10A NCAC 09 .0304 · Violation

Name of Operation: Little Fisch Childcare LLC Facility ID: 27000139 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/19/2025 Number Present: 11 Completed Date: 8/19/2025 Age: From 1 To 9 Total Minutes: 405 Time In: 08:45 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s Annual Compliance visit was to monitor compliance with applicable child care requirements. Change of Operation from FCCH to CLIAR – 10/17/24 18-month compliance history from 2/15/24 – 8/14/25 = 96% Last Sanitation Inspection – 8/4/25 - Approved Water Testing (Lead) – completed 7/5/24; due again 7/5/27 Last Fire Inspection – 8/1/25 – Satisfactory; Daytime Care Only; previous fire inspection 7/24/24; expired 7/31/25 *Sanitation and fire inspections are required at least annually by the end of the month of the previous inspection. Send fire inspections to me within seven (7) days of the inspection. A. Fischer, Administrator, was present and assisted me with the visit. The facility currently operates with a Three-Star Center License, issued 4/15/25 (capacity change). The next rated license assessment is due by 1/1/28. The Child Care Commission adopted the QRIS Modernization rules (Pathways to Stars), and the Division is in the process of transitioning from the former rated license rules to the new QRIS rules. Information, training, resources, and updated forms will be shared with you as we implement the new rules. See Additional Comments for more information about upcoming webinars. Note that the current program assessment tool is changing from the Family Child Care Environment Rating Scale – Revised (FCCERS-R) to Family Child Care Environment Rating Scale – 3rd Edition (FCCERS-3). Information and training on the new program assessment tool is available on the NC Rating License Assessment Project website at https://ncrlap.org/. Even though you are more than two years away from having to renew your rated license, I encourage you to participate in the information sessions. This facility is owned by Little Fisch Childcare LLC. According to the NC Secretary of State's website, this limited liability corporation is current and active as of 8/12/25. Failure to complete Annual Reports with the Secretary of State may result in dissolution of your LLC. License and contact information were current. Please contact me prior to any information change regarding the ownership of this facility, license updates, or contact information (address, phone, or email). We updated your Legal Designee form. I monitored the spaces used for child care and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2025 and Item Numbers Listing, effective 4/2025. I monitored two staff records, two children’s records and all program records. The facility continues to be approved for transportation. Center Observations: The operator and staff member were present with ten (10) children, one through nine years of age. The child care space was arranged into a toddler/two area, preschool area, and school-age area. A second toddler arrived later. The operator and parent exchanged information, and he documented arrival time on the attendance sheet available at the entrance. One lead teacher played with the two toddlers in their space. The owner/lead teacher provided activities for preschool and school-age children. They participated in morning free play with developmentally appropriate materials. It was raining so they did music and movement activities. The operator stated they would go outside after naptime if the rain stopped. Both teachers read stories to the children. Activity plans, reflecting a friendship theme were posted. The posted menu displayed chicken tenders, carrots, blueberries, whole grain crackers, and milk. However, corn was substituted for carrots. The menus were updated to reflect the substitution. After lunch, children used the bathroom and washed hands and rested on linen-covered mats. The center added a stationary rock wall climber to the playground. The wood chip surfacing measured 12 inches. A six-foot fall zone was available under and around the climber. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The previous fire inspection was completed on July 24, 2024 and expired on July 31, 2025. A new fire inspection was not completed until August 1, 2025 and was provided today. The operator did not send the completed fire inspection report within seven (7) days. 10A NCAC 09 .0304(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. Albuterol, prescribed for a school-age child, expired July 2025 and was not returned to the parent. Medication permission forms for the Albuterol and an Epi-pen expired on July 26, 2024 and were not updated. The medications were not returned. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A new staff member hired on February 10, 2025 did not provide a staff medical report until February 28, 2025. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A new staff member hired on February 10, 2025 did not provide a documentation of a negative TB screening until February 28, 2025. .0701(a) 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. Medication Action Plans for a school-age child with food allergies and asthma were dated August 25, 2022 and were not updated. .0801(b) * Child care programs are expected to achieve and always maintain compliance and are required by NC GS 110-90(4)(d) to achieve and maintain an 18-month compliance history score of at least 75%. Any violations documented may impact the compliance history score. I completed an electronic copy of the visit summary and provided a printed copy of it to you, A. Fischer. We reviewed the visit summary and violation(s) documented during today’s visit. Three of the five violations have been corrected. Correct the two violations related to medication administration immediately. Send evidence of correction to me so that I receive it no later than 9/2/25. Your compliance verification letter needs to state your facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Do not include names of children in the compliance letter. Use their initials, if needed. Send compliance verification letter in an email from your center’s official email address, littlefischcc@gmail.com to my email address, Marjorie.White@dhhs.nc.gov. You may include the compliance verification as an attachment or in the body of the email. I will email a sample compliance verification letter to you. If sufficient information is not received by the due date, a follow-up visit may be conducted. Please be aware that any information submitted by you is legal documentation. If it is determined the information provided in the compliance letter is not true, this may be considered falsification of information. If I may be of further assistance, please contact me by phone at (252) 373-9385, by e-mail at Marjorie.White@dhhs.nc.gov. You may also call Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199. Technical Assistance With Documented Violations: Annual Fire Inspection – Annual fire inspections ensure that the building meets fire codes and that your fire detection and alarm systems are operating correctly in the event of a fire. The fire inspector completed a fire inspection on 7/24/2024; a new fire inspection was due by 7/31/2025 but was not completed until 8/1/2025; you did not provide a copy of the inspection to me until today, 8/19/2025. You stated that you requested the fire inspection at the beginning of July, but the fire inspector was not able to schedule a visit in July and then you forgot to scan and email it to me. To request a fire inspection in Currituck, contact the County Inspections Department, complete the appropriate form and pay the annual inspection fee. Have your fire and electrical systems tests and annual fire safety training completed before the inspection so that documentation is available for the fire inspector. Consider beginning this process at least two months before the actual fire inspection is due to ensure the final inspection is completed on time. Expired Medication/Medication Permission Forms – Having expired medication or expired authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. Albuterol, prescribed for a school-age child, expired July 2025. Medication permission forms for the Albuterol and an Epi-pen expired on 7/26/24. The emergency medications were not returned to the parent within 72 hours after the medication permission forms expired in July 2024 or after the Albuterol expired in July 2025. You stated that you thought the parent just updated the permission forms. Return the expired Albuterol to the parent or request a current Albuterol canister with a new medication permission form authorized for up to six months. Return the Epi-pen to the parent or provide them with a new medication permission form to complete.. Consider checking your medication bag monthly to verify that medication and permission forms are current. For your compliance letter, state the date when the Albuterol and Epi-pen are returned to the parent or updated medication permission forms are available Staff Records - Receipt of a Staff Medical Report and Documentation of a negative TB Test or a TB Screening received from new staff by their first day of working in your center verifies that they are healthy enough to work with children and other staff and complete the physical responsibilities needed to work in child care. A new staff member was hired on 2/10/2025 but did not provide a current Staff Medical Report and documentation of a negative TB screening until 2/28/25. The administrator stated that she had to reschedule her appointment which was originally scheduled before her first day of work. Use a Staff File Check list to track receipt of required documents at employment helps you ensure required forms are received before a new employee starts. These violations have been corrected. Expired Medical Action Plan – Medical Action Plans are valid for one year and must be updated annually. Because the medical action plan is used as a guide for administering medication, it needs to be updated annually to ensure dosage and administration are current. Medication Action Plans for a school-age child with food allergies (Epi Pen) and asthma were dated 8/25/22. You were not aware that they had expired. Have the parent review the Medical Action Plan and update if information is still valid or provide you with updated Medical Action Plans from the physician. For your compliance letter, state the date when current Medical Action Plans are available. Include updated copies with the Child’s Application in this file and in the Ready-To-Go File. General Visit Information: As a licensed child care facility, it is your responsibility to be knowledgeable of the child care laws and rules and to teach your staff the rules to ensure your center remains in compliance. The most recent versions of laws and rules regarding child care facilities in North Carolina are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. You can also review the “What’s New” section and download a copy of the Items Number Listing which you can use as a checklist for your program. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies and Child Care Health Consultants provide general training to meet on-going training hours, health and safety training requirements, Environment Rating Scale training and training specific to your center’s needs. They can also work with you to provide on-site technical assistance. