copy of the report to me upon completion. ONGOING/REQUIRED TRAINING: Staff members are required to complete annual in-service hours each year. The number of hours for each staff member is based on education. Any training completed after the last annual compliance visit conducted on June 1, 2023, was counted towards completion. Remember that in order for training to count, in-service training slips are required. The training must be documented on the in-service training log, documentation of the completed training attached and maintained in their file. As a reminder, CPR and First Aid training is required for all staff and can no longer be used to meet the annual in-service training requirement. The training is good for two (2) years and the wallet cards along with the training certificate must be maintained in employee personnel files. CPR/First Aid training for one employee expired on June 17, 2023 and the training will expire for six (6) more employees on June 30, 2024. Recognizing and Responding to Suspicions of Child Maltreatment must be completed within ninety (90) days of hire. One employee with a hire date of January 2, 2024, did not have the completed training certificate on file. In order to meet the requirement, the training must be completed through Prevent Child Abuse NC at https://www.preventchildabusenc.org/. During today’s visit, we reviewed staff and training worksheets. As a reminder, completing and reviewing this document will help you identify due dates and prevent violations. Keeping it updated will let you see at a glance when items are due. Best practice is to update the worksheet quarterly or when staff changes or change positions. You may want to create a spreadsheet with due dates for criminal background checks, ITS-SIDS, and CPR/First Aid. Several employees have not completed their staff development plans, the annual medical care plan review or the EPR review. Please refer to the staff/training worksheets for additional information. STAFF/CHILD RATIOS: During today's visit, Ms. Wilcox and I had an extensive discussion regarding staff/child ratios. Currently, the facility is meeting the highest reduced staff/child ratios, including reduced ratios minus 1 based on the 7point level, and reduced space. I explained to Ms. Wilcox that she could reduce the points in program standards from 7 points to 6 points allowing her to meet the enhanced ratios and space, but she would no longer be required to reduce the ratios by 1. By removing the restriction, the facility would still maintain a 5 star rated license. Ms. Wilcox stated that she would like to have the restriction removed. Once all violations are corrected/brought into compliance, I will submit the request for the new license. All current permit restrictions must continue to be met until a new license is issued. As a reminder, retrain all staff on staff/child ratios. Direct each staff member to the classroom staff to child ratio sheet. Show each staff member what the program is required to meet based on your license type. When combining age groups, the staff/child ratio for the youngest child in the group shall be maintained for the entire group. Children of all ages may be cared for together in groups at the beginning and end of the operating day provided the staff/child ratio for the youngest child in the group is maintained. Maintaining staff/child ratios ensures that caregivers can effectively supervise the entire group while engaging kids one-on-one as required to meet their needs. Thank you for your time today. For additional information or should you have any questions, please contact me at Teraesa.Leak@dhhs.nc.gov or 919-971-7765. 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 .0901 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. 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: ratio. Open / not marked corrected.

10A NCAC 09 .0803 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. 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 .0901 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. 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 .2818 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. 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. 110-102 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

G.S. 110-91 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. 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: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. If the operator fails to correct any documented violations within the established time period, the Division of Child Development and Early Education may deny, suspend, terminate, or revoke any permit to operate (10A NCAC 09 .2000). All information in this report has been reviewed with me today.I understand that it is my responsibility to maintaincompliance with applicable NC Child Care Requirements at all times

GS110-91 · Violation

Name of Operation: FIRST STEPS LEARNING CENTER, INC. Facility ID: 43000559 Consultant: TERAESA LEAK Operation Type: Center Case Number: Visit Date: 5/16/2024 Number Present: 38 Completed Date: 5/16/2024 Age: From 0 To 5 Total Minutes: 150 Time In: 10:15 AM Time Out: 12:45 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of today’s unannounced visit was to monitor applicable child care requirements during your annual compliance visit. Tanya Herring, Child Care Consultant, accompanied me during today's visit. The annual compliance monitoring checklist for Child Care Centers was used to note requirements monitored today. Upon our arrival, we were greeted by a staff member, who we later determined was caring for children in the classroom designated for preschoolers. The staff member stated that the director was not on-site but would place a phone call to her informing her of our visit. We were unaccompanied as we completed a general walk through of the indoor environment, which consisted of four (4) classrooms, and the kitchen. The children were observed during free play, completing routine tasks and