10A NCAC 09 .0302 · Violation

Name of Operation: ALMOST HOME WEE CARE, LLC Facility ID: 35000098 Consultant: FELICIA FAISON Operation Type: Center Case Number: Visit Date: 8/16/2024 Number Present: 30 Completed Date: 8/16/2024 Age: From 0 To 5 Total Minutes: 240 Time In: 09:00 AM Time Out: 01:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my unannounced visit today was to monitor compliance with child care requirements applicable to an annual compliance visit. You, J. Holden, administrator, were present and assisted with the visit. Currently, this center operates with a Three-Star license issued on June 28, 2017, earning four (4) points in the Education Component, two (2) points in the Program Component and one (1) Quality point. The last annual compliance visit conducted on September 6, 2022. The last sanitation inspection was completed June 26, 2024, earning a Superior rating. The last fire inspection was conducted December 12, 2023, and the facility was approved for daytime care only. Children were observed playing in activity centers, participating in teacher directed art, and infant feedings. Observed interactions between teachers and children were nurturing in nature. FACILITY PROFILE This facility is owned by ALMOST HOME WEE CARE, LLC. The corporation listed as owner of this facility is documented as current and active in the Secretary of State Database and is required to remain so per child care rules. I reviewed contact information for the owner and the facility with you and you verified the current information listed with DCDEE remains correct. The following violations of child care requirements were documented. Violation Number Comment Rule 620 All walls and ceilings including doors and windows were not kept clean, free of visible fungal growth, and in good repair. The bottom hinge of the door to the storage closet in space #5 is broken. 15A NCAC 18A .2825(a) 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Leftover medicines were not returned to the parent after the course of treatment was completed, after authorization was withdrawn or after authorization had expired and/or medication was not discarded within 72 hours of completion of treatment or withdrawal of authorization. An expired container of Aquaphor diaper cream was stored in space #4. .0803(12) 1034 All staff, including the director, did not have an annual health questionnaire on file following the initial medical statement. The staff person hired 9/12/22 did not have an annual health questionnaire on file. .0701(a) 1035 Child care providers, including the director, uncompensated providers, substitute providers, and volunteers did not have the required Emergency Information Form on file on or before the first day of work, which included all the required information and/or the information on the form was not updated as changes occur and at least annually. The staff person hired 9/12/22 did not have an emergency information form on file. .0701(a) 1323 Each child was not immunized as per Article 6 of Chapter 130A and an immunization record was not on file before or within 30 days after admission. Child enrolled 7/13/22 and 7/10/23 did not have an immunization record on file. 10A NCAC 09 .0302(d)(2) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing beneath the play equipment on the toddler playground measures below the required six (6) inches depth. .0605(k)(1-4) The violations documented above must be corrected immediately. A signed and dated letter of compliance can be mailed or emailed to me and must be received by August 30, 2024. If mailing, you must submit two (2) signed and dated copies. My mailing and email addresses are noted at the bottom. The letter of compliance must detail how the violations were corrected. Please be aware any written information you submit regarding the correction of the violation is legal documentation. Therefore, it is important that all submitted information is accurate and truthful. If it is determined that submitted information was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. COMPLIANCE HISTORY Prior to today’s visit your compliance history was 91% over an eighteen (18) month period. CHILDREN RECORDS I reviewed ten percent of children records, and a violation was documented. Children enrolled on 7/13/22 and 7/10/23 do not have immunization records in their files. The children are indicated on the Children’s Records form left with you. Child Care Rules require that both the medical and immunization reports be completed and on file within the firsts thirty (30) days of enrollment. I recommend requiring families to submit medical reports and immunization records in less than the allotted thirty (30) day time limit. This may ensure they are received within the required time frame. STAFF RECORDS I also reviewed ten (10) percent or more of staff records and a violation was documented. The staff person hired 9/12/22 and is indicated on the staff and training worksheet did not have a completed health questionnaire (HQ) or emergency information (EI) form on file. The staff person completed these forms during the visit, and they were placed in the file. Therefore, this violation was corrected during the visit. OUTDOOR ENVIRONMENT While monitoring the outdoor play are I observed that the wood chip surfacing below equipment on the toddler playground is measuring around 4.5 and 5 inches in some areas. Areas below play equipment measuring more than eighteen (18) inches are required to have at least six (6) inches of resilient surfacing it. This helps decrease the risk of injury should a child fall while playing. I recommend adding more surfacing or tilling and redistributing current surfacing and remeasuring. GENERAL REQUIREMENTS The door leading to the storage closet in space #5 has a broken bottom hinge. Therefore, the door will not close fully and swings open. Staff has placed a wooden toy kitchenette in front of the door to keep it closed and discourage children from moving the door. This must be repaired