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Child Care Health Consultant – C. Smith - (252) 340-0212 or cindy@aacfnc.org *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *Birth to 3 Quality Specialist: J. Davidson – Phone (252) 333-1233; joy@aacfnc.org *Other On-going Training and CEU Resources - Southwestern Child Development Commission, www.swcdcinc.org, Child Care Resources Inc., https://www.childcareresourcesinc.org/ and Early Years, https://www.earlyyearsnc.org/ offer DCDEE approved, on-line, self-paced and virtual real-time training and training that counts towards CEU’s. SWCDC also offers affordable annual packages allowing you to take as many courses as you need or want for one price. The Natural Learning Initiative (https://naturalearning.org/) offers a variety of resources such as training, YouTube videos, handouts, etc. to help you add natural elements to your outdoor play spaces to promote time outdoors. Check out the NLI Resource Hub including Design Sites, Infosheets, The Green Desk, Interactive Apps and more! Your children and your teachers will want to go outdoors again! Reminders: ABCMS Portal - I will email the ABCMS Provider Portal Access Guide which will assist with the step-by-step process of working in the ABCMS Portal, accessing your Pay Codes, helping your staff complete their Connecting Applications, and eventually “hiring” staff to your roster. • If you need assistance accessing or using the ABCMS Provider Portal, contact the Criminal Background Check Unit at (919) 814-6401 or DCDEE_ABCMS_Provider@dhhs.nc.gov and someone will assist you. • If you or your staff need assistance with completing a Criminal Background Check in the ABCMS Applicant Portal, contact the Criminal Background Check Unit at (919) 814-6401 or DHHS.CBC.Unit@dhhs.nc.gov and someone will assist you. • If you or your staff need assistance with your NCID, contact https://myNCID.nc.gov or (919) 754-6000. Staff Worksheets – Your Staff Worksheets are a great tool to help you track when items such as Criminal Background Checks, required trainings and staff forms expire and need to be updated. I encourage you to update information on the staff worksheets throughout the year as items are updated and/or staff change. *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *Health and Safety Training – current for all staff *On-going Training Hours – Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours returning staff will need by 8/19/25, anniversary of today’s Annual Compliance visit). *Update various staff forms on a cycle so that all staff forms required to be reviewed and updated are completed for all staff at the same time. Even though DR’s Annual Evaluation and Professional Development Plan are not due until February 2026, consider completing them when yours are due to be updated in October 2025. Staff Education and Works – D. Rheaume completed EDU 119 and needs to request an official, original transcript. She can mail an unopened copy to DCDEE or request that a hard copy or electronic copy be sent from COA to DCDEE. She needs to register for Works and request to be approved as a lead teacher, teacher, and group leader. The BSAC form can be uploaded into Works, but the college transcripts need to be sent directly to DCDEE. DR also has three semester hours in Dev Psych that can count towards her education. Have transcripts from that community college sent to Works also. *EPR Plan – last updated in Portal – July 2025 *Ready-to-Go File – current; be sure to update when new children start at the beginning of the school year *Emergency Medical Care Plan – current *Fire and Emergency Drills - current Additional Comments: Transition to New QRIS - Pathway to the Stars – The Child Care Commission voted to adopt the Quality Rating Improvement System (QRIS) Modernization Proposed Rule Amendments and Adoptions. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition will begin soon with the following informational opportunities: In August, we’ll provide a rule roll out module in the DCDEE e-learning Moodle platform and host webinars on the following dates and times: • August 20th at 1:00pm (family child care homes) and 6:30pm (child care centers and centers located in a residence) All the newest information will be posted at QRIS Modernization and will also be provided through emails and Raise NC newsletters. Raise NC Newsletter – If you are not receiving and reading the Raise NC Newsletter, you are missing out on current relevant information about early childhood issues in North Carolina, information about proposed rules, available trainings and other information that may be of interest to you and your staff. The Raise NC Newsletter is typically sent out weekly to all facility contact email addresses, but if your email is not the facility contact email address, you can go to the DCDEE Website, https://ncchildcare.ncdhhs.gov/ and click on the “What’s New” tab. Click on “What’s New” and enter your email address and name under “Sign Up for Updates”. As an early learning professional, you need to stay in the know about issues in North Carolina that affect you and your business. Share with your staff so they can be in the know too! Keep Your NCID Active - Did you know that if you do not login on to any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. *Pro Tip: Set your calendar to remind you, your staff and your household members (CLIAR only) every 6 months to log in and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. *For assistance with NCID, contact ncid.nc.gov or 919.754.6000. I shared information on the following topics and emailed the information to you after the visit: 1. Pathway to Stars Updates – Webinars, Meetings, Implementation 2. Address the Stress: Take Care of You! - Free self-paced, online Professional Development for NC Child Care Professionals (1 DCDEE training credit hour) 3. Setting Up Effective Classroom Environments Webinar– Tuesday, 8/19; 7 – 8pm 4. New Training in Moodle – Child Development 5. Moodle Helpful Hints 6. Environment Rating Scales – Get Ready for the 3’s! Thank you for your time and assistance today. Refer to this visit summary for a refresher of our discussions today, and I encourage you to share with staff and use the information as a teaching tool. If you have any questions, do not hesitate to call or email me at the contact information listed 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: supervision. Open / not marked corrected.

10A NCAC 09 .0701 · Violation

Name of Operation: Little Fisch Childcare LLC Facility ID: 27000139 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/19/2025 Number Present: 11 Completed Date: 8/19/2025 Age: From 1 To 9 Total Minutes: 405 Time In: 08:45 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s Annual Compliance visit was to monitor compliance with applicable child care requirements. Change of Operation from FCCH to CLIAR – 10/17/24 18-month compliance history from 2/15/24 – 8/14/25 = 96% Last Sanitation Inspection – 8/4/25 - Approved Water Testing (Lead) – completed 7/5/24; due again 7/5/27 Last Fire Inspection – 8/1/25 – Satisfactory; Daytime Care Only; previous fire inspection 7/24/24; expired 7/31/25 *Sanitation and fire inspections are required at least annually by the end of the month of the previous inspection. Send fire inspections to me within seven (7) days of the inspection. A. Fischer, Administrator, was present and assisted me with the visit. The facility currently operates with a Three-Star Center License, issued 4/15/25 (capacity change). The next rated license assessment is due by 1/1/28. The Child Care Commission adopted the QRIS Modernization rules (Pathways to Stars), and the Division is in the process of transitioning from the former rated license rules to the new QRIS rules. Information, training, resources, and updated forms will be shared with you as we implement the new rules. See Additional Comments for more information about upcoming webinars. Note that the current program assessment tool is changing from the Family Child Care Environment Rating Scale – Revised (FCCERS-R) to Family Child Care Environment Rating Scale – 3rd Edition (FCCERS-3). Information and training on the new program assessment tool is available on the NC Rating License Assessment Project website at https://ncrlap.org/. Even though you are more than two years away from having to renew your rated license, I encourage you to participate in the information sessions. This facility is owned by Little Fisch Childcare LLC. According to the NC Secretary of State's website, this limited liability corporation is current and active as of 8/12/25. Failure to complete Annual Reports with the Secretary of State may result in dissolution of your LLC. License and contact information were current. Please contact me prior to any information change regarding the ownership of this facility, license updates, or contact information (address, phone, or email). We updated your Legal Designee form. I monitored the spaces used for child care and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2025 and Item Numbers Listing, effective 4/2025. I monitored two staff records, two children’s records and all program records. The facility continues to be approved for transportation. Center Observations: The operator and staff member were present with ten (10) children, one through nine years of age. The child care space was arranged into a toddler/two area, preschool area, and school-age area. A second toddler arrived later. The operator and parent exchanged information, and he documented arrival time on the attendance sheet available at the entrance. One lead teacher played with the two toddlers in their space. The owner/lead teacher provided activities for preschool and school-age children. They participated in morning free play with developmentally appropriate materials. It was raining so they did music and movement activities. The operator stated they would go outside after naptime if the rain stopped. Both teachers read stories to the children. Activity plans, reflecting a friendship theme were posted. The posted menu displayed chicken tenders, carrots, blueberries, whole grain crackers, and milk. However, corn was substituted for carrots. The menus were updated to reflect the substitution. After lunch, children used the bathroom and washed hands and rested on linen-covered mats. The center added a stationary rock wall climber to the playground. The wood chip surfacing measured 12 inches. A six-foot fall zone was available under and around the climber. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The previous fire inspection was completed on July 24, 2024 and expired on July 31, 2025. A new fire inspection was not completed until August 1, 2025 and was provided today. The operator did not send the completed fire inspection report within seven (7) days. 10A NCAC 09 .0304(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. Albuterol, prescribed for a school-age child, expired July 2025 and was not returned to the parent. Medication permission forms for the Albuterol and an Epi-pen expired on July 26, 2024 and were not updated. The medications were not returned. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A new staff member hired on February 10, 2025 did not provide a staff medical report until February 28, 2025. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A new staff member hired on February 10, 2025 did not provide a documentation of a negative TB screening until February 28, 2025. .0701(a) 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. Medication Action Plans for a school-age child with food allergies and asthma were dated August 25, 2022 and were not updated. .0801(b) * Child care programs are expected to achieve and always maintain compliance and are required by NC GS 110-90(4)(d) to achieve and maintain an 18-month compliance history score of at least 75%. Any violations documented may impact the compliance history score. I completed an electronic copy of the visit summary and provided a printed copy of it to you, A. Fischer. We reviewed the visit summary and violation(s) documented during today’s visit. Three of the five violations have been corrected. Correct the two violations related to medication administration immediately. Send evidence of correction to me so that I receive it no later than 9/2/25. Your compliance verification letter needs to state your facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Do not include names of children in the compliance letter. Use their initials, if needed. Send compliance verification letter in an email from your center’s official email address, littlefischcc@gmail.com to my email address, Marjorie.White@dhhs.nc.gov. You may include the compliance verification as an attachment or in the body of the email. I will email a sample compliance verification letter to you. If sufficient information is not received by the due date, a follow-up visit may be conducted. Please be aware that any information submitted by you is legal documentation. If it is determined the information provided in the compliance letter is not true, this may be considered falsification of information. If I may be of further assistance, please contact me by phone at (252) 373-9385, by e-mail at Marjorie.White@dhhs.nc.gov. You may also call Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199. Technical Assistance With Documented Violations: Annual Fire Inspection – Annual fire inspections ensure that the building meets fire codes and that your fire detection and alarm systems are operating correctly in the event of a fire. The fire inspector completed a fire inspection on 7/24/2024; a new fire inspection was due by 7/31/2025 but was not completed until 8/1/2025; you did not provide a copy of the inspection to me until today, 8/19/2025. You stated that you requested the fire inspection at the beginning of July, but the fire inspector was not able to schedule a visit in July and then you forgot to scan and email it to me. To request a fire inspection in Currituck, contact the County Inspections Department, complete the appropriate form and pay the annual inspection fee. Have your fire and electrical systems tests and annual fire safety training completed before the inspection so that documentation is available for the fire inspector. Consider beginning this process at least two months before the actual fire inspection is due to ensure the final inspection is completed on time. Expired Medication/Medication Permission Forms – Having expired medication or expired authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. Albuterol, prescribed for a school-age child, expired July 2025. Medication permission forms for the Albuterol and an Epi-pen expired on 7/26/24. The emergency medications were not returned to the parent within 72 hours after the medication permission forms expired in July 2024 or after the Albuterol expired in July 2025. You stated that you thought the parent just updated the permission forms. Return the expired Albuterol to the parent or request a current Albuterol canister with a new medication permission form authorized for up to six months. Return the Epi-pen to the parent or provide them with a new medication permission form to complete.. Consider checking your medication bag monthly to verify that medication and permission forms are current. For your compliance letter, state the date when the Albuterol and Epi-pen are returned to the parent or updated medication permission forms are available Staff Records - Receipt of a Staff Medical Report and Documentation of a negative TB Test or a TB Screening received from new staff by their first day of working in your center verifies that they are healthy enough to work with children and other staff and complete the physical responsibilities needed to work in child care. A new staff member was hired on 2/10/2025 but did not provide a current Staff Medical Report and documentation of a negative TB screening until 2/28/25. The administrator stated that she had to reschedule her appointment which was originally scheduled before her first day of work. Use a Staff File Check list to track receipt of required documents at employment helps you ensure required forms are received before a new employee starts. These violations have been corrected. Expired Medical Action Plan – Medical Action Plans are valid for one year and must be updated annually. Because the medical action plan is used as a guide for administering medication, it needs to be updated annually to ensure dosage and administration are current. Medication Action Plans for a school-age child with food allergies (Epi Pen) and asthma were dated 8/25/22. You were not aware that they had expired. Have the parent review the Medical Action Plan and update if information is still valid or provide you with updated Medical Action Plans from the physician. For your compliance letter, state the date when current Medical Action Plans are available. Include updated copies with the Child’s Application in this file and in the Ready-To-Go File. General Visit Information: As a licensed child care facility, it is your responsibility to be knowledgeable of the child care laws and rules and to teach your staff the rules to ensure your center remains in compliance. The most recent versions of laws and rules regarding child care facilities in North Carolina are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. You can also review the “What’s New” section and download a copy of the Items Number Listing which you can use as a checklist for your program. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies and Child Care Health Consultants provide general training to meet on-going training hours, health and safety training requirements, Environment Rating Scale training and training specific to your center’s needs. They can also work with you to provide on-site technical assistance. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Child Care Health Consultant – C. Smith - (252) 340-0212 or cindy@aacfnc.org *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *Birth to 3 Quality Specialist: J. Davidson – Phone (252) 333-1233; joy@aacfnc.org *Other On-going Training and CEU Resources - Southwestern Child Development Commission, www.swcdcinc.org, Child Care Resources Inc., https://www.childcareresourcesinc.org/ and Early Years, https://www.earlyyearsnc.org/ offer DCDEE approved, on-line, self-paced and virtual real-time training and training that counts towards CEU’s. SWCDC also offers affordable annual packages allowing you to take as many courses as you need or want for one price. The Natural Learning Initiative (https://naturalearning.org/) offers a variety of resources such as training, YouTube videos, handouts, etc. to help you add natural elements to your outdoor play spaces to promote time outdoors. Check out the NLI Resource Hub including Design Sites, Infosheets, The Green Desk, Interactive Apps and more! Your children and your teachers will want to go outdoors again! Reminders: ABCMS Portal - I will email the ABCMS Provider Portal Access Guide which will assist with the step-by-step process of working in the ABCMS Portal, accessing your Pay Codes, helping your staff complete their Connecting Applications, and eventually “hiring” staff to your roster. • If you need assistance accessing or using the ABCMS Provider Portal, contact the Criminal Background Check Unit at (919) 814-6401 or DCDEE_ABCMS_Provider@dhhs.nc.gov and someone will assist you. • If you or your staff need assistance with completing a Criminal Background Check in the ABCMS Applicant Portal, contact the Criminal Background Check Unit at (919) 814-6401 or DHHS.CBC.Unit@dhhs.nc.gov and someone will assist you. • If you or your staff need assistance with your NCID, contact https://myNCID.nc.gov or (919) 754-6000. Staff Worksheets – Your Staff Worksheets are a great tool to help you track when items such as Criminal Background Checks, required trainings and staff forms expire and need to be updated. I encourage you to update information on the staff worksheets throughout the year as items are updated and/or staff change. *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *Health and Safety Training – current for all staff *On-going Training Hours – Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours returning staff will need by 8/19/25, anniversary of today’s Annual Compliance visit). *Update various staff forms on a cycle so that all staff forms required to be reviewed and updated are completed for all staff at the same time. Even though DR’s Annual Evaluation and Professional Development Plan are not due until February 2026, consider completing them when yours are due to be updated in October 2025. Staff Education and Works – D. Rheaume completed EDU 119 and needs to request an official, original transcript. She can mail an unopened copy to DCDEE or request that a hard copy or electronic copy be sent from COA to DCDEE. She needs to register for Works and request to be approved as a lead teacher, teacher, and group leader. The BSAC form can be uploaded into Works, but the college transcripts need to be sent directly to DCDEE. DR also has three semester hours in Dev Psych that can count towards her education. Have transcripts from that community college sent to Works also. *EPR Plan – last updated in Portal – July 2025 *Ready-to-Go File – current; be sure to update when new children start at the beginning of the school year *Emergency Medical Care Plan – current *Fire and Emergency Drills - current Additional Comments: Transition to New QRIS - Pathway to the Stars – The Child Care Commission voted to adopt the Quality Rating Improvement System (QRIS) Modernization Proposed Rule Amendments and Adoptions. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition will begin soon with the following informational opportunities: In August, we’ll provide a rule roll out module in the DCDEE e-learning Moodle platform and host webinars on the following dates and times: • August 20th at 1:00pm (family child care homes) and 6:30pm (child care centers and centers located in a residence) All the newest information will be posted at QRIS Modernization and will also be provided through emails and Raise NC newsletters. Raise NC Newsletter – If you are not receiving and reading the Raise NC Newsletter, you are missing out on current relevant information about early childhood issues in North Carolina, information about proposed rules, available trainings and other information that may be of interest to you and your staff. The Raise NC Newsletter is typically sent out weekly to all facility contact email addresses, but if your email is not the facility contact email address, you can go to the DCDEE Website, https://ncchildcare.ncdhhs.gov/ and click on the “What’s New” tab. Click on “What’s New” and enter your email address and name under “Sign Up for Updates”. As an early learning professional, you need to stay in the know about issues in North Carolina that affect you and your business. Share with your staff so they can be in the know too! Keep Your NCID Active - Did you know that if you do not login on to any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. *Pro Tip: Set your calendar to remind you, your staff and your household members (CLIAR only) every 6 months to log in and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. *For assistance with NCID, contact ncid.nc.gov or 919.754.6000. I shared information on the following topics and emailed the information to you after the visit: 1. Pathway to Stars Updates – Webinars, Meetings, Implementation 2. Address the Stress: Take Care of You! - Free self-paced, online Professional Development for NC Child Care Professionals (1 DCDEE training credit hour) 3. Setting Up Effective Classroom Environments Webinar– Tuesday, 8/19; 7 – 8pm 4. New Training in Moodle – Child Development 5. Moodle Helpful Hints 6. Environment Rating Scales – Get Ready for the 3’s! Thank you for your time and assistance today. Refer to this visit summary for a refresher of our discussions today, and I encourage you to share with staff and use the information as a teaching tool. If you have any questions, do not hesitate to call or email me at the contact information listed 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

NC GS 110-90 · Violation