having lunch. Today’s meal was in compliance with the Meal Pattern requirements. The director, Ms. F. Wilcox, arrived a short time later. LICENSE STATUS: This child care center currently operates with a five star rated license issued on December 20, 2019. ANNUAL INSPECTIONS: The last annual sanitation inspection was completed on 4/17/2024 and received a 'Superior' classification with 7 demerits. The last annual fire inspection was conducted on 5/31/2024. The last documented quarterly lockdown/shelter-in-place drill was conducted on 3/14/2024. Information regarding monthly fire drills and outdoor play inspections was not available. During today’s visit a full assessment of the child care requirements was conducted. We observed all required postings, attendance logs and safe sleep logs. We monitored all applicable program records and a sample of children’s records. The director had not completed the staff/training worksheets; therefore, staff files were not monitored. The facility does not provide transportation. Any items not in compliance during today’s visit are listed in the violations section below. The following violations were cited during today’s visit: Violation Number Comment Rule 108 The operator made an effort to falsify information. The fire drill logs reflected a date of April 14, 2024, which fell on a Sunday, was not a day that children were in care. The following date of May 18, 2024, had not occurred at the time of the visit. Monthly playground logs were signed and predated for May 24, 2024 and June 1, 2024. G.S. 110-91(14) 115 A summary of the NC Child Care Law was not posted in a prominent place in the center. The facility did not have a copy of the summary of NC Child Care Laws posted as required by the rule. G.S. 110-102 501 Meals/snacks did not comply with the Meal Patterns for Children in Child Care Programs. The facility was serving 2% milk instead of low or no fat milk as required by the rule. 10A NCAC 09 .0901(a) 526 Menus for all meals and snacks were not current or posted where easily seen by parents and cook. Posted menus were dated for April 29-May 3, 2024. 10A NCAC 09 .0901(b) 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The date of the last monthly fire drill could not be determined. The dates indicated on the log were dates that had not occurred as of today's visit and on a date that included a weekend when children were not in care. .0604(t); .0302(d)(5) 840 All corrosive agents, pesticides, bleaches, detergents, cleansers, polishes, any product which is under pressure in an aerosol dispenser, and any substance which may be hazardous to a child if ingested, inhaled, or handled were not stored in a locked room or cabinet. In space 4, a bottle of body spray with an aerosol dispenser was not stored in a locked cabinet. .2820(b) 844 Prescribed medicine was not in original labeled container or accompanied by signed and dated written instructions from prescribing physician or health care professional. Two albuterol inhaler pumps were not in the original labeled containers. .0803(2)(a) 847 Parent's medication authorization did not include required information. Permission to administer medication authorization forms did not include children names, dosage, frequency to administer and/or parent signature. 10A NCAC 09 .0803(4)(6-9) 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. Diaper cream was not discarded or returned to the parent after the course of treatment was completed. .0803(12) 859 Monthly playground inspections were not completed and/or they were not completed by an individual trained in playground safety requirements. The date of the last monthly playground inspection could not be determined. The dates indicated on the monthly outdoor playground inspections were dates that had not occurred as of today's visit. .0605(q) 1301 Center did not maintain a record of daily attendance. In space 1, daily attendance was not maintained. GS 110-91(9) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. One child did not have a health assessment on file. GS110-91(1) 1756 Enhanced staff/child ratios and group sizes were not met. In space 1, one caregiver was observed with 15 children when the staff/child ratio for the children in care was 1:9. 10A NCAC 09 .2818 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. Medical action plans for two enrolled children did not include the required information. .0801(b) 1908 A child's file did not have a statement with parent signature acknowledging receipt and explanation of the Prevention of Shaken Baby Syndrome and Abusive Head Trauma policy and/or the acknowledgement did not have all the required information. An enrolled child did not have a signed statement with parent signature acknowledging receipt of the Shaken Baby Syndrome and Abusive Head Trauma policy on file. .0608(b)(1-6) 9999 A violation was found for which there is no item number. Various bags of snacks and cereals were not stored in an approved, clean, tightly covered, storage containers once the original package is opened. This is a violation of 15A NCAC 18A .2806(a) COMPLIANCE HISTORY: Prior to today’s visit, the 18-month compliance history for this facility was 100%. COMPLIANCE LETTER: All violations must be corrected immediately. A compliance letter is due to me within two (2) weeks of today's visit. By May 30, 2024, please send me a letter addressing each violation, how the violations were corrected and how compliance will be maintained in the future. In your letter, be sure to include your facility name, facility ID number and each item number for the violations cited. You may submit the letter to me electronically at Teraesa.Leak@dhhs.nc.gov or by mail. Should you wish to mail me your letter, please ensure that you allow sufficient time so that the letter reaches me on time. My mailing address is: Teraesa Leak PO Box 40493 Raleigh, NC 27629 TECHNICAL ASSISTANCE/CONSULTATION: Please ensure that staff/training worksheets are completed and available prior to your annual compliance