as it is required that all doors be kept clean and in good repair. This could cause a pinching hazard also if children move the kitchenette and play with the hinge or opening and closing the door. TECHNICAL ASSISTANCE & REMINDERS Please be reminded that staff who have not earned their required number of on-going training hours must complete them by August 29th as this was the date your last Annual Compliance was completed. Keep the training log and certificates for the current and previous year between annual compliance visits. Technical assistance discussed regarding the playground fencing and possibly adding some yellow tubing to the top of the fencing to ensure it always meets the four-foot height requirement. If not, then removing buildup of compacted dirt would need to be done to combat settling and avoid future non-compliance. I also discussed staff noting their initials on the sleep check form when they note the time. This will ensure that if there is ever a question or concern regarding when an infant was checked it is documented who completed the check. I also recommend having parents or staff do the same when check children in our out for the day and for the same reason. Child care licensing requirements are established to ensure a safe and healthy child care environment. It is your responsibility to maintain compliance with all applicable laws and rules. The best way to do so is to periodically review the child care laws and rules. The current rule book dated January 1, 2024, is available at the DCDEE website https://ncchildcare.ncdhhs.gov/. Modules are now available to review the new Child Care Rules on Moodle, which can be found on the Division website. I recommend you frequently click the “What’s New” tab to stay informed of all updates on the DCDEE website. Please feel free to contact me at (984) 867-7089 or email at Felicia.faison@dhhs.nc.gov for questions and assistance. If needed my mailing address is PO Box 61161, Raleigh NC 27661. You may also contact Susan Fuller, Licensing Supervisor at (252) 373-9809. 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 .0803 · Violation

Name of Operation: ALMOST HOME WEE CARE, LLC Facility ID: 35000098 Consultant: FELICIA FAISON Operation Type: Center Case Number: Visit Date: 4/17/2024 Number Present: 42 Completed Date: 4/17/2024 Age: From 0 To 5 Total Minutes: 170 Time In: 09:10 AM Time Out: 12:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Routine Unannounced Announced/Unannounced: Unannounced The purpose of my unannounced visit today was to monitor compliance with child care requirements applicable to a routine unannounced visit. You, J. Holden, administrator, were present and assisted with the visit. Currently, this center operates with a Three-Star license issued on June 28, 2017, earning four (4) points in the Education Component, two (2) points in the Program Component and one (1) Quality point. The last annual compliance visit was conducted on August 29, 2023. The last sanitation inspection was completed June 29, 2023, earning a Superior rating. The last fire inspection was conducted December 12, 2023, and the facility was approved for daytime care only. Children were observed engaging in outdoor play, infant feeding and rest time. Observed interactions between teachers and children were nurturing in nature. The following violations of child care requirements were documented. Violation Number Comment Rule 847 Parent's medication authorization did not include required information. There was no medication authorization form on-site for a container of desitin stored in space #6. 10A NCAC 09 .0803(4)(6-9) 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. The AHA Basic Life Support training did not include pediatric first aid modules for staff hired 9/5/23. .1102(c) The violations documented above must be corrected immediately. A signed and dated letter of compliance can be mailed or emailed to me and must be received by May 1, 2024. If mailing, you must submit two (2) signed and dated copies. My mailing and email addresses are noted at the bottom. The letter of compliance must detail how each violation was corrected. Please be aware that any written information you submit regarding the correction of the violation is legal documentation. Therefore, it is important that all submitted information is accurate and truthful. If it is determined that submitted information was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. STAFF/CHILD INTERACTION I observed infants completing breakfast or being held while receiving their bottle. Some infants were napping while another played in a bouncy seat. The older children were playing outdoors as a fire drill was just completed. There were plenty of materials available to help them engage in gross motor activities such as push toys, play equipment with slides and climbers, a sand box and balls. Please be reminded that staff/child ratios and maximum group sizes must be maintained on the playground as well. However, this does not include fire drills due to practicing for a true emergency. Activity plans, schedules and other required items were posted in each space. Teachers interacted with each child in a caring and nurturing manner. STAFF RECORDS & MEDICATION You confirmed that only one new staff member has been hired since the last visit on August 29, 2023. The staff person hired 9/5/23 completed an American Heat Association BLS (CPR and AED) training. However, was not specific to the age group in care as the optional pediatric first aid module was not included. The staff person must complete the required module to be in compliance. If this can not be completed by May 1st you may request an extension through the date of the next available pediatric CPR/first aid training. While monitoring space #6 I observed a container of desitin stored for an enrolled child. There was no corresponding medication permission form on-site authorizing staff to use the ointment on the child. Please be reminded to return or throw away