Name of Operation: Little Fisch Childcare LLC Facility ID: 27000139 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 8/19/2025 Number Present: 11 Completed Date: 8/19/2025 Age: From 1 To 9 Total Minutes: 405 Time In: 08:45 AM Time Out: 03:30 PM Time In: Time Out: List to Use: Center Type Of Visit: Annual Comp Full Announced/Unannounced: Unannounced * The purpose of today’s Annual Compliance visit was to monitor compliance with applicable child care requirements. Change of Operation from FCCH to CLIAR – 10/17/24 18-month compliance history from 2/15/24 – 8/14/25 = 96% Last Sanitation Inspection – 8/4/25 - Approved Water Testing (Lead) – completed 7/5/24; due again 7/5/27 Last Fire Inspection – 8/1/25 – Satisfactory; Daytime Care Only; previous fire inspection 7/24/24; expired 7/31/25 *Sanitation and fire inspections are required at least annually by the end of the month of the previous inspection. Send fire inspections to me within seven (7) days of the inspection. A. Fischer, Administrator, was present and assisted me with the visit. The facility currently operates with a Three-Star Center License, issued 4/15/25 (capacity change). The next rated license assessment is due by 1/1/28. The Child Care Commission adopted the QRIS Modernization rules (Pathways to Stars), and the Division is in the process of transitioning from the former rated license rules to the new QRIS rules. Information, training, resources, and updated forms will be shared with you as we implement the new rules. See Additional Comments for more information about upcoming webinars. Note that the current program assessment tool is changing from the Family Child Care Environment Rating Scale – Revised (FCCERS-R) to Family Child Care Environment Rating Scale – 3rd Edition (FCCERS-3). Information and training on the new program assessment tool is available on the NC Rating License Assessment Project website at https://ncrlap.org/. Even though you are more than two years away from having to renew your rated license, I encourage you to participate in the information sessions. This facility is owned by Little Fisch Childcare LLC. According to the NC Secretary of State's website, this limited liability corporation is current and active as of 8/12/25. Failure to complete Annual Reports with the Secretary of State may result in dissolution of your LLC. License and contact information were current. Please contact me prior to any information change regarding the ownership of this facility, license updates, or contact information (address, phone, or email). We updated your Legal Designee form. I monitored the spaces used for child care and outdoor play area for applicable child care center requirements using the Child Care Center Requirements, effective 7/1/2025 and Item Numbers Listing, effective 4/2025. I monitored two staff records, two children’s records and all program records. The facility continues to be approved for transportation. Center Observations: The operator and staff member were present with ten (10) children, one through nine years of age. The child care space was arranged into a toddler/two area, preschool area, and school-age area. A second toddler arrived later. The operator and parent exchanged information, and he documented arrival time on the attendance sheet available at the entrance. One lead teacher played with the two toddlers in their space. The owner/lead teacher provided activities for preschool and school-age children. They participated in morning free play with developmentally appropriate materials. It was raining so they did music and movement activities. The operator stated they would go outside after naptime if the rain stopped. Both teachers read stories to the children. Activity plans, reflecting a friendship theme were posted. The posted menu displayed chicken tenders, carrots, blueberries, whole grain crackers, and milk. However, corn was substituted for carrots. The menus were updated to reflect the substitution. After lunch, children used the bathroom and washed hands and rested on linen-covered mats. The center added a stationary rock wall climber to the playground. The wood chip surfacing measured 12 inches. A six-foot fall zone was available under and around the climber. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 106 Operator has not scheduled and obtained a fire inspection within 12 months of the previous inspection. Operator did not submit the original approved report to DCDEE within one week of the inspection visit on a form provided by the Division. The previous fire inspection was completed on July 24, 2024 and expired on July 31, 2025. A new fire inspection was not completed until August 1, 2025 and was provided today. The operator did not send the completed fire inspection report within seven (7) days. 10A NCAC 09 .0304(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. Albuterol, prescribed for a school-age child, expired July 2025 and was not returned to the parent. Medication permission forms for the Albuterol and an Epi-pen expired on July 26, 2024 and were not updated. The medications were not returned. .0803(12) 1032 Child care providers and uncompensated providers who are not substitute providers or volunteers, including the director did not have a medical report on file prior to employment that was signed by a health care professional and/ or the medical report was older than 12 months. A new staff member hired on February 10, 2025 did not provide a staff medical report until February 28, 2025. 10A NCAC 09 .0701(a) 1033 On or before the first day of work, all staff, including the director and individuals who volunteer more than once per week did not provide results indicating that they were free of active TB and/or TB test or screening was older than 12 months. A new staff member hired on February 10, 2025 did not provide a documentation of a negative TB screening until February 28, 2025. .0701(a) 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. Medication Action Plans for a school-age child with food allergies and asthma were dated August 25, 2022 and were not updated. .0801(b) * Child care programs are expected to achieve and always maintain compliance and are required by NC GS 110-90(4)(d) to achieve and maintain an 18-month compliance history score of at least 75%. Any violations documented may impact the compliance history score. I completed an electronic copy of the visit summary and provided a printed copy of it to you, A. Fischer. We reviewed the visit summary and violation(s) documented during today’s visit. Three of the five violations have been corrected. Correct the two violations related to medication administration immediately. Send evidence of correction to me so that I receive it no later than 9/2/25. Your compliance verification letter needs to state your facility name and license number and list each violation by Item # and describe in detail when and how each violation has been corrected. Do not include names of children in the compliance letter. Use their initials, if needed. Send compliance verification letter in an email from your center’s official email address, littlefischcc@gmail.com to my email address, Marjorie.White@dhhs.nc.gov. You may include the compliance verification as an attachment or in the body of the email. I will email a sample compliance verification letter to you. If sufficient information is not received by the due date, a follow-up visit may be conducted. Please be aware that any information submitted by you is legal documentation. If it is determined the information provided in the compliance letter is not true, this may be considered falsification of information. If I may be of further assistance, please contact me by phone at (252) 373-9385, by e-mail at Marjorie.White@dhhs.nc.gov. You may also call Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199. Technical Assistance With Documented Violations: Annual Fire Inspection – Annual fire inspections ensure that the building meets fire codes and that your fire detection and alarm systems are operating correctly in the event of a fire. The fire inspector completed a fire inspection on 7/24/2024; a new fire inspection was due by 7/31/2025 but was not completed until 8/1/2025; you did not provide a copy of the inspection to me until today, 8/19/2025. You stated that you requested the fire inspection at the beginning of July, but the fire inspector was not able to schedule a visit in July and then you forgot to scan and email it to me. To request a fire inspection in Currituck, contact the County Inspections Department, complete the appropriate form and pay the annual inspection fee. Have your fire and electrical systems tests and annual fire safety training completed before the inspection so that documentation is available for the fire inspector. Consider beginning this process at least two months before the actual fire inspection is due to ensure the final inspection is completed on time. Expired Medication/Medication Permission Forms – Having expired medication or expired authorization to administer medication, could create medical or liability issues if there are changes to the child’s medication, dosage, or instructions for administration. Albuterol, prescribed for a school-age child, expired July 2025. Medication permission forms for the Albuterol and an Epi-pen expired on 7/26/24. The emergency medications were not returned to the parent within 72 hours after the medication permission forms expired in July 2024 or after the Albuterol expired in July 2025. You stated that you thought the parent just updated the permission forms. Return the expired Albuterol to the parent or request a current Albuterol canister with a new medication permission form authorized for up to six months. Return the Epi-pen to the parent or provide them with a new medication permission form to complete.. Consider checking your medication bag monthly to verify that medication and permission forms are current. For your compliance letter, state the date when the Albuterol and Epi-pen are returned to the parent or updated medication permission forms are available Staff Records - Receipt of a Staff Medical Report and Documentation of a negative TB Test or a TB Screening received from new staff by their first day of working in your center verifies that they are healthy enough to work with children and other staff and complete the physical responsibilities needed to work in child care. A new staff member was hired on 2/10/2025 but did not provide a current Staff Medical Report and documentation of a negative TB screening until 2/28/25. The administrator stated that she had to reschedule her appointment which was originally scheduled before her first day of work. Use a Staff File Check list to track receipt of required documents at employment helps you ensure required forms are received before a new employee starts. These violations have been corrected. Expired Medical Action Plan – Medical Action Plans are valid for one year and must be updated annually. Because the medical action plan is used as a guide for administering medication, it needs to be updated annually to ensure dosage and administration are current. Medication Action Plans for a school-age child with food allergies (Epi Pen) and asthma were dated 8/25/22. You were not aware that they had expired. Have the parent review the Medical Action Plan and update if information is still valid or provide you with updated Medical Action Plans from the physician. For your compliance letter, state the date when current Medical Action Plans are available. Include updated copies with the Child’s Application in this file and in the Ready-To-Go File. General Visit Information: As a licensed child care facility, it is your responsibility to be knowledgeable of the child care laws and rules and to teach your staff the rules to ensure your center remains in compliance. The most recent versions of laws and rules regarding child care facilities in North Carolina are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. You can also review the “What’s New” section and download a copy of the Items Number Listing which you can use as a checklist for your program. Check the designated facility email at least weekly to stay current with communication and email blasts from DCDEE. Your local and regional Smart Start Partnerships and Child Care Resource and Referral Agencies and Child Care Health Consultants provide general training to meet on-going training hours, health and safety training requirements, Environment Rating Scale training and training specific to your center’s needs. They can also work with you to provide on-site technical assistance. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Child Care Health Consultant – C. Smith - (252) 340-0212 or cindy@aacfnc.org *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *Birth to 3 Quality Specialist: J. Davidson – Phone (252) 333-1233; joy@aacfnc.org *Other On-going Training and CEU Resources - Southwestern Child Development Commission, www.swcdcinc.org, Child Care Resources Inc., https://www.childcareresourcesinc.org/ and Early Years, https://www.earlyyearsnc.org/ offer DCDEE approved, on-line, self-paced and virtual real-time training and training that counts towards CEU’s. SWCDC also offers affordable annual packages allowing you to take as many courses as you need or want for one price. The Natural Learning Initiative (https://naturalearning.org/) offers a variety of resources such as training, YouTube videos, handouts, etc. to help you add natural elements to your outdoor play spaces to promote time outdoors. Check out the NLI Resource Hub including Design Sites, Infosheets, The Green Desk, Interactive Apps and more! Your children and your teachers will want to go outdoors again! Reminders: ABCMS Portal - I will email the ABCMS Provider Portal Access Guide which will assist with the step-by-step process of working in the ABCMS Portal, accessing your Pay Codes, helping your staff complete their Connecting Applications, and eventually “hiring” staff to your roster. • If you need assistance accessing or using the ABCMS Provider Portal, contact the Criminal Background Check Unit at (919) 814-6401 or DCDEE_ABCMS_Provider@dhhs.nc.gov and someone will assist you. • If you or your staff need assistance with completing a Criminal Background Check in the ABCMS Applicant Portal, contact the Criminal Background Check Unit at (919) 814-6401 or DHHS.CBC.Unit@dhhs.nc.gov and someone will assist you. • If you or your staff need assistance with your NCID, contact https://myNCID.nc.gov or (919) 754-6000. Staff Worksheets – Your Staff Worksheets are a great tool to help you track when items such as Criminal Background Checks, required trainings and staff forms expire and need to be updated. I encourage you to update information on the staff worksheets throughout the year as items are updated and/or staff change. *We reviewed your staff worksheet. I highlighted items that were delinquent and items that are coming due in the next year. *Health and Safety Training – current for all staff *On-going Training Hours – Review Row 18 (# hours to carry over) on the Staff Worksheets to determine how many on-going training hours returning staff will need by 8/19/25, anniversary of today’s Annual Compliance visit). *Update various staff forms on a cycle so that all staff forms required to be reviewed and updated are completed for all staff at the same time. Even though DR’s Annual Evaluation and Professional Development Plan are not due until February 2026, consider completing them when yours are due to be updated in October 2025. Staff Education and Works – D. Rheaume completed EDU 119 and needs to request an official, original transcript. She can mail an unopened copy to DCDEE or request that a hard copy or electronic copy be sent from COA to DCDEE. She needs to register for Works and request to be approved as a lead teacher, teacher, and group leader. The BSAC form can be uploaded into Works, but the college transcripts need to be sent directly to DCDEE. DR also has three semester hours in Dev Psych that can count towards her education. Have transcripts from that community college sent to Works also. *EPR Plan – last updated in Portal – July 2025 *Ready-to-Go File – current; be sure to update when new children start at the beginning of the school year *Emergency Medical Care Plan – current *Fire and Emergency Drills - current Additional Comments: Transition to New QRIS - Pathway to the Stars – The Child Care Commission voted to adopt the Quality Rating Improvement System (QRIS) Modernization Proposed Rule Amendments and Adoptions. The DCDEE team looks forward to working with child care facilities across the state to transition to the new QRIS system, also known as Pathways to the Stars, located in Section .3200 of the Child Care Rules. The transition will begin soon with the following informational opportunities: In August, we’ll provide a rule roll out module in the DCDEE e-learning Moodle platform and host webinars on the following dates and times: • August 20th at 1:00pm (family child care homes) and 6:30pm (child care centers and centers located in a residence) All the newest information will be posted at QRIS Modernization and will also be provided through emails and Raise NC newsletters. Raise NC Newsletter – If you are not receiving and reading the Raise NC Newsletter, you are missing out on current relevant information about early childhood issues in North Carolina, information about proposed rules, available trainings and other information that may be of interest to you and your staff. The Raise NC Newsletter is typically sent out weekly to all facility contact email addresses, but if your email is not the facility contact email address, you can go to the DCDEE Website, https://ncchildcare.ncdhhs.gov/ and click on the “What’s New” tab. Click on “What’s New” and enter your email address and name under “Sign Up for Updates”. As an early learning professional, you need to stay in the know about issues in North Carolina that affect you and your business. Share with your staff so they can be in the know too! Keep Your NCID Active - Did you know that if you do not login on to any DCDEE platforms (e.g., Moodle, WORKS, CBC) for a period of 12 months, your account will be archived? An archived account cannot be reinstated. You will need to create a new one and then email all platforms (e.g., Moodle, WORKS, CBC) to merge accounts. *Pro Tip: Set your calendar to remind you, your staff and your household members (CLIAR only) every 6 months to log in and out at https://myncid.nc.gov to keep your account activated and it will NOT be archived. *For assistance with NCID, contact ncid.nc.gov or 919.754.6000. I shared information on the following topics and emailed the information to you after the visit: 1. Pathway to Stars Updates – Webinars, Meetings, Implementation 2. Address the Stress: Take Care of You! - Free self-paced, online Professional Development for NC Child Care Professionals (1 DCDEE training credit hour) 3. Setting Up Effective Classroom Environments Webinar– Tuesday, 8/19; 7 – 8pm 4. New Training in Moodle – Child Development 5. Moodle Helpful Hints 6. Environment Rating Scales – Get Ready for the 3’s! Thank you for your time and assistance today. Refer to this visit summary for a refresher of our discussions today, and I encourage you to share with staff and use the information as a teaching tool. If you have any questions, do not hesitate to call or email me at the contact information listed 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 .0604 · Violation

Name of Operation: Little Fisch Childcare LLC Facility ID: 27000139 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 11/25/2024 Number Present: 6 Completed Date: 11/25/2024 Age: From 0 To 4 Total Minutes: 330 Time In: 09:30 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with all applicable child care requirements during the first temporary time period visit (TTP). On 10/17/2024, your program transitioned from operating as a family child care home to a center located in a residence (CLIAR). The facility was issued a temporary license on 10/17/2024, caring for no more than twelve (12) children on first shift only. Restrictions are daytime care only; meets enhanced ratios; meets enhanced space. The CLIAR is owned by Little Fisch Childcare, LLC and was current/active on the NC Secretary of State website. We updated the owner email to littlefischcc@gmail.com . Last Sanitation Inspection – 2/20/24 - Superior (10 demerits) Last Fire Inspection – 7/24/24 – Satisfactory; Daytime Care Only *Sanitation and fire inspections are required at least annually by the date of the previous inspection. Send fire inspections to me within seven (7) days of the inspection. Required Water, Lead Paint, and Asbestos Testing - The Clean Classrooms for Carolina Kids website reflects the following information about your center’s required three-year water testing and one-time lead paint testing and asbestos testing: Three-year Water Testing – 7/5/24; due again 7/5/27 Lead Paint Testing – exempt 8/5/24 per survey review by RTI Asbestos Testing – exempt 8/5/24 per survey review by RTI Maintain any paperwork received by mail or email in your Program Records file. *For more information check out the FAQ page at https://www.cleanwaterforuskids.org/en/carolina/. A. Fischer, Administrator, assisted me with the visit. During the visit I monitored the primary child care space arranged in the living room, hallway leading to the bathroom, bathroom, eat-in-kitchen and outdoor playground. I completed a sampling of three children’s records and reviewed all staff and program records. Observations: The administrator/lead teacher and teacher were present with five children, eleven months through four years of age. The Temporary License and parent information were posted at the entrance. Activity plans from Gee Whiz, an approved curriculum used by the program were also posted. The teacher played with the infant and toddler in a separate space set up to provide a place for floor play away from the older children and toys and materials that were not potential choking hazards. The infant was laid down for a mid-morning nap. The teacher placed him on his back to sleep and documented safe sleep checks. The toddler continued to play. The older children enjoyed free play in their space where materials were arranged in activity centers. Both staff members interacted warmly with children, encouraging language and conversation, social/emotional skills, and cognitive development. The fenced outdoor playground provided opportunities for active play with portable climbers, playhouses, and sand play. A sunshade was set up to provide shade for children. Children used the bathroom down the hall that also had a diaper changing table. The family’s personal items were stored in a locked closet. Lunch was chicken nuggets, peas, peaches, roll and milk. It was prepared in the kitchen and served in the dining area of the kitchen. The hot water faucet was locked to prevent access. A new child, two years of age, arrived for her first day. The administrator showed her how to wash her hands. The parent signed her in, and the administrator reviewed the enrollment documents to ensure all information was collected. Discovering that the child has a milk sensitivity, she added it to allergy posting in the kitchen and informed the parent that she is able to offer Lactaid. After lunch children rested on linen-covered mats. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in the bathroom used by children was not protected with an outlet cover. 10A NCAC 09 .0604(c) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bag of cough drops was stored out of reach of children in a cabinet in the kitchen, but the cabinet was not locked. 15A NCAC 18A .2820(d) * Child care programs are expected to achieve and always maintain compliance and are required by NC GS 110-90(4) (d) to achieve and maintain an 18-month compliance history score of at least 75%. Any violations documented may impact the compliance history score. I completed an electronic copy of the visit summary and provided a printed copy of it to you, A. Fischer. We reviewed the visit summary and violation(s) documented during today’s visit. You corrected both violations so no further action is required except to maintain compliance. If I may be of further assistance, please contact me by phone at (252) 373-9385, by e-mail at Marjorie.White@dhhs.nc.gov. You may also call Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199. Technical Assistance with Documented Violation(s): Outlets - Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. The majority of these injuries involve children under the age of six. An outlet in the bathroom used by children was not protected with stated that one of your children forgot to recover it. You corrected it during the visit by covering the outlet and will remind household members to cover outlets when not in use. Do a safety check daily before children arrive to check for items that need to be locked, uncovered outlets, and other safety hazards. Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In the kitchen, a bag of cough drops was stored in an unlocked cabinet. You stated that you had them stored in a locked cabinet, but one of your household members probably forgot to lock the cabinet. All medications (topical ointments and creams, OTC, and prescription) must be inaccessible to children. Diaper creams and lotions may be stored out of reach, on a shelf or in a cabinet at least five feet or higher. OTC and prescription medications must be locked. You immediately locked the cabinet and stated that you will address this with your family members. General Visit Information: As a licensed child care center operator, it is your responsibility to be knowledgeable of the child care laws and rules. The most recent versions of laws and rules regarding child care facilities in North Carolina are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. You can also review the “What’s New” section and download a copy of the Items Number Listing which you can use as a checklist for your program. Your local and regional Smart Start Partnership and Child Care Resource and Referral Agency are available to assist you with technical assistance and training on a multitude of topics not limited to training, technical assistance, and mock assessments to prepare for the FCCERS-R, infant/toddler practices, healthy behaviors, and other required training. Child Care Health Consultants can provide training and technical assistance on topics related to health and safety such as sanitation, handwashing, diapering, illness policies, etc. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Child Care Health Consultant – C. Smith - (252) 340-0212 or cindy@aacfnc.org *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *Birth – 3 Quality Specialist: J. Davidson – Phone (252) 333-1233; joy@aacfnc.org Reminders: CBC Provider Portal - Technical Assistance & Notification to the Division of New Hires or Residents As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. Then you will update this information in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Trash Cans – To prevent the spreading of germs or pests, trash cans used to dispose of anything more than paper products such as food, diapers or pull-ups, needs to be lined and have a lid. A hands-free lid is preferred. You stated that after diapering you place the diaper in a lined trash can with a lid on the back porch. New Center Discussion Points: Staff Training for 1st Year – I shared a list of staff training and professional development required for you and your teacher during your center’s first year of operation. This includes orientation, Recognizing and Responding to Suspicions of Child Maltreatment. CPR/First Aid, Basics of School-Age Care Training (BSAC), Playground Safety Training, Health & Safety Training, and Emergency Preparedness and Response (EPR) Training. You completed most of these trainings before your program transitioned to a CLIAR. Moodle Support - The Division offers early childhood professionals a wide range of professional development opportunities through the online learning platform Moodle. DCDEE has established a new email address and phone number for Moodle Support. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. DCDEE WORKS – After K. Grimes completes EDU 119 in the spring, help her create a Works account. Volunteers – Volunteers can assist in a child care but may not be left alone with children or count in staff/child ratios. Differences Between FCCH and CLIAR: 1. Meets enhanced staff/child ratios *If youngest child is Birth – 12 months = 1:5 preschool children + 3 school-age Or 2:10 *If youngest child is 12 – 24 months = 1:6 preschool children + 2 school-age Or 2:12 *If youngest child is 2 years – 1:9 or 2:12 *If youngest child is 3 years – 1:10 or 2:12 *If youngest child is 4 or 5 years – 1:12 *If all children are school-age – 1:15 (Enhanced space is 14 so max capacity would be 14) *When only one caregiver is required to meet the staff/child ratio for a center located in a residence, and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. *When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as desc 2. Sanitation and Fire Inspections will be required at least once per year before the previous one expires. Have fire and emergency systems checked annually prior to requesting your fire inspection. Then contact Currituck County Inspections Department to pay for and schedule fire inspection. Send your fire inspection to me within seven (7) days. Environmental Health Specialist will complete semi-annual or annual sanitation inspections. Post Sanitation Placard. EHS usually send me copy of inspection but shoot me an email when completed and I can review on Albemarle Regional Health Services website. 3. Any sink used for handwashing (handwashing sinks in kitchen and bathroom) must be tempered between 80 to 110 degrees. The faucet in the bathtub in the hall bathroom is accessible to children and may not be more that 110 degrees. The water in the kitchen sink must be 120 degrees but may not be accessible to children. When not in use, the faucet must be locked to make it inaccessible, per Environmental Health. 4. You are licensed to transport children in your van. Children younger than three years of age may not participate in off premises activities if transportation is involved. Review Transportation Standards in Section .1000 which also includes rules related to Off-Premises Activities. 5. As a CLIAR, you do not have to use the Written Plan of Care form. 6. You are required to follow playground safety requirements related to surfacing for stationary equipment. Ensure grass is cut and grass and weeds are trimmed along the fence line to discourage pests from taking up residence or having a hiding place. 7. Mats or cots need to be spaced out at least 18 inches apart during naptime. Rated License Information: We discussed the rated license process. The temporary license is valid through 4/16/2025; however, you corrected the violations documented during today’s visit, so we will be transitioning you to a Rated License. We reviewed the rated license information for a center located in a residence, including the rated license worksheets and quality point form. You completed an Application for Assessment for a Two Component Star Rated License today. Program Standards – Five (5) Points Your center meets minimum requirements and enhanced ratios and space. Your FCCERS-R score completed when you were a fcch. FCCERS-R – 11/9/23 – Score = 4.76 earning 5 points Education – 1 (One) Point *based on information available in DCDEE Works *final education points determined by lowest points earned in each staff category CLIAR Administrator Education (Lead Teacher) – 3 Points Administrator/Lead Teacher (A. Fischer) – NCECC + 6 hrs w/ 2 y ece and ad experience = 3 points *expected to be 4 points after 3 years exp or when enrolled in ECE class CLIAR Teacher Education – 1 Point Teacher (K. Grimes) – HS w/ 1 m exp = 1 point *Complete NC Early Childhood Credential (NCECC) to earn 4 points; planning to enroll in Spring 2025 Quality Point (QP) – 1 Point You can earn a quality point by meeting one of the Education or Program options. I shared the list of Quality Points. You chose to meet approved curriculum (using Gee Whiz). Program Standards (5 PTS) + Education Standards (1 PT) + QP (1 PT) = 7 Points = 3 Stars I will add the following two restrictions back to your license: Outdoor play restricted to fenced play area. Children on ground level only. Thank you for your time and assistance today. Refer to this visit summary for a refresher of our discussions today. If you have any questions, do not hesitate to call or email me at the contact information listed 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: supervision. Open / not marked corrected.

G.S. 110-90 · Violation

Name of Operation: Little Fisch Childcare LLC Facility ID: 27000139 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 11/25/2024 Number Present: 6 Completed Date: 11/25/2024 Age: From 0 To 4 Total Minutes: 330 Time In: 09:30 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with all applicable child care requirements during the first temporary time period visit (TTP). On 10/17/2024, your program transitioned from operating as a family child care home to a center located in a residence (CLIAR). The facility was issued a temporary license on 10/17/2024, caring for no more than twelve (12) children on first shift only. Restrictions are daytime care only; meets enhanced ratios; meets enhanced space. The CLIAR is owned by Little Fisch Childcare, LLC and was current/active on the NC Secretary of State website. We updated the owner email to littlefischcc@gmail.com . Last Sanitation Inspection – 2/20/24 - Superior (10 demerits) Last Fire Inspection – 7/24/24 – Satisfactory; Daytime Care Only *Sanitation and fire inspections are required at least annually by the date of the previous inspection. Send fire inspections to me within seven (7) days of the inspection. Required Water, Lead Paint, and Asbestos Testing - The Clean Classrooms for Carolina Kids website reflects the following information about your center’s required three-year water testing and one-time lead paint testing and asbestos testing: Three-year Water Testing – 7/5/24; due again 7/5/27 Lead Paint Testing – exempt 8/5/24 per survey review by RTI Asbestos Testing – exempt 8/5/24 per survey review by RTI Maintain any paperwork received by mail or email in your Program Records file. *For more information check out the FAQ page at https://www.cleanwaterforuskids.org/en/carolina/. A. Fischer, Administrator, assisted me with the visit. During the visit I monitored the primary child care space arranged in the living room, hallway leading to the bathroom, bathroom, eat-in-kitchen and outdoor playground. I completed a sampling of three children’s records and reviewed all staff and program records. Observations: The administrator/lead teacher and teacher were present with five children, eleven months through four years of age. The Temporary License and parent information were posted at the entrance. Activity plans from Gee Whiz, an approved curriculum used by the program were also posted. The teacher played with the infant and toddler in a separate space set up to provide a place for floor play away from the older children and toys and materials that were not potential choking hazards. The infant was laid down for a mid-morning nap. The teacher placed him on his back to sleep and documented safe sleep checks. The toddler continued to play. The older children enjoyed free play in their space where materials were arranged in activity centers. Both staff members interacted warmly with children, encouraging language and conversation, social/emotional skills, and cognitive development. The fenced outdoor playground provided opportunities for active play with portable climbers, playhouses, and sand play. A sunshade was set up to provide shade for children. Children used the bathroom down the hall that also had a diaper changing table. The family’s personal items were stored in a locked closet. Lunch was chicken nuggets, peas, peaches, roll and milk. It was prepared in the kitchen and served in the dining area of the kitchen. The hot water faucet was locked to prevent access. A new child, two years of age, arrived for her first day. The administrator showed her how to wash her hands. The parent signed her in, and the administrator reviewed the enrollment documents to ensure all information was collected. Discovering that the child has a milk sensitivity, she added it to allergy posting in the kitchen and informed the parent that she is able to offer Lactaid. After lunch children rested on linen-covered mats. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in the bathroom used by children was not protected with an outlet cover. 10A NCAC 09 .0604(c) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bag of cough drops was stored out of reach of children in a cabinet in the kitchen, but the cabinet was not locked. 