visit each year. It is strongly recommended that the document be saved to your computer so that changes can be updated as they occur. It is also recommended that you use a dry erase board, email or electronic device to set reminders for expired training or CBC qualification letters. A return visit will take place in the near future to monitor staff files. During today’s visit, a staff member was observed greeting a parent at the front door, leaving a second staff member alone to care for a group of fifteen (15) children ranging from three (3) to five (5) years of age. The staff/child ratio for the group of children is 1:9. The facility currently follows the highest enhanced staff/child ratios and space requirements. Violations of staff/child ratio requirements are particularly serious as they directly impact the safety of children. The director explained that the reason for the violation was due to a staffing issue at the facility. In addition, the front door is kept locked beginning at 9am and that ordinarily there is an additional staff member in place to assist with greeting visitors at the door “because we, the Division, don’t want parents going to classroom.” I reminded Ms. Wilcox that all flexibilities regarding Covid-19 expired in August 2022. I stated that if the facility wanted the door to remain locked, then they must develop a plan so that staff/child ratios are maintained should a teacher need to open the door for parents and guests. MEDICAL ACTION PLANS: During today’s visit, I observed two (2) asthma inhalers locked in the medication box and a missing medical action plan. For any child with health care needs such as allergies, asthma, or other chronic conditions that require specialized health services, a medical action shall be attached to the application. Sample medical action plans may be found on the Division of Child Development and Early Education website at http://ncchildcare.ncdhhs.gov/providers/pv_provideforms.asp. In the classroom designated for toddlers, an asthma inhaler was not in its original container. All prescribed medications shall be stored in the original containers in which they were dispensed with the pharmacy labels that should include the following: the child's name; the names of the medication; the amount and frequency of dosage; the signature of the prescribing physician or other health professional; and the date the instructions were signed by the physician or other health professional. The medication shall be administered only to the child for whom they were prescribed; and shall be administered according to the prescription, using amount and frequency of dosage specified on the label. A parent's written authorization for the administration of a prescription medication described as listed above shall be valid for the length of time the medication is prescribed to be taken. Any medication remaining after the course of treatment is completed, after authorization is withdrawn or after authorization has expired shall be returned to the child's parents. Any medication the parent fails to retrieve within 72 hours of completion of treatment, or withdrawal of authorization, shall be discarded. STORAGE OF HAZARDOUS PRODUCTS AND MEDICATION: We also reminded staff that emergency medication such as inhalers, Epi-pens and seizure medication, is not required to be locked but must remain out of the reach of children. All medications, including topical ointments, require an authorization to administer medication form. The forms must be completed in their entirety, including the full name of the child, dates the medication is to be administered, dosage, frequency and parents signature. Authorization forms are good for a period of twelve (12) months, so please be sure to include the expiration date. Medications are required to be stored out of the reach of children, unless the product is dispensed from an aerosol can. Any product dispensed from an aerosol can must be locked. During today’s visit, a bottle of body spray was observed on a shelf in a cabinet that was not locked creating an unsafe environment for children. As a reminder, the only acceptable locks are combination locks, magnetic locks or locks that require a key. Please remember to remove the key from the lock in order for compliance to be met. FALSIFICATION: During today's visit, we requested to see the monthly fire drill log and monthly outdoor play inspections. After multiple requests, Ms. Wilcox produced the logs for both. A fire drill was documented for April 14, 2024 and May 18, 2024. April 14, 2024 was on a Sunday and May 18, 2024 had not yet occurred as the date of today's visit was May 16, 2024. Because I could not determine the date that the facility had conducted a monthly fire drill, a violation was cited. Outdoor play inspections were documented for May 24, 2024 and June 1, 2024. I stated to Ms. Wilcox that the play inspections could not have occurred on the dates documented since the dates had not occurred. When confronted with the information, Ms. Wilcox removed the inspections from the folder and said "oh, these are the wrong dates." Due to the signed, posted-dated fire drill logs and outdoor play inspections, a violation for falsification was documented. Please be reminded of the importance of providing accurate information, and never falsifying documents pertaining to your license. This type of violation can lead to the issuance of an administrative action, up to and including revocation of your license. The playground designated for toddlers has an increase of fire ants making it unsafe for children to play. Ms. Wilcox stated that she was aware of the fire ants and was caused by the recent rain the area has experienced. I stated that an exterminator would need to treat the area before the children can return to the outdoor learning environments. Thank you for your time today. For questions about today's visit, please contact me at 919-971-7765 or at the email above. 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