any medication that is no longer in use, expired, or the permission has expired. TECHNICAL ASSISTANCE & REMINDERS While a violation was not warranted technical assistance given related to staff storing purses in locked areas. If a purse is accessible to children, it is part of the environment and may be monitored as well for hazardous items or products such as medicine, lighters, etc. While sanitation may require these items be stored five (5) feet above the floor you will not be penalized if it is kept in locked storage. Technical assistance given regarding depth of wood mulch surfacing on toddler playground. The depth should be monitored periodically to ensure that it remains at the required six (6) inch level. Resilient surfacing, such as wood chips, helps to reduce the chance of injury should a child fall from the play equipment. The building siding should be monitored for areas that may crack and expose sharp edges or pieces broken off. The Clean Water for Carolina Kids program is expanding to the Clean Classrooms for Carolina Kids program. This is a legislatively mandated effort to address lead and asbestos hazards in North Carolina public schools, licensed child care centers, and licensed family child care homes. Participation allows facilities to meet all rule requirements for identified lead and asbestos hazards, as required by law. Rules 10A NCAC 41C .1001 through .1007 require all programs to be free of lead and asbestos hazards. RTI is coordinating all the lead in water, paint and asbestos testing and remediation. There are webinars that child care providers can watch to get instructions. Go to https://www.cleanwaterforuskids.org/en/carolina/ for more information. Currently operating child care facilities are required to test for lead in paint and asbestos once unless the consultant notes a concern during a visit and refers the program to environmental health. All existing licensed programs must complete the application summary for their program regarding lead paint and asbestos by May 1, 2024. The application is on the following website: https://www.cleanwaterforuskids.org/en/carolina/. The rule also requires all licensed child care centers to test all drinking water faucets and food preparation sinks for lead contamination once every three years. I recommend you review the date of your initial lead water testing to see if you are due this year. Child care licensing requirements are established to ensure a safe and healthy child care environment. It is your responsibility to maintain compliance with all applicable laws and rules. The best way to do so is to periodically review the child care laws and rules. The current rule book dated January 1, 2024, is available at the DCDEE website https://ncchildcare.ncdhhs.gov/. There are also modules of the new Child Care Rules available on Moodle, which can be found on the Division website. I recommend you frequently click the “What’s New” tab to stay informed of all updates on the DCDEE website. Please feel free to contact me at (984) 867-7089 or email at Felicia.faison@dhhs.nc.gov for questions and assistance. If needed my mailing address is PO Box 61161, Raleigh NC 27661. You may also contact Susan Fuller, Licensing Supervisor at (252) 373-9809. 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.

GS110-91 · Violation

Name of Operation: ALMOST HOME WEE CARE, LLC Facility ID: 35000098 Consultant: FELICIA FAISON Operation Type: Center Case Number: Visit Date: 8/29/2023 Number Present: 37 Completed Date: 8/29/2023 Age: From 0 To 5 Total Minutes: 335 Time In: 09:15 AM Time Out: 02:50 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced The purpose of my unannounced visit today was to monitor compliance with child care requirements applicable to an annual compliance visit. You, J. Holden, administrator, were present and assisted with the visit. Currently, this center operates with a Three-Star license issued on June 28, 2017, earning four (4) points in the Education Component, two (2) points in the Program Component and one (1) Quality point. The last annual compliance visit conducted on September 6, 2022. The last sanitation inspection was completed June 29, 2023, earning a Superior rating. The last fire inspection was conducted December 13, 2022, and the facility was approved for daytime care only. Children were observed finishing breakfast and engaging in free choice activity center play. Observed interactions between teachers and children were nurturing in nature. FACILITY PROFILE This facility is owned by ALMOST HOME WEE CARE, LLC. The corporation listed as owner of this facility is documented as current and active in the Secretary of State Database and is required to remain so per child care rules. I reviewed contact information for the owner and the facility with you and you verified the current information listed with DCDEE remains correct. The following violations of child care requirements were documented. Violation Number Comment Rule 805 Fire drills were not practiced monthly and/or the drill record was incomplete. The current fire drill log listed dates for fire drills and staff signature but none of the other required information. .0604(t); .0302(d)(5) 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. An expired Avi-Q epi medication in space #2 and a tube of A&D ointment with a 2021 expiration in space #5 were on-site for use. .0803(12) 1321 Medical exam or health assessment record was not on file before or within 30 days after admission. A child enrolled 10/19/20 has medical report that as completed 11/23/21. A child 7/25/22 does not have a medical report on file. GS110-91(1) 1812 The center did not complete an EPR Plan within four months of completing the EPR in Child Care training and/or the Plan was not completed on a template provided by the Division. The EPR plan was not available for review. .0607(c) 1867 The depth of the loose surfacing was not based on critical height of the equipment. The surfacing beneath the play equipment on the