15A NCAC 18A .2820(d) * Child care programs are expected to achieve and always maintain compliance and are required by NC GS 110-90(4) (d) to achieve and maintain an 18-month compliance history score of at least 75%. Any violations documented may impact the compliance history score. I completed an electronic copy of the visit summary and provided a printed copy of it to you, A. Fischer. We reviewed the visit summary and violation(s) documented during today’s visit. You corrected both violations so no further action is required except to maintain compliance. If I may be of further assistance, please contact me by phone at (252) 373-9385, by e-mail at Marjorie.White@dhhs.nc.gov. You may also call Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199. Technical Assistance with Documented Violation(s): Outlets - Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. The majority of these injuries involve children under the age of six. An outlet in the bathroom used by children was not protected with stated that one of your children forgot to recover it. You corrected it during the visit by covering the outlet and will remind household members to cover outlets when not in use. Do a safety check daily before children arrive to check for items that need to be locked, uncovered outlets, and other safety hazards. Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In the kitchen, a bag of cough drops was stored in an unlocked cabinet. You stated that you had them stored in a locked cabinet, but one of your household members probably forgot to lock the cabinet. All medications (topical ointments and creams, OTC, and prescription) must be inaccessible to children. Diaper creams and lotions may be stored out of reach, on a shelf or in a cabinet at least five feet or higher. OTC and prescription medications must be locked. You immediately locked the cabinet and stated that you will address this with your family members. General Visit Information: As a licensed child care center operator, it is your responsibility to be knowledgeable of the child care laws and rules. The most recent versions of laws and rules regarding child care facilities in North Carolina are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. You can also review the “What’s New” section and download a copy of the Items Number Listing which you can use as a checklist for your program. Your local and regional Smart Start Partnership and Child Care Resource and Referral Agency are available to assist you with technical assistance and training on a multitude of topics not limited to training, technical assistance, and mock assessments to prepare for the FCCERS-R, infant/toddler practices, healthy behaviors, and other required training. Child Care Health Consultants can provide training and technical assistance on topics related to health and safety such as sanitation, handwashing, diapering, illness policies, etc. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Child Care Health Consultant – C. Smith - (252) 340-0212 or cindy@aacfnc.org *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *Birth – 3 Quality Specialist: J. Davidson – Phone (252) 333-1233; joy@aacfnc.org Reminders: CBC Provider Portal - Technical Assistance & Notification to the Division of New Hires or Residents As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. Then you will update this information in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Trash Cans – To prevent the spreading of germs or pests, trash cans used to dispose of anything more than paper products such as food, diapers or pull-ups, needs to be lined and have a lid. A hands-free lid is preferred. You stated that after diapering you place the diaper in a lined trash can with a lid on the back porch. New Center Discussion Points: Staff Training for 1st Year – I shared a list of staff training and professional development required for you and your teacher during your center’s first year of operation. This includes orientation, Recognizing and Responding to Suspicions of Child Maltreatment. CPR/First Aid, Basics of School-Age Care Training (BSAC), Playground Safety Training, Health & Safety Training, and Emergency Preparedness and Response (EPR) Training. You completed most of these trainings before your program transitioned to a CLIAR. Moodle Support - The Division offers early childhood professionals a wide range of professional development opportunities through the online learning platform Moodle. DCDEE has established a new email address and phone number for Moodle Support. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. DCDEE WORKS – After K. Grimes completes EDU 119 in the spring, help her create a Works account. Volunteers – Volunteers can assist in a child care but may not be left alone with children or count in staff/child ratios. Differences Between FCCH and CLIAR: 1. Meets enhanced staff/child ratios *If youngest child is Birth – 12 months = 1:5 preschool children + 3 school-age Or 2:10 *If youngest child is 12 – 24 months = 1:6 preschool children + 2 school-age Or 2:12 *If youngest child is 2 years – 1:9 or 2:12 *If youngest child is 3 years – 1:10 or 2:12 *If youngest child is 4 or 5 years – 1:12 *If all children are school-age – 1:15 (Enhanced space is 14 so max capacity would be 14) *When only one caregiver is required to meet the staff/child ratio for a center located in a residence, and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. *When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as desc 2. Sanitation and Fire Inspections will be required at least once per year before the previous one expires. Have fire and emergency systems checked annually prior to requesting your fire inspection. Then contact Currituck County Inspections Department to pay for and schedule fire inspection. Send your fire inspection to me within seven (7) days. Environmental Health Specialist will complete semi-annual or annual sanitation inspections. Post Sanitation Placard. EHS usually send me copy of inspection but shoot me an email when completed and I can review on Albemarle Regional Health Services website. 3. Any sink used for handwashing (handwashing sinks in kitchen and bathroom) must be tempered between 80 to 110 degrees. The faucet in the bathtub in the hall bathroom is accessible to children and may not be more that 110 degrees. The water in the kitchen sink must be 120 degrees but may not be accessible to children. When not in use, the faucet must be locked to make it inaccessible, per Environmental Health. 4. You are licensed to transport children in your van. Children younger than three years of age may not participate in off premises activities if transportation is involved. Review Transportation Standards in Section .1000 which also includes rules related to Off-Premises Activities. 5. As a CLIAR, you do not have to use the Written Plan of Care form. 6. You are required to follow playground safety requirements related to surfacing for stationary equipment. Ensure grass is cut and grass and weeds are trimmed along the fence line to discourage pests from taking up residence or having a hiding place. 7. Mats or cots need to be spaced out at least 18 inches apart during naptime. Rated License Information: We discussed the rated license process. The temporary license is valid through 4/16/2025; however, you corrected the violations documented during today’s visit, so we will be transitioning you to a Rated License. We reviewed the rated license information for a center located in a residence, including the rated license worksheets and quality point form. You completed an Application for Assessment for a Two Component Star Rated License today. Program Standards – Five (5) Points Your center meets minimum requirements and enhanced ratios and space. Your FCCERS-R score completed when you were a fcch. FCCERS-R – 11/9/23 – Score = 4.76 earning 5 points Education – 1 (One) Point *based on information available in DCDEE Works *final education points determined by lowest points earned in each staff category CLIAR Administrator Education (Lead Teacher) – 3 Points Administrator/Lead Teacher (A. Fischer) – NCECC + 6 hrs w/ 2 y ece and ad experience = 3 points *expected to be 4 points after 3 years exp or when enrolled in ECE class CLIAR Teacher Education – 1 Point Teacher (K. Grimes) – HS w/ 1 m exp = 1 point *Complete NC Early Childhood Credential (NCECC) to earn 4 points; planning to enroll in Spring 2025 Quality Point (QP) – 1 Point You can earn a quality point by meeting one of the Education or Program options. I shared the list of Quality Points. You chose to meet approved curriculum (using Gee Whiz). Program Standards (5 PTS) + Education Standards (1 PT) + QP (1 PT) = 7 Points = 3 Stars I will add the following two restrictions back to your license: Outdoor play restricted to fenced play area. Children on ground level only. Thank you for your time and assistance today. Refer to this visit summary for a refresher of our discussions today. If you have any questions, do not hesitate to call or email me at the contact information listed 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

NC GS 110-90 · Violation

Name of Operation: Little Fisch Childcare LLC Facility ID: 27000139 Consultant: MARJORIE WHITE Operation Type: Center Case Number: Visit Date: 11/25/2024 Number Present: 6 Completed Date: 11/25/2024 Age: From 0 To 4 Total Minutes: 330 Time In: 09:30 AM Time Out: 03:00 PM Time In: Time Out: List to Use: Center Type Of Visit: Temp Time Period Announced/Unannounced: Unannounced * The purpose of today’s visit was to monitor your program for compliance with all applicable child care requirements during the first temporary time period visit (TTP). On 10/17/2024, your program transitioned from operating as a family child care home to a center located in a residence (CLIAR). The facility was issued a temporary license on 10/17/2024, caring for no more than twelve (12) children on first shift only. Restrictions are daytime care only; meets enhanced ratios; meets enhanced space. The CLIAR is owned by Little Fisch Childcare, LLC and was current/active on the NC Secretary of State website. We updated the owner email to littlefischcc@gmail.com . Last Sanitation Inspection – 2/20/24 - Superior (10 demerits) Last Fire Inspection – 7/24/24 – Satisfactory; Daytime Care Only *Sanitation and fire inspections are required at least annually by the date of the previous inspection. Send fire inspections to me within seven (7) days of the inspection. Required Water, Lead Paint, and Asbestos Testing - The Clean Classrooms for Carolina Kids website reflects the following information about your center’s required three-year water testing and one-time lead paint testing and asbestos testing: Three-year Water Testing – 7/5/24; due again 7/5/27 Lead Paint Testing – exempt 8/5/24 per survey review by RTI Asbestos Testing – exempt 8/5/24 per survey review by RTI Maintain any paperwork received by mail or email in your Program Records file. *For more information check out the FAQ page at https://www.cleanwaterforuskids.org/en/carolina/. A. Fischer, Administrator, assisted me with the visit. During the visit I monitored the primary child care space arranged in the living room, hallway leading to the bathroom, bathroom, eat-in-kitchen and outdoor playground. I completed a sampling of three children’s records and reviewed all staff and program records. Observations: The administrator/lead teacher and teacher were present with five children, eleven months through four years of age. The Temporary License and parent information were posted at the entrance. Activity plans from Gee Whiz, an approved curriculum used by the program were also posted. The teacher played with the infant and toddler in a separate space set up to provide a place for floor play away from the older children and toys and materials that were not potential choking hazards. The infant was laid down for a mid-morning nap. The teacher placed him on his back to sleep and documented safe sleep checks. The toddler continued to play. The older children enjoyed free play in their space where materials were arranged in activity centers. Both staff members interacted warmly with children, encouraging language and conversation, social/emotional skills, and cognitive development. The fenced outdoor playground provided opportunities for active play with portable climbers, playhouses, and sand play. A sunshade was set up to provide shade for children. Children used the bathroom down the hall that also had a diaper changing table. The family’s personal items were stored in a locked closet. Lunch was chicken nuggets, peas, peaches, roll and milk. It was prepared in the kitchen and served in the dining area of the kitchen. The hot water faucet was locked to prevent access. A new child, two years of age, arrived for her first day. The administrator showed her how to wash her hands. The parent signed her in, and the administrator reviewed the enrollment documents to ensure all information was collected. Discovering that the child has a milk sensitivity, she added it to allergy posting in the kitchen and informed the parent that she is able to offer Lactaid. After lunch children rested on linen-covered mats. I observed and documented the following violations during today’s visit. Violation Number Comment Rule 812 Electrical outlets and power strips, not in use, which were located in space used by children did not have safety outlets or were not covered with safety plugs unless located behind furniture or equipment that cannot be moved by a child. An outlet in the bathroom used by children was not protected with an outlet cover. 10A NCAC 09 .0604(c) 841 Medications including prescription and non-prescription items were not stored in a locked cabinet or other locked container. A bag of cough drops was stored out of reach of children in a cabinet in the kitchen, but the cabinet was not locked. 15A NCAC 18A .2820(d) * Child care programs are expected to achieve and always maintain compliance and are required by NC GS 110-90(4) (d) to achieve and maintain an 18-month compliance history score of at least 75%. Any violations documented may impact the compliance history score. I completed an electronic copy of the visit summary and provided a printed copy of it to you, A. Fischer. We reviewed the visit summary and violation(s) documented during today’s visit. You corrected both violations so no further action is required except to maintain compliance. If I may be of further assistance, please contact me by phone at (252) 373-9385, by e-mail at Marjorie.White@dhhs.nc.gov. You may also call Jennifer Linhardt, Licensing Supervisor, at (252) 373-4199. Technical Assistance with Documented Violation(s): Outlets - Approximately 2,400 children are injured annually by inserting objects into the slots of electrical outlets. The majority of these injuries involve children under the age of six. An outlet in the bathroom used by children was not protected with stated that one of your children forgot to recover it. You corrected it during the visit by covering the outlet and will remind household members to cover outlets when not in use. Do a safety check daily before children arrive to check for items that need to be locked, uncovered outlets, and other safety hazards. Storage of Medication - Improper storge of medications results in millions of accidental poisonings in children annually. In the kitchen, a bag of cough drops was stored in an unlocked cabinet. You stated that you had them stored in a locked cabinet, but one of your household members probably forgot to lock the cabinet. All medications (topical ointments and creams, OTC, and prescription) must be inaccessible to children. Diaper creams and lotions may be stored out of reach, on a shelf or in a cabinet at least five feet or higher. OTC and prescription medications must be locked. You immediately locked the cabinet and stated that you will address this with your family members. General Visit Information: As a licensed child care center operator, it is your responsibility to be knowledgeable of the child care laws and rules. The most recent versions of laws and rules regarding child care facilities in North Carolina are available on the DCDEE website, www.ncchildcare.ncdhhs.gov. You can also review the “What’s New” section and download a copy of the Items Number Listing which you can use as a checklist for your program. Your local and regional Smart Start Partnership and Child Care Resource and Referral Agency are available to assist you with technical assistance and training on a multitude of topics not limited to training, technical assistance, and mock assessments to prepare for the FCCERS-R, infant/toddler practices, healthy behaviors, and other required training. Child Care Health Consultants can provide training and technical assistance on topics related to health and safety such as sanitation, handwashing, diapering, illness policies, etc. *Albemarle Alliance for Children and Families (AACF) and Region 1 Child Care Resource and Referral: Phone – (252) 333-1233; website - www.aacfnc.org . *Child Care Health Consultant – C. Smith - (252) 340-0212 or cindy@aacfnc.org *Healthy Behaviors Specialist: P. White – Phone (252) 333-1233; pam@aacfnc.org *Birth – 3 Quality Specialist: J. Davidson – Phone (252) 333-1233; joy@aacfnc.org Reminders: CBC Provider Portal - Technical Assistance & Notification to the Division of New Hires or Residents As stated in G.S. 110-90.2 & .2703(r) child care operators are to notify the Division of any new child care providers working who were hired or moved into the child care facility within five business days. The process of notifying the Division has changed and is now captured in ABCMS. This change has been in effect since February 2024. Effective immediately, you will need to obtain a Business NCID and complete ABCMS Provider Portal training in Moodle at https://www.dcdee.moodle.nc.gov/course/view.php?id=119. No action is needed on your part if you have completed the reference training and are currently using the ABCMS Provider Portal to update information regarding new hires or residents. Once the training has been completed and access has been given, you must verify your facility roster to ensure current staff are noted on the roster. Then you will update this information in ABCMS in an ongoing basis as staff members are hired and when their employment is terminated. This satisfies the requirement to notify the Division of new child care providers working who were hired or moved into the child care facility within five business days. The compliance of this rule will be monitored during your next visit. Please note, the hard copy of the Change of Information form will no longer be needed or accepted. Should you need assistance please contact the Criminal Background Check Unit at (919) 814-8401 and someone will assist you. Trash Cans – To prevent the spreading of germs or pests, trash cans used to dispose of anything more than paper products such as food, diapers or pull-ups, needs to be lined and have a lid. A hands-free lid is preferred. You stated that after diapering you place the diaper in a lined trash can with a lid on the back porch. New Center Discussion Points: Staff Training for 1st Year – I shared a list of staff training and professional development required for you and your teacher during your center’s first year of operation. This includes orientation, Recognizing and Responding to Suspicions of Child Maltreatment. CPR/First Aid, Basics of School-Age Care Training (BSAC), Playground Safety Training, Health & Safety Training, and Emergency Preparedness and Response (EPR) Training. You completed most of these trainings before your program transitioned to a CLIAR. Moodle Support - The Division offers early childhood professionals a wide range of professional development opportunities through the online learning platform Moodle. DCDEE has established a new email address and phone number for Moodle Support. To get help with Moodle, email DCDEE_Moodle_Support@dhhs.nc.gov or call (919) 814-6326. DCDEE WORKS – After K. Grimes completes EDU 119 in the spring, help her create a Works account. Volunteers – Volunteers can assist in a child care but may not be left alone with children or count in staff/child ratios. Differences Between FCCH and CLIAR: 1. Meets enhanced staff/child ratios *If youngest child is Birth – 12 months = 1:5 preschool children + 3 school-age Or 2:10 *If youngest child is 12 – 24 months = 1:6 preschool children + 2 school-age Or 2:12 *If youngest child is 2 years – 1:9 or 2:12 *If youngest child is 3 years – 1:10 or 2:12 *If youngest child is 4 or 5 years – 1:12 *If all children are school-age – 1:15 (Enhanced space is 14 so max capacity would be 14) *When only one caregiver is required to meet the staff/child ratio for a center located in a residence, and children under two years of age are in care, that person shall not concurrently perform food preparation or other duties that are not direct child care responsibilities. *When only one caregiver is required to meet the staff/child ratio for a center located in a residence, as desc 2. Sanitation and Fire Inspections will be required at least once per year before the previous one expires. Have fire and emergency systems checked annually prior to requesting your fire inspection. Then contact Currituck County Inspections Department to pay for and schedule fire inspection. Send your fire inspection to me within seven (7) days. Environmental Health Specialist will complete semi-annual or annual sanitation inspections. Post Sanitation Placard. EHS usually send me copy of inspection but shoot me an email when completed and I can review on Albemarle Regional Health Services website. 3. Any sink used for handwashing (handwashing sinks in kitchen and bathroom) must be tempered between 80 to 110 degrees. The faucet in the bathtub in the hall bathroom is accessible to children and may not be more that 110 degrees. The water in the kitchen sink must be 120 degrees but may not be accessible to children. When not in use, the faucet must be locked to make it inaccessible, per Environmental Health. 4. You are licensed to transport children in your van. Children younger than three years of age may not participate in off premises activities if transportation is involved. Review Transportation Standards in Section .1000 which also includes rules related to Off-Premises Activities. 5. As a CLIAR, you do not have to use the Written Plan of Care form. 6. You are required to follow playground safety requirements related to surfacing for stationary equipment. Ensure grass is cut and grass and weeds are trimmed along the fence line to discourage pests from taking up residence or having a hiding place. 7. Mats or cots need to be spaced out at least 18 inches apart during naptime. Rated License Information: We discussed the rated license process. The temporary license is valid through 4/16/2025; however, you corrected the violations documented during today’s visit, so we will be transitioning you to a Rated License. We reviewed the rated license information for a center located in a residence, including the rated license worksheets and quality point form. You completed an Application for Assessment for a Two Component Star Rated License today. Program Standards – Five (5) Points Your center meets minimum requirements and enhanced ratios and space. Your FCCERS-R score completed when you were a fcch. FCCERS-R – 11/9/23 – Score = 4.76 earning 5 points Education – 1 (One) Point *based on information available in DCDEE Works *final education points determined by lowest points earned in each staff category CLIAR Administrator Education (Lead Teacher) – 3 Points Administrator/Lead Teacher (A. Fischer) – NCECC + 6 hrs w/ 2 y ece and ad experience = 3 points *expected to be 4 points after 3 years exp or when enrolled in ECE class CLIAR Teacher Education – 1 Point Teacher (K. Grimes) – HS w/ 1 m exp = 1 point *Complete NC Early Childhood Credential (NCECC) to earn 4 points; planning to enroll in Spring 2025 Quality Point (QP) – 1 Point You can earn a quality point by meeting one of the Education or Program options. I shared the list of Quality Points. You chose to meet approved curriculum (using Gee Whiz). Program Standards (5 PTS) + Education Standards (1 PT) + QP (1 PT) = 7 Points = 3 Stars I will add the following two restrictions back to your license: Outdoor play restricted to fenced play area. Children on ground level only. Thank you for your time and assistance today. Refer to this visit summary for a refresher of our discussions today. If you have any questions, do not hesitate to call or email me at the contact information listed 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