preschool playground measures 4.5 inches or less in depth facing the fence. .0605(k)(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. The staff person hired 9/12/22 has yet to complete the Recognizing and Responding to Suspicions of Maltreatment training. .1102(g) The violations documented above must be corrected immediately. A signed and dated letter of compliance can be mailed or emailed to me and must be received by September 12, 2023. If mailing, you must submit two (2) signed and dated copies. My mailing and email addresses are noted at the bottom. The letter of compliance must detail how the violations were corrected. Please be aware any written information you submit regarding the correction of the violation is legal documentation. Therefore, it is important that all submitted information is accurate and truthful. If it is determined that submitted information was inaccurate or willfully falsified, an Administrative Action, including Revocation of the facility’s license could be issued. COMPLIANCE HISTORY Prior to today’s visit your compliance history was 86% over an eighteen (18) month period. CHILDREN RECORDS I reviewed ten percent of children files, and three violations were documented. I observed that a child enrolled 10/19/20 has a medical report on file that was completed 11/23/21. The child enrolled 7/25/22 does not have a medical report. Child Care Rules require that both the medical reports be completed and on file within the firsts thirty (30) days of enrollment. STAFF RECORDS All new staff files and ten percent of remaining staff files were reviewed, and a violation was documented. The staff person hired 9/12/22 has yet to complete the required Recognizing and Responding to Suspicions of Child Maltreatment training. This specialized training is required to be complete within the first ninety (90) days of staff employment. Please be reminded that any form that is required to be updated annually must be done prior to or on the last date it was completed including evaluations, development plans, plan/policy review, etc. I reminded you that CPR and First Aid training does not count toward on-going training hours. It may be listed on the on-going training log but the hours cannot be added to meet staff’s required amount. The newest staff person hired PROGRAM RECORDS The current year’s fire drill log was monitored today. While dates and administrator signature were listed for the months September 2022 through August 2023 none of the other information was documented. Child Care Rules require that the time and length of time to evacuate is documented along with spaces for other information. There was no EPR plan available for review. You stated that while it has been completed you could not locate it after looking for it. I recommend that if you do not find it that you log into the risk management portal (https://rmp.nc.gov/portal/#) and reprint it. Continue to ensure that you log in every to review the plan even if no changes are needed. OUTDOOR PLAY AREA I monitored the outdoor play areas today. The wood chip surfacing below the large equipment on the preschool playground measured 4.5 inches or less in two areas facing the fence. You informed me that the surfacing often becomes displaced after a large storm and wash down toward the fencing and must be moved back into place. I recommend this be done prior to play on the equipment after weather causes the displacement and additional surfacing be added so depth measures at least six inches. Resilient surfacing is an important part of playground safety as it decreases the chance of serious injury should a child fall from the play equipment. MEDICATION During monitoring of space #2 I noted that the Avi-Q epinephrine medication stored for use expired 6/14/23. This medication must be returned to the parents and new medication brought in for use while in care. I also observed a tube of A&D ointment stored for use in space #5 that expired in 2021 and when told the teacher disposed of it. Please remember Child Care Rules require that all medications administered to children not be expired. I also recommended that you ensure parents note the date along with their signature for verification of the timeframe. TECHNICAL ASSISTANCE & REMINDERS Please be reminded that staff who have not earned their required number of on-going training hours must complete them by September 6th as this was the date your last Annual Compliance was completed. Keep the training log and certificates for the current and previous year between annual compliance visits. Ensure all staff know that disinfectant cleaning wipes must be kept in locked storage when not in use, storing these items above five (5) feet means they are out of compliance and a violation may be warranted. Technical assistance discussed regarding the playground fencing and possibly adding some yellow tubing to the top of the fencing to ensure it always meets the four-foot height requirement. If not then the build up of compacted dirt would need to be removed from the base to continue meeting this requirement to avoid future non-compliance. Child care licensing requirements are established to ensure a safe and healthy child care environment. It is your responsibility to maintain compliance with all applicable laws and rules. The best way to do so is to periodically review the child care laws and rules. The current rule book dated July 1, 2023, is available at the DCDEE website https://ncchildcare.ncdhhs.gov/. Modules are now available to review the new Child Care Rules on Moodle, which can be found on the Division website. I recommend you frequently click the “What’s New” tab to stay informed of all updates on the DCDEE website. Please feel free to contact me at (984) 867-7089 or email at Felicia.faison@dhhs.nc.gov for questions and assistance. If needed my mailing address is PO Box 61161, Raleigh NC 27661. You may also contact Susan Fuller, Licensing Supervisor at (252) 373-9809. 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.